July 22, 2010,
J.M. asks from Reno, NV on July 14, 2010
5 Year Old Has Not Pooped for 2 1/2 Weeks
Now this is not abnormal for my son, he just turned 5 and has had chronic constipation on and off most of his life. I want to take him to a gastro doctor but right now I am laid off and I dont' have insurance. I give him Miralax and most of the time it works, I have given him 1 tablespoon for 4 days now and nothing. Most of the time he acts like he has to go and I know he is holding it in and we just give him an enema. This time is different because he isn't showing any signs he has to go, but I am worried because it has been so long. Should I just give him the enema anyway? I hate to do it to him, it is so stressful and he just screams. Thanks for any advice.
So What Happened?™
Thank you so much for all your advice, this is a great site! He finally went today after I gave him 2 tablespoons of Miralax, the problem with him is he has had so many problems that I know he holds it and I can't make him understand that it just makes it worse. He was diagnosed with autism at 27 months and I have heard and read about there being a link. A friend of mine's daughter who was diagnosed has the same problem and they just got done doing all these tests, ultrasounds, etc. and can't find the problem. I can't imagine how frustrating that would be. I have done suppositories and either I don't put it up far enough or I don't keep him in the position long enough because as soon as he sits on the toilet it comes out. Thank you so much for all your help!
D.H. answers from Los Angeles on July 16, 2010
You can use dulcolax suppositories. He would take just a half of one. You have to insert it in his bottom and use a q-tip to push it up a little. My son had this chronically for a very long time. We used enemas, suppositories, you name it! That's too long to wait and he needs to know how sick it can really make him if he doesn't go each day or every other day. Crying or not, he needs to go to the bathroom! Good luck, I feel for you because I have been right where you are at!
K.F. answers from Minneapolis on July 15, 2010
I didn't read all the responses, but I would up the dose of Miralax. My daughter is 3 and for quite awhile now she has been taking one capful (one adult dose) every morning. Has kept her completely regular. This was what the Pediatric Gastro. we saw told us to start doing for her. It also doesn't work instantly, it may take a couple of days to get things "moving." Just my experience!
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M.T. answers from Dallas on July 14, 2010
The goal is to help your child to have soft, comfortable stools again. In toddlers, constipation is almost always related to diet, so a step-by-step approach that targets what she eats and drinks is the best way to treat this condition:
1. Make sure your child is drinking enough fluids -- juice, milk and water. If your child is dehydrated, her stool will become harder, leading to constipation. It is particularly important for your child to stay hydrated in hot weather. Since it's difficult to make specific recommendations as to how much fluid is enough, try following the pediatricians' rule of thumb: If your child is urinating at least every three hours while awake, then she's probably getting plenty of fluids.
2. Increase your child's fiber intake. Many fresh fruits and vegetables are high in fiber. The United States Department of Agriculture recommends three servings of vegetables and two servings of fruit daily for 2- to 6-year-olds. This may seem an impossible goal to meet if you've got a picky eater, but not all high-fiber foods taste "yucky." Prunes and raisins are particularly high in fiber. In addition, fiber breakfast bars and cereals, bananas, apples, peas, grainy breads and peanut butter (which does not cause constipation, but actually helps prevent it) are all good choices.
In addition, supplemental fiber preparations such as Metamucil, Fiberall and Citrucel can be helpful as they make the stools absorb more water, allowing them to move gently through the intestines.
3. Try giving your child mineral oil. This remedy is somewhat controversial, but in my practice, I've found it's one of the best treatments and is generally safe. Mineral oil coats the stool and helps it slide easily through the intestines. At one time, it was thought that it blocked the absorption of important minerals through the intestinal wall, but this was recently found not to be the case. In rare instances, it has caused pneumonia, but only in children who were unable to swallow properly.
I recommend that parents start by giving their child 2 teaspoons of mineral oil twice a day, for a 20- to 30-pound toddler. Thereafter, increase the dosage by 1 teaspoon every other day until the child is passing soft stool and any anal fissures have healed. (Mineral oil tastes awful, but it can be well-disguised in shakes, juice, Jell-O and ice cream.)
4. Encourage your child to sit on the toilet after meals. Children who have experienced painful bowel movements are often reluctant to sit on the toilet. But the longer a child avoids going to the bathroom, the harder the stool will become. You can help break this cycle by having the child sit on the toilet for 5 or 10 minutes after meals, when intestinal reflexes make passing bowel movements easier.
5. Consider eliminating milk from your child's diet. On occasion, a child can become constipated due to a cow's milk allergy or sensitivity. However, because cow's milk is an excellent source of protein and calcium, which are both essential for growth, you should not eliminate it from the diet without first consulting your doctor. If you have tried the above strategies without success and feel that milk may be the culprit, contact your pediatrician.
**Don't give your child an over-the-counter laxative. Laxatives should be used rarely, if at all, in children and can cause serious problems such as electrolyte imbalances. Only a doctor can determine if this level of treatment is needed.
**Do consult your doctor if constipation develops suddenly or is associated with pain or fever.
**Don't worry if there is a small amount of blood on the surface of the stool or the toilet tissue. This probably indicates an anal fissure, a painful but non-serious condition. Larger amounts of blood, blood mixed with the stool, or blackening of the stool, however, may indicate a more serious condition.
**Do contact your doctor if constipation develops in early infancy -- this might indicate a more serious condition, such as intestinal blockage, and should be evaluated quickly.
When all esle fails and you have no where to turn you. Take him to the emergency room.They can not reject you and sure wouldn't reject your son .
They will send you a bill but you don't have to pay it right away. You pay it when you can afford it. I was a single mom with no isurance and the ER has saved us a few times and made my daughter better.
I know its crappy but some times you just have to do what ya gotta do.
8 moms found this helpful
D.B. answers from Minneapolis on July 14, 2010
The laxative and enemas could have supressed his natural urge to go by himself. They can become 'addicting' like that. I would stop them immediately, and try to get his natural elimination system back on course. I'd suggest in the morning skipping any solid food until he's had some sugary juice (pref. Prune Juice) followed by warm water or tea. Let this sit and work it's way down for a while before giving solids. Personally, if I don't do this for myself (i have coffee with cream after a glass of water), I'm messed up for a week. What color is his urine? If not clear, he's not getting enough liquid which also promotes this problem. Start pushing liquids!!! Not drinking enough can be a chronic problem. Finally, try a stool softener. He may be holding back because of discomfort. The softener could get him going again, thus avoiding a trip to the dr. Don't make this a big issue around him or he'll hold back unintentionally. If nothing emerges for a few more days or he starts to experience pain in the abdomen, then go see the doctor. Good luck!
4 moms found this helpful
K.C. answers from Philadelphia on July 14, 2010
My son also goes between 9 - 11 days between BMs in his "natural state". We give him Magnesium Citrate supplements to get his bowels moving, Calcium Citrate supplements to make sure the Magnesium goes to his bowels and not his bones, and something called Ultrazyme (which is a digestive enzyme to help with digestion, pineapple and papaya also are great for digestion). With this regimen, he now goes every 4 - 5 days (which, of course, is still too long for most people, but for him is awesome - I'll take that over 9 - 11 days). We had docs tell us to try Miralax, he even got prescription strength, but it did NOTHING. He eats fruits and veggies, so getting more fiber is not the issue. He doesn't drink milk because he's allergic to it, so that's been eliminated as a reason. My son just has a super slow digestive tract and almost never gets "the feeling". We've been told that digestive problems go hand in hand with Autism Spectrum Disorders, which he does have. Our current approach seems to be the most effective. He's almost 13 and we've been dealing with this issue since he was about 3, so we've had lots of experience with "ways to get a kid to poop". We tried an over the counter laxative once (disastrous results), enema (didn't work at all, shockingly), and several other methods (including something my Italian MIL suggested which involved a sprig of parsley dipped into olive oil and briefly inserted you-know-where when we were desperate, also didn't work at all). The best thing we did was take him to a naturopath. She's the one who recommended the supplements which have done more for him than all the docs' recommendations combined. Good luck!
3 moms found this helpful
K.B. answers from Columbus on July 15, 2010
We've been through this, too. It had been two weeks between BM's with my four year old a few weeks ago, and when she did finally go it was terrible for her.
I would give him the enema to get things moving before it gets worse (harder), but you've got to figure out what works for him to keep things moving, because enema's aren't a long term solution. Prescription strength Miralax didn't ever work for us, and I found these vitamins called PediaLax. They're gummy vitamins and she takes one after each meal. This has gotten her to having a BM about every other day. Not sure why they worked for us when the Miralax didn't, but it's worth a try for you.
Good Luck, I hate that you're little guy is having this problem!
3 moms found this helpful
P.M. answers from Portland on July 14, 2010
Sounds like he could be developing Encopresis, a serious condition in which the bowel becomes so distended the nerves go to sleep. He has no urge, but at some point moist feces will start to push past the blockage, and he'll start soiling himself because he can't tell it's happening. OR, he could become so backed up he'll start vomiting, since his little system can't ingest any more food.
Be sure he's getting as much water as he can hold, because without it, added fiber can add to the blockage.
Money problems or not, this could seriously use medical attention if your son doesn't start pooping really soon. A specialist may not be necessary if you take him to a pediatrician who can guide you.
In the meantime, I'd give him a liquid children's suppository – probably somewhat less traumatic than a fullscale enema, and it may be enough to kickstart his little guts. Both supports should be used only occasionally, and for no more than a few days at a time.
2 moms found this helpful
C.C. answers from Fresno on July 14, 2010
Our doctor gave us the advice with our older daughter, when she hadn't gone in a very long time, to increase the Miralax (which is not, of course, a laxative, just a stool softener), and then to give her ~2 tablespoons of mineral oil twice a day until she went. (If he won't drink it, put it in some orange juice, that helps disguise the taste.) You want to make sure that once you start the mineral oil regimen, that you stay at home because when he goes, he'll REALLY go. Once he finally goes, you can stop with the mineral oil and then just keep going with the Miralax. We did that and it worked like a charm.
If that doesn't work in 12-24 hours, call the health department and see if there is a free clinic you can take him to, just to make sure nothing is seriously wrong.
Good luck, this is such a miserable thing to go through with your child. =(
2 moms found this helpful
M.B. answers from Washington DC on July 14, 2010
My children have never had huge constipation problems, but whenever there were any issues, prune juice worked 100% of the time. I personally hate the taste, but three of my kids don't mind it, and for the other one I mixed it with apple juice. Obviously this is a big issue for a long time for you guys, so maybe you have tried it?
Interesting story- I was a nanny to a girl who has had big constipation issues, and for SOME REASON, they have chosen to not try prune juice after many suggestions of mine (???) ...But, they have given her enemas... confuses me... FYI, prune juice is entirely healthy and OK to give to even the youngest of babies in need of "relief".
2 moms found this helpful
S.C. answers from Los Angeles on July 15, 2010
LA has awesome free clinics. Look up LA Free Clinic to find the one nearest you, and then call them to see how you can show up as a "walk in." I have used the free clinic many times. You may have to wait around an hour, but you would do that at the "regular doctor" anyway.
1 mom found this helpful