should I take her to hospital?

[Worriedmum222]

Hello - my 11 yr old daughter has had long term issues with constipation and soiling. We have muddled along for years with patchy use of Macrogol She continues to soil occasionally and usually passes a mega poo once a week.

But tonight she was very uncomfortable and told me that she stopped herself pooing earlier because it was so sore. I massaged her back and abdomen as this often helps and found that her tummy was distended and hard, with a palpable lump just above her pubic bone. I’ve never felt that before.

She has had 2 Macrogol sachets today with no effect and she is also saying that she doesn’t want to poo as she knows it will be painful. She is also v nauseous. Poor love 😢

So my question is -if it is too painful for her to move her bowels now should I take her to A&e? And if I do what is likely to happen? What might the treatment be?

If I increase the sachets at home can this soften the stool currently in her rectum and make it easier to pass or will it be unlikely to reach that far along her blocked large intestine?

Thank you for responding!

[Yaleamanda]

Have you disimpacted her? It sounds like she is impacted which can be treated effectively at home with high doses of osmotic laxatives. No need for the hospital.

[Worriedmum222 in reply to Yaleamanda]

Thanks - yes that is my second question - will high doses of osmotic laxatives actually soften the poo in her rectum so that it is not so painful for her? Or will it only get her body to absorb water higher up her digestive tract?

[Yaleamanda in reply to Worriedmum222]

It will soften the stools making them easier to pass,adding a stimulant to the regime will help move things along too. It does sound like you need to disimpact her.

[Worriedmum222 in reply to Yaleamanda]

Thank you for your advice - I will start this with her today.

[Yaleamanda]

Ensure you have enough laxative to effectively disimpact l.

[Worriedmum222 in reply to Yaleamanda]

Thanks. We have a box and a half and I’ll put in a request for more.

I am realising that we have both been in denial about the seriousness of the issue and the commitment needed to resolve it. I have been very much impacted by the stories on these threads and the energy and patience shown by other parents in helping their children manage this issue. Had no idea it was so common nor that it could get to the point of stoma bags and eating disorders.

It has been a problem with both of my daughters although my elder seemed to resolve it when she moved to secondary school. Am going to find help with food sensitivity (coeliac test came back negative but I’m wondering about dairy) and psychological factors. My daughter is scared if flushing the toilet - particularly worried that snakes might come down the pipes. 😳

[Yaleamanda]

While for some children the constipation can be put down to dehydration or a food intolerance, or very rarely another underlying problem, for most children with constipation have 'idiopathic' or 'functional' constipation. Both these terms mean that there is no diagnosable underlying cause. The treatment is the same - sufficient laxatives to clear them out if they are impacted and then sufficient to keep them passing a soft good amount of poo most days. There is lots of information about constipation on the Bladder & Bowel UK website at bbuk.org.uk/bowel-resources/ You may find the leaflet at bbuk.org.uk/wp-content/uplo... the most helpful to start with

[CCBaxter28]

Thanks for posting this question.

I often wonder about the effectiveness of pouring more cosmocol into our 7yo son when I know he has a large poo 'ready to go'.

Currently in that predicament, one poo a week at best. Sent him to school this morning but waiting by the phone for the school to call and say he's had an accident.

I think hospital would only add to the distress for all of you. Hopefully at home remedies take effect soon.

[Worriedmum222 in reply to CCBaxter28]

Thank you both for helpful responses.

Yes have decided not to go to hospital as I think you are right, it would add to distress. Was just v worried last night when she was saying that she wouldn’t go at all because of the pain.

But the hard lump in her abdomen has gone this morning from the Movicol she had yesterday and she has been sitting on the toilet this morning. Went for a little walk to try to help her along which did the trick but by the time we walked the 5 mins home she had held it in and lost the urge.

The standard advice is all good but each child is different and needs to be understood. Having said that I have got so ashamed, frustrated and exhausted by it over the years (13 yrs since I failed to teach my elder daughter to use the potty healthily), have had so much conflict with my daughters and husband around the issue and have not had much help from gp, I think I am guilty of sticking my head in the sand and not doing the disimpacting regime properly. So renewed determination not to get emotional about it and support my daughter more diligently so she can get on the path to health.

I do find giving meds after school, and getting her to sit with her feet on a rolled towel and do blowing up the balloon exercise does help with doing poos at home.

I’m also wondering about a bowel stimulant as mega poos mean that she doesn’t get the signals to go often enough. Have you tried that with your son? I guess one poo a week isn’t a comfortable habit!

[CCBaxter28 in reply to Worriedmum222]

All i can say is that I heavily relate to everything you have mentioned in your post.

It's not easy to stay calm on the surface, the distress of the situation really makes it hard on everyone. My son is often on tears on the toilet and it feels like we're punishing him as he repeatedly asks to get up. But we can tell the poo is close, usually a mega poo. We've somehow managed a little consistency, the last 3 Mondays he's pooped. But we've been up to 12, 13, 14 days in the last few months. And he's been like this since he was 4yo.

It's hard to maintain patience as my wife and I sometimes take different approaches. We try and make him laugh and just relax but he even says that laughing makes it more painful. Under the advice of a mental health specialist i've taken a firmer approach telling him to push through the pain and sound less sympathetic. Can't say it's worked.

There's also inconsistency with how effective the cosmocol is. When we're strict with ourselves and give doses everyday it sometimes takes just as long for a poo to come. And sometimes when we give him a break from it, it comes after 5,6 days...which for us is a win. he fact is that he hates the taste so it's easier said than done to give loads of sachets every day.

We'll look into a bowel stimulant. We have a few things to try although some of the bottles suggest for adults only. Don't want to make the situation worse!

Thanks

[Le15]

It really does help. I promise it will even if the poo is in the rectum. Follow the Eric disinpacting regime and call Eric. They are so incredibly helpful over the phone - so much more so than doctors who don’t seem to prioritise it as an issue. Once disinpacted, keep to a ‘toilet time schedule’. This has had the biggest long term benefit for us. 30 mins after breakfast he sits for 20 mins on the loo with an iPad so distract from the withholding. There are also some really good books - one called ‘it’s no accident’ by Steve Hodges that really changed my life! It’s taken a huge commitment from us as a family but now is the best time to get control of the issue before school starts again. Best of luck x

[Worriedmum222 in reply to Le15]

Great advice - thank you!

[14crosstitch14]

She needs to drink loads, so it don't hurt and not stop herself. Appleorange/prune juice. Loads of water will soften hervup. Has she ever had senacot? Hospital will just make her wait around, so try everything 1st. Prunes/juice i'v found helps my girls too. Flush her with as much fluids as possible. Its going to hurt and the more she stops it the worse it'll be.

[Worriedmum222 in reply to 14crosstitch14]

Thanks. I didn’t take her to hospital and followed the advice to give her multiple sachets which did, in fact work to soften her poo right through her bowel so she was eventually able to go, without too much pain.

Unfortunately she was in a summer show so not able to follow through with disimpaction regime last week but starting that today as we have some days clear before return to school.

Thanks for support and advice everyone 🙂