Sharing a chat with a paediatric surgeon

[Barbiecar]

I have an old friend who is a consultant paediatric surgeon and I quizzed her tonight about my daughter’s chronic constipation and the best course of action. Here’s what she had to say.

Many many cases arise from an anal fissure (tear) at some point in the child’s past, even as a baby. A fissure is notoriously slow to heal and easily torn again when passing any solid poo. So you can well understand why withholding becomes the preferred option for a child who has experienced it. Looking back, I remember one occasion when my daughter did make herself bleed by pushing too hard. Things are starting to make sense.

My friend went on to say that because of this, Movicol is the preferred treatment; it it is considered to have no side effects and creates the right consistency for healing to take place. 3 months of porridge like poo is required to allow the fissure to heal. In other words you WANT the poo to be falling out of them so that it eases all pressure on the anus.

So I would say from that, even after a disimpaction, keep the poo as loose as porridge with the laxatives, don’t aim for solid poos for 3 months. I guess the child needs to be disimpacted AND healed before he or she can even think about pushing again! Otherwise, as with my daughter, the likelihood is that the whole thing will just keep repeating itself.

It was a useful conversation and I hope it sheds a glimmer of light for some.

[halftime]

That's really interesting and could explain such a lot in retrospect. Thank you for sharing that.

[MrsKS30]

Thanks for sharing! My daughter had a very sore bowel movement a few weeks after toilet training - this most probably has hugely contributed to our problems. I’m at the stage of trying to distinguish overflow versus too much Movicol. It’s confusing. Best of luck to everyone here!

[OlivesYou]

Thank you for sharing this information 🤗

[Misty10]

Very Interesting we were told too to stay at type 6 mash potatoes and porridge for at least 6 mths so bowel has enough time to shrink back to normal size. Thankyou.