3 year old struggling with constipation/relieving himself

[Moonbeam16]

My little boy has been struggling with constipation since we started potty training. We successfully managed to get him weeing on the potty and toilet without issue but he wouldn't pass any stools on it. We transitioned into pants easily but he wouldn't ever tell us when he needed to poo meaning he would be constantly pooing in his pants which was a nightmare for washing and he'd get really upset about it (even though we held back from making a fuss about this).

His stools at this stage were also quite large and hard and it was clear he was struggling to pass these at times, and so we were advise to give him lactulose to help. Over the past couple of months he seems to be holding himself back from passing anything substantial - instead everytime we change him we are met with messy stools within his bumcheeks, nothing really formed or substantial enough to actually nest in the nappy properly. He doesn't seem to recognise any urge to pass stools, or have any control over this - it's just like it leaks out throughout the day. Because of this we have no idea how much he is actually passing relative to a 'normal' amount of poo a day/week.... I have no idea! He doesn't complain about a sore tummy and is eating normally (he is constantly hungry!)

I just don't how how to get past this.... our Dr was very patronising about the lactulose and amount we were previously giving our child when I spoke to him last and told me to up it to 20ml a day. It doesn't seem to be doing anything other than making the stools super soft which seems to remove that urgency to pass anything. I have contacted them today for another phone appt for a next step, I'm really worried that this is having a long-term effect on our boy.

I'm an an utter loss of what to do or what can be done. We are keen to get our boy out of nappies and back on the toilet properly, especially as he is in school now and also because he just constantly has a bottom of poo which is uncomfortable and smells bad. But until he starts recognising a need to pass anything and overcoming the idea of pooing on the potty/loo, we won't be getting to that stage.

If anyone has any advice I'd be really grateful, especially before we manage to speak to the Dr as I don't want to be talked down to again or fobbed off with laxatives in the hope it'll solve all issues.

Thank you!

[laurendyer90]

Try a suppository or two that should clear it out!

Just make sure you put a nappy on after as it will work pretty urgently!

[Deetah1711]

I feel for you, I've been in exactly that place with my daughter very recently. Maybe your little boy needs a different medication? The meds help the body to expel poo, not just make it soft so maybe lactulose isn't working right for his needs? How's his fibre intake?

Read up on disimpaction on the ERIC website and give them a call. Maybe try and speak to a different GP. If your little boy is withholding it may be that he is backed up and disimpacting will clear him out. Scary and messy but THE best thing we could have done for our daughter.

I rang ERIC and spoke to an advisor and we also spoke to the school and they agreed 1 week medical absence before half term so we gave a higher dose of her usual medication and you wouldn't believe what moved through her little system!! For our daughter it helped her realise that poo can be soft as well and doesn't hurt so she doesn't have the fear that previous constipation/lactulose/large very firm poo's gave her.

She's 4 and in school and we've had a fair few accidents but with the help of many many reward stickers (home & school) she's now making real progress and is doing them on the toilet probably about 70% of the time which up from 0% is massive. We think the meds are now making her poo too soft for her to know to go so we've stopped the Cosmocol sachets she was prescribed (just for a week to see if the maintenance dose was too high) and going by the Bristol Stool Chart her poo was very soft and possibly going through her bowel too quick so I've upped her fibre and am trying to cut down on her saturates which for the crisp addict she is, isn't easy!!!

Its a journey and one that can go back and forth a bit, just recently I felt like we'd taken 100 steps forward but 110 backwards, then we turn a corner and its not as bad as we think - it really can be an emotional rollercoaster but you'll soon be a few more steps forward and making progress, each little step forwards is in the right direction and will move you forwards from where you are now. Don't depair

[Moonbeam16 in reply to Deetah1711]

Sounds very similar to us! His fibre intake is generally fine, fruit and veg everyday, he also has diluted smoothie, beans, cereal etc. From reading a few other posts it seems he would be better going on a laxative that bulks the stools but makes them soft enough to pass - I mean, that makes sense anyway. We have a Dr appt next Wed so I'll see what they say about it. We've stopped the lactulose for a few days to see if this has any improved effect. Forever in hope of hearing "Mum, I need a poo" haha

[DC1987]

Has he tried movicol - it works in a different way to Lactulose. Movicol takes fluid to the bowel. Ask the GP to check the NICE guidelines!!

[Moonbeam16 in reply to DC1987]

No only lactulose at the moment, the Dr wanted us to stick with that for a while rather than giving laxatives. We have a phone appointment next Wed with one of the practice GPs so I'll be pushing for the next step. Thank you!

[laurendyer90]

You can buy enemas on Amazon some for kids give them a go!

Or liquid suppositores too.

But put a Nappy on straight after unless you want a big mess!