HELP! Opinions needed on 8 year old daughter in severe pain when passing soft stools?

[Pogue22]

Hi, apologies in advance as this post is long, vague and non-specific to any known conditions, but my wife and I are completely at a loss for an obvious cause to our 8 year old daughters severe pain when going for a poo.

She is often in floods of tears and thrashing around on the toilet and describes the pain like a stinging/tearing sensation when pushing - as if she is severely constipated and is trying to pass a large hard stool. However the small amount of poo she usually manages to get out following a bout of pain are either dark and sticky or porridge like consistency?

We have been to the doctors 4 times and been referred to the hospital last year - the specialist suggested Movicol and/or Lactulose to help soften her stools. On 2 occasions we have had to use suppositories to help clear impacted stools following 4/5 days of withholding - but this was only twice in 3 years of the problem.

On occasions she has clearly been constipated and eventually passed large amounts of poo following a few days of movicol treatment.

We are hesitant to give her regular large doses of Movicol as more often than not she is in pain but only passes small amounts of very soft/sticky poo. So we dont want to treat her as if she has constant constipation when it seems she doesn't?

She does however describe the sensation like a larger poo wanting to come out but hurting to push - if this is the case then how is it that only soft porridge like poo emerges?

We are all very stressed with the situation having seen specialists and nothing really improving. Her diet is varied and good and she exercises well, she does however seem worse following birthday parties or occasions where she will eat more 'treats' or bread/cake type foods.

She tends to always be concerned with trying to go to the toilet before going to school as children have been told off for messing around when going to the toilets too often. We have spoken to her teacher and explained the situation, she seems to be worse when a school trip is planned or a change of routine is expected?

We are now even unsure if the pain is physical or more psychological? She can sometimes scream the house down and the pain seems very real and physical but no large impacted poo emerges?

Could she be constipated and the sticky poo that comes out is passing around a larger blockage further up? i would have expected any leakage to be wetter? she doesn't have any unexpected leakage/accidents during the day/night.

We feel so sorry for her as it clearly effects her day to day life with the worry of going to the toilet - she always seems concerned if she hasn't gone every day due to previous bouts of constipation and the pain she associates with it. Is she trying to go for a poo when she doesn't need to? would this cause as much pain as she appears to be in? 90% of her poo's are soft/flurry type consistency anyway? I will return to the doctors again - but having been 4 times and explained all the above it seems a bit pointless as we have seen the specialist already who treated it like a constipation issue also.

We are a bit lost with the situation and my daughter hates the idea of going to the doctors to have her bottom looked at - this has been going on since she was about 5/6 years old.

Any opinions on what may be going on would be appreciated so i can talk to the professionals about potential other reasons asides from solely constipation?

Thanks,

[AANN1977]

We didn’t consider that our daughter could be constipated, because she was having accidents with soft poo, but it turned out she was (this started at about 2.5-3 years old, when we were potty training). Have you watched ‘The Poo in You’ (catchy title, I know! youtu.be/SgBj7Mc_4sc)(Not working as expected?)? It explains it really well. We were lucky and were referred to a really good consultant; also the ERIC helpline were incredibly supportive and helpful. Have you done the sweet corn test - have her not eat sweet corn for a few days, give her some, and then see how long it takes to appear in her poo? I think it should be 2-3 days for children; if it’s longer, that would indicate a blockage. If so, maybe try a disimpaction with Movicol or Laxido (you can find instructions online)? Half term would be a good time to try! This should get rid of any blockage - it’s not particularly pleasant, but works! And if she has been constipated, her rectum may have stretched out a bit, and she may not be able to feel very well when she needs to go, so a good routine of sitting on the toilet 10 minutes after each meal may help. Since she’s articulating the problem, it doesn’t sound like she may be constipated - it sounds exactly like what we had - but as she’s a bit older, I’m sure it will be easier to deal with. You may need a maintenance dose of softener for a while to keep things easy for her. Good luck - it’s really difficult. Our experience has been solely constipation - but it seems like a lot of doctors aren’t necessarily as sympathetic or proactive in treating this as they could be.