Seeking Suggestions for 5 Year Old with Chronic Constipation

Updated on September 13, 2006
N.N. asks from Fort Lauderdale, FL
26 answers

My little girl had an anal fissure when she was two and potty training, she would hold her BMs in because they were painful, and then they'd get even bigger. It was heartbreaking to watch her cry when she couldn't hold it in anymore and she let it out. Our family doctor hadn't seen that before so he referred us to pediatric specialists and they put her under and examined her and explained it to us. They also put her on prescription laxative Miralax and she totally healed. After that, they said when she is doing well for a few months to wean her off of the medicine and see if her BMs are still soft. But each time we take her off the medicine, it gets painful for her again. She's 5 now, and we didn't expect this to last this long.

Every year at her check-up we tell her pediatrician she is still having this problem, and they say we need to wean her off of the prescription, and put her on fiber therapy instead, like Benefiber for example. But it doesn't help, she still gets constipated again until we put her back on the Miralax, which she hates taking. She eats the same as we all do, and none of us have this problem. She used to eat more starches like crackers and cheerios, but I've been cutting back on that, and give her fruits or veggies with every meal, and lots of water.

Is there a light at the end of the tunnel? Or have we given her this medicine for too long, and messed up something? Has anyone had a kid just grow out of this? Would going to a nutritionist help?

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So What Happened?

Thank you all so much for your responses. I will try them until we have a good resolution. It helps me so much to see that we're not alone dealing with this, and that so many of you have had some success. My MiL has become dependent on daily enemas to stay regular, and I was a little fearful that my daughter would develop a lifelong dependency on the Miralax the same way. We've needed to increase the doasge to 17 gms every other day, when at 2 years 1/3 of that daily was all it took. You all give me hope and some great suggestions to try, so I don't feel like we are just standing by doing nothing!

We have switched her to soy at home, but at school she still chooses the macaroni and cheese or the pizza or whatever has dairy in the school lunch. But you all gave me some can-do attitude I needed, so I packed her a dairy-free lunch today. She was so happy to bring her princess lunchbox LOL.

UPDATED TO ADD:
She is having fun taking lunch to school, and I have added the ground flaxseed to her diet as well. I made an appointment for our family to see a nutritionist, and her to see a pediatric gastroenterologist who was recommended by the one my DH sees, in Hollywood, Dr. Mario Tano, so I hope that will help. I am weaning her down off the Miralax again, giving her smaller daily doses, and she is doing well so far. Also, she goes to Tae Kwan Do, and I forgot to say that I think the exercise helps her, too, because it gets her warm and she drinks more water. Thank you all again for taking time to help me with this, what a kick-butt team :)

UPDATED AGAIN TO ADD:

It's been almost a month now of no problems at all. I am so grateful to all of you who wrote in, who showed me that this isn't a hopeless problem that my daughter is stuck with. When I took her to Dr. Tano, I saw his partner Dr. Diaz, who showed me that while her anal fissure had healed, that she still had a skin tag, and that this would still cause her to avoid using the restroom when she needed, and so he gave me a cortisone cream that healed it up totally in two weeks. I am so sorry that I didn't think to look again, I didn't even know that it was there. I have been checking a few times a week to make sure that its still gone. Now she is totally off of the Miralax and benefiber. I still give her lots of fruits and veggies and put the flaxseed in her oatmeal. Also, since hurricane season is over she's getting plenty of water from all the bottles we stocked up with. Thank you all again, if this recurs I will have a ton of great ideas!

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D.

answers from Tampa on

Dear N.,

Go to the health food store and read books about digestion. There are a couple of things that will help; probiotics (they are beneficial bacteria that get wiped out by drugs, antibiotics, etc) these are essential for good digestion. Also get enzymes and these can be gotten in chewable form. Papaya enzymes, and there are other enzymes. You might want to try cutting back on any dairy. Use almond milk and other stuff besides milk and cheese which are very binding.

Find a good chiropractor that is good with kids. There is one in Tarpon Springs Fl. Alton Gustafson. Or get referrals.

That is what I know about digestion.

D.

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M.N.

answers from Miami on

I think you should see a Gastro, Dr. Hernandez in West Boca is great.
9970 Central Park Blvd Ste 205
Boca Raton , FL 33428
###-###-####

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K.J.

answers from Jacksonville on

HI N.,
THERE IS A REGENCY HEALTH AND VITAMIN STORE IN REGENCY MALL IT SITS RIGHT BY GYMBOREE, THERE IS A MAN(OLDER GENTLEMAN SALT AND PEPPER HAIR) IN THERE I DONT KNOW HIS NAME BUT HE HAS BEEN THERE FOR YEARS. HE IS SO KNOWLEDGEABLE ABOUT HERBAL REMEDIES. IT COULD BE AS SIMPLE AS PUTTING HER ON A HERBAL AND FINDING OUT WHAT FOOD SHE IS HAVING A PROBLEM WITH. GENERALLY FROM MY KNOWLEDGE WHEN THE BODY STARTS ACTING UP IT IS WHAT WE PUT IN THAT CAUSES IT. YOU WOULD THINK THAT FRUITS AND VEGGIES WOULD WORK BUT MAYBE HER BODY DOESNT RESPOND TO THAT. MEDICATIONS TEND TO NOT CORRECT THE PROBLEM BUT SUBSTITUTES AND COVERS THE CONDITION. IM NOT A DOCTOR OF COURSE BUT JUST SOME THINGS I HAVE LEARNED . I HOPE THIS HELPS YOU.

1 mom found this helpful
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P.O.

answers from Miami on

Hi N.,

i am a nutritionist, but do not specialize in pediatrics. Weaning anybody off a laxative is extremely challenging and the longer you stay on it the harder it is. there are other options beside Benefiber. there are also juices which are much more pallatable with high fiber and can be diluted with water to help increase fluid intake. The fruits, veggies and water are very important - keep that going.

I have a dietitian friend that specializes in pediatrics. she is out of town right now and she'll be back on Monday. I will check with her on more specific guidelines for kids.
the juice available that I use for some of my patients is Firberbasic juice. Also, it is very hard for the intestines to adjust to not having a laxative, so the first few weeks between weaning off the laxative and transitioning to the natural fiber based diet so you will have a period where contstipation will exist. Do you ever use mild fleet enema's?

You may want to check with your physician but those may help in the transition period if used only with constipation.

good luck and I will get back to you with more details from my friend.

P. O
Dietitian

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T.E.

answers from Miami on

hello-
i'd like to offer a suggestion that should be able to help if not heal your daughter. his name is dr. karp and he has been given an amazing gift to heal. it's not magic but you do have to be open minded as there are no meds involved. he's not a holistic doctor either! i tried him when my son at 6 months had got krup and every time he had got a little cold it went right to his chest. my pediatrician wanted to keep him on steriods but after a short while i couldn't stand it. he was only 7 months and i was pumping steriods into his lungs! so a few of my mommy friends had previously told me about dr. karp and i decided to give him a try. and i'm sooooo grateful i did b/c gavin has not needed any steriod treatments since he was treated by dr. karp. since then, i bring my kids to him when they get sick but i also got to my pediatrician if they need meds. i also go for treatments for myself! i can write lots more, but i think it would be worth your while to take your daughter to see dr. karp. his number is ###-###-####, ask to speak w/kelli she is the office manager & very sweet. you can tell her jaiden & gavins mommy, T., referred you.
please let me know what happens. best wishes to you & your family!

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L.B.

answers from Miami on

I will second the mineral oil suggestion. Although not as severe, my son has problems with constipation. As well as making sure he was getting lots of fruit and veggies and water, I started him on 1 tablespoon of mineral oil each day, mixed in with a little OJ. It has no taste, and makes the stool softer and slippery and very easy to push out.

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S.C.

answers from Tampa on

Hi!
My daughter is six and we are going through this too. I can't understand why the miralax is bothering her to take...it just disolves into the drink and is tasteless (my daughter takes it under generic Glycolax). Are you giving her the full 17 gram dosage? Have you tried lessening the dosage or giving it every other day??
Several tests were run on my daughter including stool samples to test for parasites and an allergy panel.
We have eliminated dairy from her diet and this has helped TREMENDOUSLY! Her discomfort is probably about 1/4 or less compared to what it was.
We just discovered this on our own after she (uncharacteristically) had cereal without milk one morning and didn't have a belly ache that day.
I would insist that the pediatrician test her for parasites and allergies and just try eliminating dairy for a few days and see what happens. Soy can be substituted. My little girl was so happy not to have a belly ache, she could have cared less about the taste difference.
Anyway, we do about 4 grams of the Miralax daily now with no dairy in her diet. She has an occasional belly ache, but is MUCH better. She also sees Dr. Michelle Winesett a pediatric gastro specialist.
If eliminating the dairy doesn't help, try wheat. Email me for more suggestions...we've been working on this for a while.
____@____.com

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R.W.

answers from Ocala on

Hi,
I have a 6 year old daughter that also has difficulty with continuous constipation. She was always difficult, even in diapers. She would hold it in until she couldn't anymore. I put her on Milk of Magnesia, an OVC liquid, for a few months until she was more relaxed, and she is constanly taking in fiber...such as green grapes, fiber enriched cereal, veggies, etc. I also limit her dairy intake to 3 servings a day. Other things that our pediatrician suggested was warm baths, and when on the potty to do a BM, give her water to drink, for some reason it seems to work. I also require my daughter to do a BM (even just a small one) daily. She must take the time to relax and allow her body time to go. Sometimes they are so stressed about possible pain, as well as in such a hurry to get back a play, that they will try to bybass the process. I allow her to take her games or a book and sit in the bathroom...I really keep track, just to make sure she stays regular, and she hasn't had any major backups for quite a while. I would suggest weaning her off, but if she gets stopped up, try an OVC remedy...just don't let it get to the point of being painful, or you are back at square one.

Good Luck!

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J.S.

answers from Sarasota on

Hi N.,
A friend of mine sent me this because she knows my little girl to have the same problems. She is 6 years old and is on Miralax and exlax on the weekends to empty her out. I have stopped the exlax just because I dont want to keep giving it to her I dont think it could be good for her. She has had a chronic contispation problem since she was 3 months old. The doctors tell me the same thing as far as diet. I did put prune juice mixed with regular juice and that worked for her when she was younger. Like you I also give her more fruits and veges with fiber. Seems like the only thing that really works is the miralax. I have cut down to every other day with that. My doctor has offered me no other help, so I will be switching doctors to get a second opinion. I wish I had that light at the end of the tunnel for you but I am in there with you. Just stay on top of when she goes and make sure it is not to long in between. Which I am sure you know already...Hope this helps a little bit. J.

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D.W.

answers from Tampa on

Hi N.. I had a lengthy message typed up to you, but lost it somehow (hate when that happens). Long story short, keep your chin up and hang in there. My son (almost 12 now) began with the same issues. We went through years of Miralax and enema misery. Finally, we took him to a pediatric gastroenterologist (I highly recommend this as your first step), where he was diagnosed with encopresis. Weeks of researching led me to several treatment ideas and he is now cured. Here is a link to get you started:

http://www.keepkidshealthy.com/WELCOME/conditions/encopre...

Hang in there -- it DOES get better.

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C.F.

answers from Ocala on

have you tried pear juice

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L.R.

answers from Fort Myers on

Hi N.,

I too have been battling this same problem with my 2 1/2 year old daughter, since she was 6 months old, right after breast feeding was over. I have used Miralax for a long time and my pediatrician just changed her perscription to a different type of laxative and it is not working.

I have tried to take her off of the Miralax too and her stools become so hard she cannot pass them. She had a fissure too, so sad. She drinks plenty of fluids and is a vegetarian like me but she is such a poor eater...only eats a few things. I do natural medicine and have tried all kinds of remedies and herbs to no avail. She holds in her stools out of fear from the pain she remembers. I also sent her stool to a lab to see if she had parasites or something. It came back saying she had inflammation of the GI tract and intestines. So right now I have her on digestive enzymes. I will let you know if this helps. I do feel for you and your daughter, it is so hard when you try everything. I think it is a mental problem now, she really could go everyday but she is fearful.

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E.

answers from Miami on

My neice who is now 22 yrs old was just like this. But her mother (my sister) was not a good mother. was not feed right. Once she came to live with me she never had the problem anymore. I made her drink alot of water. You said you were doing that all ready. But the other food you said you cut back and she eats the same things we do. Well we don't all have the same problem. I find when I eat more starches, I don't go as lets say well. But if I eat more veggies and a little meat, definelty no problem. I deal with a fissue too, it heals but continues to come back. Are they fresh fruits are canned full of sugar fruits which are a waste and lack the same nutritional vaule. I also eat fresh vegggies or frozen. I changed my neices eating and drinking habits and her life became regulated so to speak.
I believe a nutritionist can't hurt. Just remember not all are good just because they got the title. :-)
I know I didnot give you solid info. but I hope somehow I helped.

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C.D.

answers from Tallahassee on

N.-my daughter has the same problem...we give her acidophilus (health food store/drug stores but the only brand from the grocery I like is Nature Made) crushed up in her drink. They also make flavored chewables for children. Lily used to eat nothing but vegetables and still was constipated, holding it, etc. but this works. When we take her off, it gets hard again so the physician said leave her on it...it's a natural substance and replacing something in her digestive system that is causing her constipation. No side effects for Lily and she started taking it at age 2.

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M.R.

answers from Ocala on

My son had a similar problem when he was two years old and to this day they the doctors could not explain but to say he needs more fiber. Now that he is almost five years old I have learned to trust my instinct when something is not right. Often we patients or parents rely on a doctors diagnoses and yes you have that right to disagree. You are your daughters voice and if you feel she is struggling with this than demand the pediatric specialist another doctor to see. The nutritionist may be the one to figure out what is wrong. What is even better is finding a doctor who supports the beliefs of a nutritionist. What did the doctor explained to you about the tests? If they have said there are some things are unexplained and just give her laxatives than personally I would seek another advice until I am comfortable with a doctor who is geniunely concern for my child's health. Unfortuntely, I am new to the Ocala area and don't have advice to which doctor to go see but I do know as a mother you must stand firm. The Mother is the number one person who knows best for her child.

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B.A.

answers from Jacksonville on

HI there, my grandaughter went through the whole constipation thing, used to scream every time she had to go. She just finally outgrew it. I would suggest natural fiber (Health Food Store)not the commercial stuff otc as it can CAUSE constipation. Also try adding yocurt (Activia)to her diet. Probiotics are very important for digestion. Cut out the sugars! Fresh fruit and veggies are great. Check out Brenda Watson's website. Just type her name in Google or whatever. Best to you.

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S.

answers from Miami on

My little boy had the same exact problem, I feel for you. What finally ended up working for him was mineral oil. we just gave him a teaspoon when we knew he was "holding" in his bm, and within 20 minutes he could not hold it in anymore.. If you would like to talk more about it feel free to email me. It took awhile for him to realize that it was not going to hurt if he went when he first felt like he had too. Best of luck with your little girl :)
S.

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A.R.

answers from Ocala on

N., both of my son's (1 & 5)had functional constipation. I know exactly what you mean about how they hold it in until it is so big and painful to push out, espescially with my youngest. He was referred to a specialist also and put on Miralax. He would get so bad that if I accidently missed 1 day of giving him his meds he would be constipated again and in pain. I have been fighting this with him for about 9 months and like you said, I couldn't get him off of the meds. When I took him in for his 15 month check up the nurse practitioner asked me if he drank milk. I told her he would have milk daily at breakfast and sometimes another cup later. She said I should try to cut that out of his diet because it can be constipating. And guess what, I cut milk out and viola, he is fine now. Go figure, trip after trip and test after test at Shand's and no answer except meds. A nurse practitioner says try no milk and it worked. I don't know how much milk your daughter drinks, but you should try it. Give her the miralax and take her off of it slowly after you cut out the milk just in case it does not work and she ends up in pain. Her bowels will be firmer than you are used to with the miralax but they will not be hard and constipating. Also make sure you put her on a good multi- vitamin to replace the calcium and Vit.D. Also start her on orange juice which is high in calcium and Vit. D. I hope this helps!

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A.

answers from Lakeland on

I'm not sure how much it will help, but my 4 year old had that problem(though not as severe) and my doctor at first recommended giving her a laxative, like Milk Of Magnesia, but that caused probs in the OTHER direction. So they told me just to give her about 3 or 4 oz of prune juice a day, and it should work itself out. I hope this helps!

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J.C.

answers from Raleigh on

Our peditrician recommended a tiny bit of Karo syrup in the water for our little girl, of course, she was much younger, but it worked within 2 hours...it's worth a try!

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J.M.

answers from Tampa on

I have a friend whose daughter experienced severe constipation as well. Your experience sounds very simlar if not identical to hers. She began feeding her daughter bran... bran cookies, bran muffins, etc... and that helped. It regulated her and kept her off the medicine. And they have not had problems since. She made most of her own bran items,but I imagine you could also try the bran muffins that Publix bakes. Its worth a try.

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M.S.

answers from Miami on

Hi N.,

I just saw your post. My oldest daughter who is now 8 had problems with chronic constipation when she was just a baby, starting around 10 months old. We took her to a pediatric gastroenterologist at Miami Childrens Hospital who was WONDERFUL!!!! He was so patient, understanding and best of all he actually listened to us. Since she was our first child and just a baby of course we were freaked out by her screaming every time she had a BM! Back then the course of action for her was Senekot daily (they have since pulled this off the market) which was a liquid stool softener/laxitive and mineral oil daily in her juice. There were a couple other things also but I can't remember completely, its been so long. Those two stand out because we did them the longest period of time. We did this for a good 18 months to 2 years, because we needed to erase the memory of the pain of a hurtful BM so that when it was time for her to potty train she would no longer hold it in, which is part of the problem. It creates a never ending cycle which I am sure you know already. She was fine after that, we had a few bumps in the road along the way, but we also didn't rush her and it all worked out. I know it seems frustrating. Is the specialist you are seeing a ped. gastro? We were SO thrilled with the one we saw that I would highly recommend him if you are interested. It was worth the trip to Miami Childrens Hospital which is by Jackson Memorial in Miami - I would have driven to the ends of the earth to help her!!! Feel free to email me if you want more info, I would be glad to help you any way I can.

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S.S.

answers from Daytona Beach on

I haven't dealt with this for a child, but I sometimes have problems myself due to internal hemorhoids for the past 12 yrs or so. I always try to use foods first, and meds only if the foods don't work, which is rarely.

Different foods affect different people differently, so your [her] mileage may vary. But here's what works for me; if these don't work, talk to a nutritionist about what other foods to try. I would try prunes or prune juice, spinach, oatmeal (oatmeal raisin cookies seem to work better than breakfast oatmeal, I dunno why - maybe the raisins?), or sunflower seeds. A couple of ounces of sunflower seeds work wonders, and they're good for her too - lots of zinc, fiber, a little protein, and even some iron. You'll have to play around with the "dosage" until you find out how much works for her. I usually eat a lot the first day, then about one ounce every day after that to keep things moving. Works like a charm. I hope this helps!

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T.O.

answers from Sarasota on

N., I'm so sorry to hear about your daughter's (and your whole family's) struggle. That is just heartbreaking. And I know how horrible it feels to be the mommy who can't do a thing to heal the pain. I think your thought on the nutritionist is a good one. There's no harm in consulting a professional who may be able to guide you toward a special diet or maybe a supplement that would help.
My other thought is really a question. Is it AT ALL possible that her problem is more psychological at this point? You said her doctor really wants her weaned off the Rx, so it seems the physical problem may be fixed? Or am I interpreting that all wrong? What I mean is, despite the fact that she hates taking the meds (typical of all young kids), is she so used to taking it in order to prevent the painful BMs that she's become dependent on the idea that she CANNOT go without it? Is she so afraid of going to the bathroom while off the meds that she believes she CANNOT go without it? Like I said, I may be misinterpreting what you said and the problem is solely physical. But it's a thought.
I hope you find some much needed relief here and that your daughter can finally be allowed the peace of mind she deserves. Good luck and best wishes.

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S.S.

answers from Tampa on

My oldest son developed the same issus somewhere between 2 and 3 year old -- I spent most of that year in hospital as my twins were delivered and I developed some side effects of excessive medicines and water -- that was a difficult year. He was fine and well potty trained when I suddenly had to go to hospital, and 4 months later when I was back, he had major issues with constipation. He was on the same medicine for a long time .. I think at least 2 years .. He is 7 now and takes it only occasionally. You can try following -- reduce dosage very slowly -- I am vegetarian and very health oriented, so that was not a big issue as I gave him tons of Fruits and vegetable and lots of water. I think milk and juice are not as goos as plain water itself. You can give her more yogurt and reduce milk a bit. My son still have to drink one big glass of water in the morning, as soon as he gets up and does brush, before he can go to toilet. It is at times annoying and time consuming -- when he is getting late for school OR we are on vacation --as this whole thing takes at least 30 to 40 minutes -- since he will drink water very slowly or will just goof here and there -- so I have to keep an eye on him .. But he is at least totally off the medicine.
Also the day the routine is not followed .. then all day no Poop. You can also try Prunes as they are pretty good for this issue. You may want to go to the specialist again and ask him about nutrition also. If you are giving your daughter fruits, try not to take skin off of most fruits.
Good luck

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A.

answers from Tampa on

Hi- I didn't read all the other responses so I don't know if anyone suggested this or not. When my son was an infant he had a serious problem with constipation (and I was breastfeeding which is supposed to prevent that!). Our pediatrician had us give him prune juice (straight - not watered down) and that definitely helped. He outgrew it eventually but I still force a lot of fruits and veggies because otherwise it comes back (he's 9 now). Good luck!

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