painful constipation in toddler

[mima08]

Hiya

I am looking for some advice: my 2.5year old frequently suffers from bad constipation (I say frequent - every few weeks, but sometimes not for many weeks in between). When he does not go for a day or two, it becomes very painful for him, he complains about stomach ache and has even vomited from the effort of straining (this happened the twice this year).

The minute he "goes", he is fine again - lively, happy, very active etc. I have given him Calfig when he doesn't go to avoid it getting too bad, but don't want his digestion getting used to that.

He has never suffered from other symptoms (I read on other threads about kids having a temperature etc) and is generally very healthy. His diet is good - lots of fruit and veg, lots of water, sometimes juice, next to no sweets...So I am really at a loss what can cause this?

I am taking him to the doctor this week but just wanted to get some further advice / ideas please...

thanks!

mx

[fl0wer]

Some systems are oversensitive to low-fibre foods. Others are intolerant of wheat altogether - or some other food like milk. Eggs although wholesome are rather a 'binding' food. Chocolate/cocoa seems very low fibre.

White rice, refined flour as white bread/cake/biscuits, white pasta, and potatoes without their skins, probably all unhelpful.

There are wholemeal substitutes and even if it means doing our own baking I find that preferable to medicine. Also try & stick to regular times of day for meals, sleep and exercise.

Unfortunately school dinners haven't caught up with healthy eating, by and large.

High fibre friends are: citrus fruit, plums, pears, and juice 'with bits'

Dried fruit of all kinds - especially apricots and dates, more popular than prunes!

Ordinary wheat bran - (a tablespoonful inside any family-sized savoury or sweet cooked dish will vanish, eg batch of tomato sauce or fruit crumble.)

Hope this helps. Did the heat wave affect how well your little boy felt?

[mima08]

Thanks for the suggestions

I definitely agree with wanting to avoid medicine, yet it seems the only two things I can change is switch to wholemeal pasta and juice with bits. The rest of our diet is pretty high fiber, including lots of fruit and veg every day. He does not go to nursery and the childminder cooks lovely fresh food every day- again with a good mixture. Sweet stuff (e.g. biscuits or chocolate happens once a month, maybe less...

I have avoided extra bran as I understand that young children (i.e. babies) should not be exposed to it as it interfers wit the development of their digestive system - maybe he is out of that age by now.

Strangely enough, the heat-wave had no effect, and I cannot establish a pattern at all...

[fl0wer]

It will be good to check at your doctors appointment, as it sounds like diet is pretty good already...I do hope the GP listens to your concerns and helps you trace the cause.

[buggie]

High fibre diets can cause constipation in younger children - while avoiding extra bran is v good, it might be worth checking on balance how high the fibre content is as up to 5yrs or so they can't digest fibre as well as we can and thus can have problems.

If not wanting to go down a medical route, then surely you're health visitor would be a more suitable first port of call - either via child health clinic or by telephone - as under fives are their speciality, would say their in much better position to advise and much more likely to have up to the minute advice than a GP.

[mima08]

Thanks buggie - I didn't realise it's up to 5years old that too much fiber can be a problem!

Will think about the health visitors as have not seen them in a very long time since had no need for the last year...

Does anyone know if the healtvisitors attached to DMC are still at Townley road? DCM being the other problem in all of this: impossible to get through to make an appointment, arrrggghhh!

[buggie]

You should have contact details for the HV in your red book so don't need to go via surgery to speak to them x

[caz6868]

my daughter and nephew suffered the same thing...constant straining and hiding in shame.the doctors gave us lactulose.softens stools.i know prune juice works as we gave this to my dad while on lots of medication.check the library for books on childrens health and the herbal shops.baldwins..or the one in Brixton,alantic rd.

Just to say there are healthy children now.good luck and lots of hugs for your little one.x

[mima08]

Thank you all for your messages and pm's. I spoke to my lovely healthvisitor who even remembered us (impressive memory!). She suggested that it might be a case of holding in when he is too busy playing, as there are no other symptoms but that I should still go & see the doctor to be on the safe side.

Depending on what the doc says re the fibre-balance, I will be introducing with "bits" and keeping a "diary" of when it happens, too to see if there is anything that triggers it.

Caz - did your daughter & nephew ever bring drink up because their tummies were upset by the constipation? (I am avoiding saying vomiting, as it was clear, unprocessed water...)

thanks again

mx

[caz6868]

hi there,don't remembering them vomiting.but serious straining..tears rolling down eyes.some children are less tolerant some foods.your buba could be one of these.good luck.x

[Saffron]

mima08 Wrote:

-------------------------------------------------------

> Thank you all for your messages and pm's. I spoke

> to my lovely healthvisitor who even remembered us

> (impressive memory!). She suggested that it might

> be a case of holding in when he is too busy

> playing, as there are no other symptoms but that I

> should still go & see the doctor to be on the safe

> side.

> Depending on what the doc says re the

> fibre-balance, I will be introducing with "bits"

> and keeping a "diary" of when it happens, too to

> see if there is anything that triggers it.

Our health visitor said something similar. Little Saff is definitely a "poo withholder". It doesn't sound from your posts as if it's dietary in general, or you'd been seeing more frequent episodes. Although that doesn't rule out a particular sensitivity to something. However, on balance, it would seem withholding is probably more likely simply b/c it's very common in this age group. My understanding is that at this age, withholding very quickly leads to constipation. Hopefully your GP will be able to advise further when you've kept your LO's food diary for a while.

Our health visitor recommended lactulose, which is not a drug in the classical sense in that it doesn't interact with other chemical systems. It could more be considered a digestive supplement. It's simply a sugar molecule that's too large to be absorbed across the intestinal lining, so it stays in the bowel w/o being absorbed into the body at all. In the bowel it retains water and so keeps the faeces softer helping to treat/prevent constipation.

We were also told that constipation of less than 3 days is not really a medical problem (more like a developmental phase of children learning about their bodies and toilet habits). However, if the constipation goes on for 5 days or more, the advice was to see the GP for a prescription for Movicol.

>

> Caz - did your daughter & nephew ever bring drink

> up because their tummies were upset by the

> constipation? (I am avoiding saying vomiting, as

> it was clear, unprocessed water...)

> thanks again

> mx

That would still technically be vomiting I think, but I know what you mean. My daughter doesn't do this from constipation, but something similar happens to her with coughing sometimes. The lungs and digestive organs are all so close together in their little bodies that putting strain/force on one organ can easily put force on another. Maybe try repositioning on the toilet/potty to avoid letting his tummy get doubled-up? For coughing we have Little Saff stand up or sit up very straight to avoid this problem. xx

[mima08]

Hiya

thank you that - it is very informative. I didn't know how lactulose works, knowing this makes me feel better about it should the Dr. recommend it (the HV said that a short course often helps - sounds similar to the advice you were given, Saffron).

I've heard that anything less than 3 days is not considered constipation, but even after one day, he is in obvious pain - like Caz describes, straining, tears running down his face etc.

The two instances where he vomited, it had been 2 days of no poo...each time he was in obvious distress - being clingy, complaining about stomach pain, crying, then "vomiting"- I really thought it was a stomach bug and only changed my opinion because the very minute the poo is out, he is happy, active, eats like a horse. Also, no other symptoms of illness, like fever or rash etc.

The vomiting does not occur immediately after drinking, though and no coughing is involved, either. It seems more like the stomach is convulsing, causing the drink to come up. Might be as you explain about the organs being so close together?

If it wasn't for those two incidents, I wouldn't be too concerned, but the last one had me really worried (visions of bowl obstructions, intestinal growths etc) but I guess then it would be a more frequent occurrence or increasing in frequency?

Oh the dangers of google....

thanks again, mxx

[sophie1977]

Hi there, just to let you know you are not alone and my 2.5 year old daughter is exactly the same. It can go on for

2-3 days of her crying and being in severe pain before she actually 'goes' which can sometimes look like she is in labour. It is thoroughly miserable for all concerned. Our GP wasn't particularly helpful so we ended up taking her to a private Harley St paediatrician in absolute desperation. He prescribed Movicol sachets which we have been adding to her morning milk for about 6 months now. She still has regular episodes and I am oddly convinced it is linked to teething but who knows. The Movicol does help though. She generally has a good diet but refuses to eat when going through this which adds to the worry.

I feel your pain as its horribly frustrating seeing them in pain but I am hoping it just remedies itself. I am very nervous about potty training because of it.

[Ruby-shoes]

Our boy (nearly 2.5) had this problem too. We have found that three apricots a day after a meal has solved it. He loves them, we call them his sweeties. Make sure the apricots are unsulphured and preferably organic. We use crazy jacks, which are partially rehydrated.

[mima08]

Thank you - it's reassuring to hear that it is not uncommon (although I do feel sorry for all these little ones). Dr. said it was normal (really?) and give me Movicol prescription. She also reckoned too much fibre is only a problem when given in addition to a healthy diet, i.e. all bran etc (which we don't do).

Moving to the juice with bits and will try apricots - and the Movicol if it happens again. At least she reassured me about the vomiting...

[EDlittlemoo]

I often find that fennel/aniseed tea helps!

If you can get hold of aniseed/ fennel seeds pop them on the stove with boiling water until it bubbles up, and then sieve out the seeds and pop in a beaker, doesn't taste bad if anything adds a sweet taste to the water!