Almost 4yr old wont poo

[Myztik]

As the title says, my almost 4yr old refuses to poo and it's becoming a big problem. He is holding it in as long as he can (over a week at times) which is resulting in constipation and him waking up during the night screaming in pain, soaking in sweat and almost hysterical because he cant hold it in anymore.

We've seen the doctor who told me to give him parachoc daily and keep up the high fibre foods which we are doing. The problem is trying to stop him from holding it in :hair:

Has anyone been through this? I was up with him twice during the night trying to get him to go with no luck and I know it's going to happen again tonight.

[Blueberry Crumble]

Oh gosh, we have just been through the EXACT same thing over the last few weeks it has been driving me mental!

My 4 year old did a couple of poos that hurt, then decided that he was not going to poo anymore. Everytime he needed to go, he hid somewhere in the house and clenched it in! He got so constipated that he was having back up dioreah and it was awful. I had to give him a few enemas one weekend (microlax) which you can buy from the chemist without a prescription, and they helped him just move the hard poo.

Then I took him to the doctor and he told me I could up his dose of Parachoc to 20mls a day, and to give him Coloxyl drops 1ml a day (also from the chemist, no prescription). It took a week of me thinking it wasnt working. Then finally his poos seemed to go softer and he did one or two, then realised it wasnt hurting to go anymore, and he is now going every day. On the potty though, and he gets a rasperry lolly everytime he does a poo lol!

I was ripping my hair out with stress because he point blank refused to do a poo! And a friend told me of a little boy she met who hadnt gone for 2-3 months, and it became BAD, he looked like he was pregnant :( and I was scared it would get like that, so I gave him an enema every so often just to clear it so it wouldnt build up. But I didnt want to overuse them either, and have him become dependendt on it.

So the 20mls parachoc, 1ml coloxyl drops a day and plenty of rewards and encouragement helped, but I think this is an issue that will keep arising if I dont keep ontop of it!

Apparently it is a VERY common thing for boys of this age too.

Good luck! Hang in there, it sux and for a few weeks there I found my whole life revolved around poo!!

[Blueberry Crumble]

Oh, and forgot to add that this is a psychological-physical problem that goes in a circle. They dont poo because it is too hard and hurts, so they hold it in which makes it harder!

The trick is to make their poo as soft as possible, so that they can do one or two that are soft and they realise that it wont hurt to go anymore.

Try putting him in a nappy for poos, or using a potty, it may help.

And plenty of fluids :)

[4babycinos]

This started with my ds a year ago, and is still a problem now. I agree with blueberry crumble in getting the poos to be soft. Microlax is great as it loosens the stools right up, and he wont be able to hold it in, he will HAVE to go.

The problem is, the longer he holds it in the bigger the problem will be. What they can do is cause a 'plug' which then stretches the anal wall., where they will start losing control of the rectum (As its a muscle) Then when they try to pass it its huge and they could cause an anal fissure (tear in the wall) which then makes it hurt even more.

I would advise seeing your gp. My ds is on Movicol, Parachoc and Benefibre daily. We had to give him the Microlax initially to get rid of the plug.

Also getting an xray of his abdomen is a good way to see how backed up he actually is.

Good Luck - it really is not a fun process.

[Myztik]

Thanks heaps ladies, nice to know we are not alone (not nice for the kiddies but you know what I mean lol)

Will come back and reply properly when DS3 finishes feeding and I have both hands.

[Myztik]

Ok I have both hands free now :D

I will get DF to get some Coloxyl drops when he picks DS1 up from school.

What is the movocol?

Is the microlax a suppository? I have some suppositories here from after my DS3 was born but I really cant see him letting me insert it easily :no: I dont want to have to hold him down or anything because he is already getting so distressed over it (but will if I have too of course).

Will go back to the GP tomorrow and get a referral for an xray.

The other night when he woke up screaming he did manage to get a poo out (after 45minutes of crying and struggling) and it was HUGE :no: I felt so bad for him.

He's pigged out on dried apricots today which usually help him go so will see how we go tonight. He also has a water bottle that he drinks from all day. I did give him warm water earlier just on the off chance it might help too.

I had this problem with my DS1 a few years ago and he ended up with a fissure, saw blood on the toilet paper and convinced himself he was dying. He had the parachoc and the issues resolved quite easily after that, hopefully it will be the same this time but DS2 is such a string willed little thing and he refuses to believe me that he needs to let it come out to feel better *sigh*

ETA - I am assuming the issue is worse at night because his body is relaxed when he's asleep and then he wakes up and tries to hold it in. I was thinking I might give him some nurofen before he goes to bed so if it does come it wont hurt as much?

[Persevereance]

I'm going through a half frustrating time with my 2 1/2yr old for the last 6mths. She has only gone to the toilet to do a poo three times. Every other time she has done it in her sleep at night time. There for smelling out the whole bedroom! Her two sisters who share the room don't enjoy the smell and I certainly don't like to remake the bed every day even though she wears a nappy. I also don't like having to clean it off her backside in the middle of the night, when I am dead tired or even during the morning when I'm fixing breakfast. Once in a while I can understand and handle. But not every night for 6 months! I have wondered if she is scared of doing a poo in the toilet or she needs to rest her feet on a stool. I've tried her sqatting over the toilet seat, asked her to push her bottom out each time she goes to the toilet, got her to eat more apples. I've tried to encourage her to drink more water but she refuses to. She used to drink water alot but now she doesn't and I usually don't have any other type of drinks around except for milk which she has once a day, and she likes that warm. For a while there she didn't want milk on her breakfast. Some times she lets me know she's thirsty and wants a drink of water and then asks for a refill. I've also said she would get a sticker if she does a poo in the toilet. Even though she loves stickers she still doesn't want to try! How can I get my daughter to pass her bowel motions over the toilet?
ME 34 * DH 36 * DS 14 * DD 13 *[ DS dec15mths, would be 12 on 27th June] DS 9 * DD 8 * DD 2.10 * DS 17mths * Baby due in October

[Myztik]

I wish I could give you some answers there but that is another problem we are having. My DS2 wont poo on the toilet either (when he will do it at all :rolleyes: ). Before he started holding it in he would just go in his jocks or during the night like your DD. I have tried rewards etc as well and he just isn't interested. Hopefully someone can help you though!

[mummyrissa]

My dd is almost 3 and we are going through exact same thing! She even sits on the floor when she needs to go so it doesn't come out! I've just started sitting her on toilet when I notice she needs to go n I have a box of 'special' toys we take with us to look at. I've been doing this for 3 days now n so far No poo but we havnt had any accidents during the night or in the bath like we normally do. So guessing it's just a matter of time. My dd is also on prescribed stuff to soften her stools.

[Myztik]

My DS2 will sit on the floor, pace around in circles, lie down and kick his legs, whatever he can to stop it coming out. It's quite sad to watch tbh. I have tried getting him to sit on the toilet but short of physically dragging and forcing him on there he wont do it :no:

[MegaGuts]

Hi, i've got a couple of suggestions that you may want to try. Can't guarantee they'll work but cant hurt trying.
I remember when DS was younger and started to do wees standing up (instead of sitting down) we started having problems with him doing poos in his undies instead of the toilet, so i made up a reward chart. It was just something very simple, hopefully i candescribe it properly lol! Basically, you have the words "POO" and "WEE" written down the side of some cardboard in seperate columns (you can choose to have just POO if pooing is the one you really want to focus on), then across the top have numbers 1-10 written along the top in columns again, ending with "REWARD" after number 10. Explain to your child that everytime they do a poo or wee in the toilet they get a sticker (for whichever one it is they do) once they have reached ten stickers they get a reward, that can be something that the both of you come up with together. Keep it up in the bathroom, i put mine above the toilet as a reminder. Make it bright and decorate with things that your child likes.
I found that this worked really well with my DS and in no time he picked it up and didn't need to use it anymore.
The other thing i would suggest is going online and finding a toileting DVD. We use a great one at the school i work at that the kids absolutely love and that they respond really positively too. I think it's called "Tom's toileting triumph" im pretty sure.
Goodluck, i hope some of this works!!:D

[Myztik]

Thanks I will give the reward chart another go. We also just recently borrowed the toileting DVD with Tom and his sister from my MIL and DS2 loved it, watched it over and over again but still refuses to 'do poo on the toilet like Tom did' :rolleyes: He's stubborn lol. He is currently walking circles of the kitchen trying not to poo again :hair:

[4babycinos]

Movicol is a like a laxative, but the body doesnt gain reliance on it to go to the toilet. And it doesnt make them need to go then and there, or cause diahorrea, it just helps the body work regularly.

As for the enema, its like a little tube (3cm long and very narrow that you will have to stick up his bum), and it is attached to a little pouch of oil, you squeeze the pouch and the oil is inserted in the colon. Within 20mins he will have to go to the toilet.

I found it disturbing to do the first time, as I had to get dh to hold him down, but it really helped that blockage he had.

They come in a pack of 4 and I have only ever needed the one.

It must be really hard watching him fight it :(:hugs:

[Blueberry Crumble]

My GP wouldnt prescribe or recommend Movicol at all, he said he was too young (4?) Yet ladies on these forums were saying that they used it... so I dont know!

I would give the enema first to clear out the hard bits, then parachoc and coloxyl drops daily. It took DS a week to soften enough to start going again. Try using a potty... when he starts to hold them in put him on the potty in the loungeroom with his fav tv show on and sit next to him. I give DS a little lolly if he does a poo lol, it is working!

[OJandMe]

Nel I went through this with Oliver. It's heartbreaking isn't it, the amount of anxiety and distress it causes them. :crying:

We had to use Coloxyl drops, parachoc, and a diet high in oats, pears, peaches, popcorn (POPCORN IS THE CHAMP)... steer clear of apples or bananas or cheese.

Ollie was going on about this for about a month. It was after the coloxyl drops and parachoc.. and bribing him with hot wheels cars for doing poos on the toilet. It was a very traumatic month!

Warm baths, lots of exercise, lots of water and lots of hugs.

Hope it passes for you soon.

[Blueberry Crumble]

Really? Popcorn? I never knew that, we buy the popping corn because it makes heaps for very cheap.... glad I know he was eating the right thing

[Myztik]

Popcorn Gret? Why? That seems so random lol. Am definitely willing to give it a go tomorrow *adds it to shopping list* but I just made him eat an apple because apple juice usually goes straight through him but we ran out so an apple seemed like the next best thing :no: Will steer clear of banana's but he'll be ****ed about that lol, he loves banana's (hmm potential bribery there :detective: )

I tried a nice warm bath earlier but as he went to sit down in it he obviously felt a BM coming and bolted out so fast it wasn't funny, then refused to get back in and just walked around crying.

It's horrible, he's not even really crying properly just walking around with tears sliding down his cheeks but no sound or anything :crying:

mamaliscious - will probably get the enema thing tomorrow too although am dreading having to do it..

[c38]

:hugs::hugs:Poor little man. I'm a Paeds Nurse and although I don't work there, I have relieved a few times and also looked after lots of kids that go through our continence clinic for the same problem.
It is very common espescially in boys. Sometimes they have been witholding so long they end up over distending their large bowel and have trouble with the sensation of needing to get/ actually being able to withhold or push out a poo and end up with over flow diarrhea (basically watery po that leaks out around the hard poo stuck inside). By this time its called encoporesis (you can google this, Dr Sears has a good page from memory)

Most Paed these days try to avoid enemas or suppositories so as to avoid creating any further fears associated with their bottom. Hense talk to your Pharmacist about Movicol Half. Its safe to use from age two and you basically increase giving it (up to s set number per day) until you get a result. It may take several days, but if he takes it it will work:yes: Then one of the softners and and only use the Movicol if he goes a day without pooping, for a few weeks until hopefully it all settles.

I wouldn't be trying too hard to get him on the loo as yet. (obviously you can suggest it, but try not to fuss too much if he refuses or goes elsewhere)The am is to get the poo so loose he can't help but go, wherever that may be. Some kids actually prefer to sit on the loo rather then wear a nappy again, or go elsewhere. Others go in all sorts of weird and wonderful places.
Once he's gone a few times and hopefully it's been so loose it hasn't hurt, then go to a reward chart if he still refuses to sit on the loo. Starting with a tick for sitting on the loo 3x day after meals for 3-5 minutes (use and egg timer if you can find one) if he actually manages to go, then he gets a sticker and after a certain number of stickers then some other reward you have negotiated.

If he is still having issues in a few weeks time, then get a referral to a Continence clinic or a paed who specialises in continence so that a long term plan of management can be made. Sometimes it takes a fair while for the bowel to regain good tone and totoal control to come back. A Clinic (if you live near a Paeds hospital ) is good because they also get to see a Physio and OT who are invaluable at helping the with the retoilet training if its needed, as well as toilet posture, muscle control, and relaxation.

Diet wise,oats and any fruit starting with P is good. Pears are apparently as effective as prunes. You can buy cans of pear juice too if you dont have a juicer and he likes juice. Pop corn is great too, though can causewind pains in some. Cooked carrots are constipating in some kids, but raw or freashly juiced are good.

[reAllytee]

MOVICOL !!!!!

Movicol is NOT A LAXATIVE !!!!

It will not force him to poo as such nor will it cause laziness in the bowl like the likes of other remedies.

Movicol draws extra fluid into the bowel to make the stools soft & this in turn makes it easier for them to pass.

You get them to drink it & you can then use it daily to keep things soft till he gets over his issues.

The problem at this point is he will be plugged & you need to clear the plug from the top & bottom ( hehe excuse the pun ! ).

So that means hitting him hard making him drink a lot of the Movicol & using a suppository.

The suppository will be hated etc but it really is the best thing to get it all moving to allow the movicol to do it's job.

For us when G plugs which is a lot due to his problems we do Movicol 3 times a day ( full strength ) & 2 suppositories if not more depending how bad it is.

The thing with the suppository is that it's the initial moment of placing it that sucks once it's past the first muscle it will be into his rectum easily ( sorry TMI ). You may need to hold his butt cheeks closed for a bit though ... I know awful :( cause when they are plugged badly the suppository will come back out within seconds rather than sitting really doing it's job.

G's used to come straight back out when he was originally in hospital for his problems so we used to have to stand for 5mins holding his butt cheeks together & then even then it would come out within a few more seconds but slowly but surely after 4 days it was staying & doing the work.

That along with large dosages of Movicol he was cleared easily.

Movicol has helped us heaps ....

It is what is prescribed by G's Paed GI & G was only 7mths .... G.p's tend to be very wary when using various meds etc because they are not learned enough about various treatments etc. They only learn the basics really.

Coloxyl is actually far worse for children as it promotes a lazy bowel when used too much & can also dehydrate the bowel which is not what you want to do.

Also be wary of offering fiberous foods because not all bowels cope with it. I know that is what we are told as in keep loads of fibre in your diet & you will stay 'regular'. If I kept the amount of fibre they advise in G's diet his bowel would shut down. The fibre for him actually creates a plug in turn causing it to settle & become almost toxic.

LOTS & LOTS of fluid ... Seriously G has to drink 1.5L at LEAST per day to make his bowel work.

That doesn't mean he has to drink it all cause you have things like jelly etc that allow you to 'sneak' in the extra fluid along with various other vegies etc.

Watch his diet otherwise as there may be a reason for his firm stools which in turn is causing the anxiety re : toileting. As he may have a sensitivity to something, not necessarily anything like an allergy but just a food that cause the binding.

Good luck lovely !!!!

[OJandMe]

I don't know why the popcorn works... it just does :yes:
random, yes... lol but at least you know they eat it!!

[Myztik]

Thanks sooo much Ally and c38 :hugs:

I will go get some movicol today :yes:

He finally pooped this morning :smiliedance: Half of it was solid and really big but the rest was quite soft so I think the parachoc is starting to work. It didn't hurt him as much and he has said a few times today that his tummy feels so much better so I'm just encouraging him to 'let the poo come out' so it doesn't get 'big' again.

ans c38 I totally agree about not worrying where he poo's as long as he's doing it lol. I'll work on getting him on the toilet once this issue is fully resolved :yes:

I'll get some pears and 'p' foods today too. He loves pears which is good.

[wigglemum]

Hi Ladies, yes we are going through exactly the same thing also. Go the Movicol from the chemist. no Need for a prescription and it now comes in a "junior" which is taste free, so you can just mix it with water or juice, or whatever they like to drink.. It works wonders. And my paediatrician said it can take up to 12 months for them to get over it - physically and psychologically. a long batlle.l xxx

[Monster's Mum]

We're going through a relapse I feel with my DD (she had this whole not pooing in the loo thing for the better part of last year) and the last few days I have caught her hiding and refusing to go to the loo again.

We had 2 poos in knickers today - I can't do this again, I really can't. My hands reek of her poo - no matter how much I wash them.

I've already done most of the suggestions provided and then some.

I feel like a failure for not being able to get her to poo on the loo and for losing my cool with her.

I'm going off to have a cry now, I'm so frustrated. :hair::crying:

:hugs: to you all, I feel your pain.

[Can I?]

Have you seen your GP or paed Monster's Mum? We started at the GP, moved to the paed and are now seeing specialists at the continence clinic at our local hospital. It's really worth seeing someone just to make sure the witholding is voluntary, and to get a good idea of what options are available.

That being said we are still struggling after 3 years. I advise getting onto it and hitting it hard before the bowel is stretched because getting it back into shape has proved to be a major issue for our son.

I so know what you mean about the smell. Our whole house stinks sometimes. It is depressing.

[veve]

Nel .. how switched on is he? understanding how a body works etc?

We had a similar issue with Jack for awhile .. but once I sat down with him - explained what foods made his poo soft (which .. once they are educated in it .. can be quite embarrassing when they go shopping with you and call out at the top of their lungs that you have to buy more pears mum because pears make your POOS SOFT REMEMBER??!!!) - I explained to him that pears, prunes, tarnies, apricots etc are important .. and why (and fruit and vege) .. and that poo contains GERMS .. icky ick y germs .. that CAN make you really sick .. which is why you feel bad if you DONT poo .. you need to get the germs out - by doing a poo .. etc etc ..

Jack is pretty good now (apart from occasionally yelling out that he NEEEEEDS a prune, while sitting ON the toilet .. :laughing: )

good luck lovely!

xx
Jen

[c38]

Monster Mum:hugs:
I agree with getting a referal to a Continence Clinic (ideal as you get to see a PAed, Physio and OT) or at least a Paed who specialises in the continence problems.

[Myztik]

Thanks Jen, we've been through all of that and he does understand but the fear is still winning out over logic iykwim. I am suprised he can hold it in at all, the kid lives on fruits and other high fibre foods, it's amazing.

We've had slight progress, he's not managing to hold it in for anywhere near as long so is going probably two or three times a week rather than once. He's also not getting as hysterical when it does happen but he still gets upset.

We've resorted to pull-ups again for a while and I am glad to say he is still going to the toilet to wee (was scared he'd get lazy and just go in the pull-ups) and once we've solved the fear of pooing problem I will get back on top of trying to get him to poo in the toilet.

[Blueberry Crumble]

How is this all going now Myztik? We are having major problems with DS (4) holding it in for dear life, petrified of pooing. He hadto go to the hospital the other day for an Xray and he is now on 3 satches of full adult Movicol a daY! Today he did the biggest poo I have ever seen in my life, so I am hoping it helps him!

[Myztik]

Hi, yeah we are finally past it and pooping on the toilet at least once a day :smiliedance: I cant say what exactly helped his move past it just perseverance I guess. Also explaining to him over and over again that is he doesn't hold it in and does lots of little poo's it wont get big and wont hurt.

Hope your DS is ok and the movicol works quickly for him.

[twofornow]

Hi, yeah we are finally past it and pooping on the toilet at least once a day :smiliedance: I cant say what exactly helped his move past it just perseverance I guess. Also explaining to him over and over again that is he doesn't hold it in and does lots of little poo's it wont get big and wont hurt.

Hope your DS is ok and the movicol works quickly for him.

Hi there, sorry to pop in to this post so long after it was created but I am desperate for some help and was hoping you could give me some advice.

My son has been 'holding' his poos on and off for at least 18 months and only ever does a poo in a nappy (but is wee TT) and I am completely at the end of my tether :hair:. Did you use the movicol? Based on what I have read here it seems to be the best option. My son is not a great eater (he has weet bix for breaky with some prune juice mixed in) but doesn't eat a lot of fruit and vegies. I am going to try explaining the process to him like you did and see how I go.

Just after some general advice as you seemed to have conquered this problem. I cannot imagine how excited we will all be when he goes on the toilet :Cloud9Blue:!

Thanks in advance, I am really losing the plot with this. He will be good for a month or so and then suddenly go back to holding it in!!!!

[Myztik]

Hi :)
No I didn't end up using the movicol so cant really say what I think of it but it does seem to be the best thing to try.
I really think just drilling it into my DS2 that if he does a little one every day it wont turn 'big' so wont hurt seemed to be what did it for us. Also making a total fool of myself and being really over the top when he did manage to do one. Use rewards if you have to!

Do you have any idea why he is holding it?

[twofornow]

Thanks so much for that reply! My son had an anal fissure when he was about 16 months old (due to constipation) and it just went downhill from there (he is now over 3 years) He will be good for a while, sometimes months at a time but he has never done it on the toilet. His Paed is basically useless and says its just something to be managed and can't come up with much else. My GP is better so I am going to try and stay on a plan of some sort for 6-9 months with the aim of getting him to forget that poo hurts at all!

Going to clean him out first (sorry TMI) and then keep him on parachoc and prune juice plus switch him to A2 milk and see how we go :fingerscrossed:.

Thanks again for your input, its some comfort to know there are others that have gone through a similar thing and have come out the other side!

[twofornow]

Oh and I have also ordered a reward chart with stickers from the parachoc website (he will love this) so hopefully this will be a little extra incentive too :)

[Myztik]

ahh ok, my DS1 had a fissure and that resulted in fear of the toilet for a while too. Difference he was already using the toilet prior to getting it so was incredibly frustrating when he went backwards.

When I saw the GP about him I was told to give him the parachoc and some nurofen around the time he would usually poo. Seemed to help.

My DS2 (who this thread was about) was like your DS. TT'd for wee's but refused to poo in the toilet. He would hold for days and days and then end up waking during the night screaming because he couldn't stop it coming out (I assume because his body was all relaxed from sleep). It's really hard to watch and so hard to deal with because you dont want to a) make it worse by getting visibly frustrated or b) have them play on it.

:fingerscrossed: the plan you have with your GP and the rewards chart works for you.


oh one other thing I did was get him a little soft padded seat and step for the toilet. The seat can be folded nice and small and taken when we go out.

[twofornow]

Yes that sounds exactly the same as my son! He gets sooo distressed it is heartbreaking and one episode resulted in a trip to the emergency room :thumbsdown:.

I am crossing all fingers and toes this new plan will give us a good result!

Thanks again!

[Herchy]

I've been having the same issue with DS. He's been TT'd for around 4 months, and a few times he's been constipated and holds it in as long as he can. It usually only last 2-3 days... but those 2-3 days are pure hell. He constantly complains about his bum being REALLY sore, cries, walks on his tip toes and refuses to poo on the toilet or potty. I keep trying to explain to him that if he does a poo on the toilet his bum won't hurt anymore and his belly will feel better.... but it takes forever to get through to him. I even resorted to a nappy yesterday as he had runny poo for 12 hours (obviously due to the blockage).
He FINALLY passed his massive stool about 15 minutes ago and was really thrilled with himself. He didn't scream like a banshee while he was doing it either. Now he's back in jocks and back to his normal self.
It's so strange! I am hoping that it stops happening very soon... it seems to happen at least once a month.

I'm hoping everyone else's kids have found something that works. Next time it happens here I'm going to get some stool softeners to try and help (although his stool today was huge, it was still reasonably soft).

[EvaandOllie]

My DD1 had the same problems, she is around your DS' age Jamoz and it all started the same way to. She was withholding from about 18 months, screaming, crying tensing every muscle in her body. Its awful stuff :(.
After getting into a continence clinic she has been on Movicol (1 full one every day) for about 6 months now and it has been fantastic for us, she poos now and those withholding problems are gone, you can actually tell a few days later if we miss one day.
DD1 got to that point where she had compacted diahorrea, her bowel is stretched and the nerves are damaged. Since the clinic she has also been referred to a peadiatrician who added in a sit routine, everyday we aim to sit for 5minutes on the toilet with her feet on a stool after breaky, lunch and dinner. She has a book and gets ticks for each sit, stickers if she poos and stickers for additional poos outside sit times, this does help.
The pead also got us to go diary free for 2 weeks which also seemed to help although on the movicol that is hard to tell.
She also reasurred me alot that this is a common problem and said that as long as it has been problem for the child is as long is it will take to fix (if DD1 has been holding on for 18 months it would take 18 months to fix).
If you have found a GP who understands the problem and doesnt think 3 days of parachoc is a long term solution :banghead2:, I'd say stick with them to start a managment program.