He won't eat fruit of veg - constipation and overflow

[MrsSquirrel]

Hi All,

Posting today on behalf of a friend I spoke to by phone yesterday. She has a 5 year old boy who has never wanted to eat fruit and veg. She suspects it may be a sensory thing - he has always had access to healthy food and been encouraged to try things from being weaned. His little sister eats everything and anything - tucking into fruit salads with enthusiasm. He eats a limited diet - plain pasta, cheese on toast, bread, no milk. She got him to eat some egg yesterday and was thrilled he actually ate it. The little boy has always had issues with constipation which have now got worse. His mum has had standard advice about diet from health visitor. She lives in rural Wales and getting referrals to any specialty is very difficult. She is going to try and get some movicol from pharmacy this week. Poos have always been very stinky and painful for him to pass but now he is pooing his pants/in bath etc inadvertantly and also she thinks he is getting overflow around the blockage of poo.

Does anyone have experience of similar and advice I could pass onto her?

Many Thanks for reading.

[CN4321]

How is he with drinking water? Whilst a healthy diet is important with all our appointments it has been the water they have focused on all the time. Also could she try giving him smoothies? It’s not as good as standard fruit and veg but has got to be better than nothing. I would just always persevere as well ie 2 peas on the plate every time or one small bit of carrot and ask every time for him to try it, hopefully eventually he will. Fingers crossed she has a breakthrough soon

[MrsSquirrel in reply to CN4321]

Yes she has done all that. Tried for years with tiny amounts of veg at every meal. Or not offering anything but veg in the hope he will get hungry enough to eat. He would rather go hungry! Fills up on water instead. Yes drinks plenty.

[Robinia]

Usually movicol is prescribed by a GP. They might be willing to do it over the phone during the current restrictions. Sounds as though it would be worth her speaking to GP and seeing if she can get referral to continence service locally. Definitely get started on the movicol. If he has sensory issues he might not like the movicol. Another option is lactulose (tastes sweet) although movicol is preferable and you can flavour it with squash. You make up the movicol with water and fully mix it and then add squash at the end (my son likes lime squash with it)

[MrsSquirrel in reply to Robinia]

Yes. Health services poor in her area and really hard to get referrals through but will tell her what you have said. I know all about weeing issues (5 years + and with continence teams/consultant for our son) but poo issues are something I'm not so clued up on. Will she need to help dis-impact him with a higher dose of movicol/laxido? Or just give 1/2 packets a day and hope it works gradually. She says she is going to explain to him that he has the choice of glass of laxido/juice or to eat fruit and veg. At any rate they can't go on like this.

[Robinia in reply to MrsSquirrel]

I would advise her discussing it with the GP. There is a good video online by the Poo Nurses. Also Eric run a helpline which I believe is still running and also I think you can email them.

From my personal experience there are so many things to tackle all at the same time but basically getting the movicol started daily is the first step.

Other factors include drinking enough fluid, routines around toilet time, encouraging positivity and fun and relaxation alongside (big emotional component), looking at sensory needs and how they can be supported- I have just started warming up the loo seat for my son with a hairdryer and have just ordered him a soft cover to go on the loo seat!!

A disimpaction is probably needed but it’s quite daunting the first time so worth discussing it with someone medically trained.

Also a stimulant like Senna can help alongside movicol.

Please encourage your friend to read the hundreds of posts on this forum as there is so much wisdom here based on trial and error!!

[Turquoisepoo]

Wouldn't worry too much about the diet in relation to constipation as there is not good evidence that eating fruit and veg will shift constipation with overflow. Better just to focus on bowel management at this stage with meds and work on food at a different time. Laxatives disguised with diluted juice lo sugar work in our household.