Dr. Hive - need immediate advice for constipation in almost 6 yo

[HappyLady]

My DD is almost 6.  Since she potty trained years ago, we've been dealing with her not wanting to have a bowel movement.  It became a vicious cycle of her holding it for a few days, then not being able to go, then having to take Miralax (as instructed by her ped), then her finally going, but having accidents in her underwear for the next few days.  Finally over the last year or so, I figured out as long as she goes right after dinner she had no problems, but if she missed that window of opportunity the cycle would start again (sometimes she could go after breakfast the next day, but only maybe half the time).

 

Well, today marks her not having a normal bowel movement for a week.  I called her ped when it hit 5 days and they said to load her up on the Miralax.  I did and it didn't do much.  She got some stuff out, but certainly not 5 days' worth.  The next day they said I had to do a cleanse with her by giving her an entire bottle (the small one) of Miralax with 64oz of green Gatorade.  I tried, but she couldn't drink that much.  Last night she was up all night crying because her stomach hurt.

 

I took her to her ped today and she did a rectal exam.  She said because of years of holding it, my DD's bowels are "loose and floppy."   She said while she wasn't impacted, she did have a lot of stuff that needed to come out so she said I had to try again with the cleanse.  We tried when we got home and all my DD could get down was about 10oz.  She's not a defiant child, but she just couldn't drink anymore.  Her stomach is so bloated and hard that she just doesn't want to eat or drink.

 

We did give her an enema yesterday and she got some stuff out, but not a lot.  The ped said I could give her another one today, which I'll be doing soon.  We got the kind for 2 - 5 year olds so it's really small and not much liquid.

 

My DD just threw up.  She's not acting lethargic, but she did nap a little while ago (which could be from not sleeping last night).  She's talking ok and playing video games so I don't think things are too serious just yet, but I don't know what to do from here.

 

I don't like the idea of giving her the Miralax to begin with and when I researched it, the amount they want her taking is what an adult would take when having to do a colon cleanse.  To me that doesn't sound right, but her ped said it was fine.

 

Does anyone have any other options?  Any suggestions or advice?  I'm worried.  :(

[wapiti]

I would call the ped's office and report to the doctor on call that your dd just threw up.  They may have different instructions under these circumstances.

[shukriyya]

Magnesium citrate. Natural Calm is a popular brand.

[Lara in Colo]

I had this same issue with two of my daughters. 

In this case I would do one of two things:  Milk of Magnesia or an enema.

 

The MOM works quickly  but not as fast as the enema., but it is a nicer procedure.

 

Then I would up the miralax amount on a daily basis.  You will find (though trial and error) your happy place where she can just go without too much leakage or stoppage.

 

this is unpleasant and I feel for you.  I still remember the calendar where I kept rack of bowel movements. 

  ****

 

 

***** I re-read your post--- with the throwing up-- do the enema.  You can get one just about anywhere-- Walmart, Walgreens, grocery stores.

 

I took DD9 to the ER for intestinal pain and they gave her the enema (of course in cost $1000.00 instead of 5)

 

[HappyLady]

I would call the ped's office and report to the doctor on call that your dd just threw up.  They may have different instructions under these circumstances.

 

 

Her ped did say she'd throw up from drinking all the Gatorade, but since she didn't drink it all maybe I should call to see what they say.

[HappyLady]

Have you tried the home remedies? A tsp of blackstrap molasses in a cup of tea?

 

 

I haven't tried any home remedies because I don't know what works and what doesn't.  My DD doesn't like tea.  I'm guessing I can just put the molasses in anything - ?

[trlt]

My dd had a lot of problems with bm's, her tummy would be so swollen and when she did finally go she was in pain and miserable. I refused to give her miralax long-term as suggested by her pediatrician so I looked into natural remedies. We give her jarro-dophilius (open capsule) and mix with pear juice, and a capsule of flaxseed oil. It has helped tremendously, she now goes regularly and is not miserable.

 

ETA: I realize that my suggestion isn't going to help the immediate problem.

[itsheresomewhere]

Does she have a step stool for the potty to put her feet up on it? It helps a lot.

[HappyLady]

My dd had a lot of problems with bm's, her tummy would be so swollen and when she did finally go she was in pain and miserable. I refused to give her miralax long-term as suggested by her pediatrician so I looked into natural remedies. We give her jarro-dophilius (open capsule) and mix with pear juice, and a capsule of flaxseed oil. It has helped tremendously, she now goes regularly and is not miserable.

 

ETA: I realize that my suggestion isn't going to help the immediate problem.

 

 

No, this is great!  I definitely want to find an alternative to Miralax because I just don't like using it.  I'll definitely look into your suggestions!  Thanks!

[Ali in OR]

My disabled dd would be chronically constipated without miralax--pretty common for wheelchair kids. She takes Miralax daily--it only takes 1 teaspoon in 8 oz of water once per day to keep her regular. It is so much better than life before Miralax (it wasn't around when she was young). Make sure your dd gets plenty of fluids. That's probably obvious, but with our dd, we have to remember to give her water as she doesn't just drink it on her own. If we forget we have more issues.

 

When she does go a few days without a bowel movement (extremely rare now), we use an enema. They work within 15-20 minutes, and since she wears a diaper, it's really a pretty easy process. I would look at using the adult size--you don't need to squirt it all in.

[Paige]

Miralax and anything oral probably won't work well at this point. She needs an enema or suppository and probably multiple ones until you can get her cleaned out. If you've been dealing with this for a while, I think seeing a gastroenterologist would be worth a try. Not that it's helped us much....What helped my DD most was youcanpooptoo. It's an online program that you can google. DD was in the pilot for it. She did great until the GI told DDhe didn't believe in milk allergies and to eat and drink whatever she wanted as it couldn't cause problems- set us back years! I don't like miralax either. Youcanpooptoo recommends exlax instead and DD did much better on that than when the GI switched her to miralax which, IMO, is worthless. She's on something else now, but I still think the exlax worked better. Youcanpooptoo recommended an enema in the morning and at night for up to 2 days with the goal of finally reaching a point where nothing but water came out. If you couldn't get to that point after 2 days, you were supposed to see a physician to check for blockages or do a hospital clean out.

 

I'd want a doctor to look further into why she is having problems. The answer that kids do it because they just want to avoid pooping doesn't fly with me anymore. Why would someone choose that? It's not comfortable to feel constipated and pooping shouldn't hurt. Why is there unusual pain? Why are the bowels possibly sluggish? Sometimes you can trace it to a food intolerance or physical problem. I would be concerned about the vomiting and would probably take DD to the Dr in the morning to check for a blockage. Vomiting can be an indicator of something serious.

[Acadie]

Poor sweetie, and I know from experience this is really tough as a mama.

 

For immediate help we used glycerin suppositories.  Not sure if you mentioned that upthread.

 

For the long term she really needs help to go every day.  Because her bowel is stretched, her body will not perceive when she needs to go at the appropriate time.  She's likely to continue to overstretch her lower bowel.  It will take months and months in a row of Miralax or some other remedy to clear her bowel regularly and give her time to heal.    

 

We used Miralax for a year or two to get past stool withholding.  I wasn't crazy about it either.  Upthread it sounds like there's an interesting, more natural solution.  But please do something, every day, for a year to give her bowel time to heal.  It's very common, it's nobody's fault, and it needs to be a simple, physical solution to get around the psychology of withholding and give her body time to heal and return to normal perception and response.

 

Amy

 

 

[marbel]

Poor sweetie, and I know from experience this is really tough as a mama.

 

For immediate help we used glycerin suppositories.  Not sure if you mentioned that upthread.

 

For the long term she really needs help to go every day.  Because her bowel is stretched, her body will not perceive when she needs to go at the appropriate time.  She's likely to continue to overstretch her lower bowel.  It will take months and months in a row of Miralax or some other remedy to clear her bowel regularly and give her time to heal.    

 

We used Miralax for a year or two to get past stool withholding.  I wasn't crazy about it either.  Upthread it sounds like there's an interesting, more natural solution.  But please do something, every day, for a year to give her bowel time to heal.  It's very common, it's nobody's fault, and it needs to be a simple, physical solution to get around the psychology of withholding and give her body time to heal and return to normal perception and response.

 

Amy

 

Yes to all the above (with usual disclaimer that I am not a medical professional and not giving advice).

 

I have one who was constipated from birth.  Seriously, the pediatrician said they'd never seen a breastfed constipated infant.  It continued for a long time, lots of withholding, lots of tears.  At least one cancelled camping trip. 

 

I'm surprised the ped is waiting 5 days to start Miralax.  That is too long, imo.  Mine was on Miralax daily for a long time, then every other day, then finally, it was over.  It took years though to get it all settled. 

 

I know not everyone agrees with Miralax use, but no natural remedies worked for us, and after the first time, enemas or suppositories were not going to be an option.  

 

BTW, it's been over 5 years and there have been no problems since.  No Miralax or other laxatives needed, either.  So there is hope.

 

[MBM]

My son had encopresis. It's a step beyond constipation and can be tricky to treat.

 

If her bowels are faccid, they are somewhat desensitized to the feeling of needing to go, so you'll want to keep her regular for a long period of time until it gets back to normal.

 

After having painful bowel movements, kids with encopresis will tighten their anal sphincters instead of relaxing because to them, going means pain. Later, when they go out to play or get lost in something mesmerizing, stool can escape. Sometimes it is just staining or sandy-like or bunny poops or even a bowel movement the size of a Coke can. It is not unusual for them to pass a Coke can-sized BM while in a warm tub because they finally relax the sphincter.

 

If she is not responding to going or is one of those too-busy-to-go kids, doing several practice sits for a few minutes at a time can help her learn to take the time to go. Ideal times are shortly after waking up, after meals, after running around and before bedtime. No pressure to produce! This is just learning to take the time to sit. For little ones, it can help sometimes to place a stool under their feet.

 

It is also really important for her to get in the habit of drinking a certain amount of water (ideally) per day. My pediatric gastroenterologist suggested 8 cups. You could fill up a pitcher daily. That way you can monitor how much she's drinking. My son was not much of a drinker so before he could do other things, he had to drink from his sippy cups.

 

I agree to find something that you can use daily that will work and then try to clear the time when she needs to go. It's a pain but well worth it.

 

At this point, I also think your daughter needs an enema. Warm baths might also help her to feel better and maybe help her go.

 

There is also another method out there that works from the bottom up -- I think using enemas? Maybe someone here can post that info for you.

 

Good luck. I hope your daughter feels better soon.

[dbmamaz]

My middle child had issues when he was little - we used Milk of Magnesia and suppositories.  He turned out to have non-celiac gluten sensitivity.  His constipation when little turned in to constant runs when older, until I finally took him off gluten (and dairy) and all  his bowel problems went away in 2 days.  Doctors really do NOT know everything.  

[Bootsie]

As a parent of a child who has suffered from constipation since birth, I know how frustrating this can be for parent and child.  The best source of information that I have found on this topic is from the clinic at Nationwide Children's Hospital in Ohio:

 

http://www.nationwidechildrens.org/constipation

 

(After years of specialists, alternative therapies, special diets, etc. we took our child across the country to the clinic there.)

 

Do not use Fleet phospho-soda enemas with a child with this problem--regular enemas are fine.  However, with my child, we never had success with enemas.  My child would vomit every time after having an enema--much like what you are describing.  

 

The Nationwide site gives a list of different therapies along with their advantages and disadvantages.  

[Lawana]

May I ask what your opposition to Miralax is?

[HappyLady]

May I ask what your opposition to Miralax is?

 

 

Well, if it's what's going to work for her I'll certainly continue it, but I'm the type that doesn't want to rely on conventional medicine for something and would rather get to the root cause of things than to put a "band aid" on it.  :)  But like I said, if I find it's the only thing that works, I'll stick with it.

[Bootsie]

Well, if it's what's going to work for her I'll certainly continue it, but I'm the type that doesn't want to rely on conventional medicine for something and would rather get to the root cause of things than to put a "band aid" on it.   :)  But like I said, if I find it's the only thing that works, I'll stick with it.

If her bowels are stretched due to prolonged constipation, in some ways she may need a "band aid" to allow for healing (which does not occur quickly).  The initial constipation could have been a one-time deal due to illness, diet, lack of quick access to the bathroom, or a number of other reasons.  Or, there could be an underlying problem causing constipation.  But, if the bowels are stretched, more can be retained and it is easier to become constipated again.  In addition, feeling is lost in the nerves making the child unaware that she needs to go to the bathroom.  

 

Although Miralax helped my child some, it was not a miracle drug in our situation (I know that it has been for many).  But, it must be used long term to allow for healing.  A common rule of thumb is that the healing takes twice as long as the child has had the problem.  So, if this has been a problem for 4 months, an 8 month Miralax treatment may be necessary, etc.  

[Lawana]

I understand completely. The problem is, though, that you and your dd have a problem. It isn't "natural" to be constipated. But until you can sort out what the actual underlying cause is (dairy, other diet, under hydration, etc.) consider that that it may do more harm than good to prolong the unnatural state. Miralax works by pulling water into the stool. In many ways, that seems preferable to artificially stimulating the bowels (ExLax) or relaxing (magnesium) them. It does address the problem of hard, compacted stools that stretch the rectum, prolonging and exacerbating the chronic issue.

[jmama]

Miralax always makes me vomit.  I know it's not supposed to, but, I've tried it several times and it makes me super sick.  I hope your poor dd gets to feeling better soon.

[LostSurprise]

There are many reasons that someone may have regular constipation. One of the most common reasons is that there isn't enough water in her system to move everything along. Over the counter medications like Miralax or Senna-lax draw water down into the large intestine in order to push things out. Many people are slightly dehydrated and don't realize it. 

 

That's the first place I'd look. 

 

 

[tabinfl]

My daughter had a similar problem at age 4, She had some hard and painful stools (an on-and-off problem since birth), so she held them, and eventually lost at least some of the tone/sensation as others have described and had problems with "leaking" and soiling her panties. She was in a pre-K class at the time and we were fortunate to have VERY understanding teachers & staff there. She had wet wipes and a clean pair of panties in ziploc bags everywhere she went, so those accidents weren't a big deal. We knew it wasn't something she could control until the underlying problem was solved, so we did our best to make it less embarassing for her (again, thankful for the preschool staff who were so helpful in this regard).

 

We were able to treat it through daily doses of Miralax, more fiber in her diet (she now asks about fiber in different foods, and makes some great choices), LOTS of water to drink, mandatory potty times rhroughout the day (she sat for several minutes or until she went, whichever came first), and occasional enemas. It took months and months before things got back to normal. You do have to get the immediate problem solved one way or another -- Miralax and home enemas will likely be the least unoleasant for all involved -- but time and patience are required for the long-twrm fix.

 

On the bright side, this girl, at age 6, now poops like clockwork nearly every evening at bedtime, and painful BMs are almost nonexistent.

[Okra]

Hi, 

 

I'm a bit late in responding with this.  But, I have had two children with terrible constipation issues.  Regarding the immediate issue of her being seriously constipated right now, I can tell you that my Ped.  would say that in this situation Miralax is not going to help.  It's not going to make it down all the way through her bowels so that she can get it out.  If you give too much when a kid is very constipated, then it will only cause stomach cramps.  She would say to give two enemas 12 -24 hours apart.  I hope you have this immediate problem solved.

 

I am going to talk with you about long-term solution.  Because really this is a long-term problem.  We struggled for YEARS with constipation with my first child. We would give Miralax for maybe three or four weeks, then wean off.  It never really fixed the problem, it was just a cycle.  Pediatrician recommended giving Miralax for a FULL year, then weaning him off.  Although I was not thrilled with this idea at all, I was also stuck between a hard place and we just didn't know what to do.  So, a year later we were weaning him off Miralax.  He had ZERO problems with going off MIralax, and has NEVER had a serious relapse.  He occasionally gets a tiny bit constipated, which we can deal with easily.  But, never like the serious problems we were having between ages 5 - 8.  I with we had just done it sooner.

 

Fast forward to another child.  Same issues.  Serious constipation.  This time I knew better.  Before we had years of struggles, we put him on long-term MIralax.  He was on Miralax for about 8 months.  When we weaned him off with no problems, he also had Zero problems.

 

Sometimes it's nice to know someone who has done it with great success.  Neither child was a problem getting off Miralax.

 

Now, one more thing.  I came across this too late, as the children were not really having problems anymore.  But, considering how much our family spent on Miralax, I would have bought this in a heartbeat, just to see if it worked.  http://www.squattypotty.com/   Healthy colon, happy life.  :)

I actually did not buy it, so I cannot say if it works.  But, I honestly wished I had tried it out when we were having serious problems.

 

We hope you get your issues resolved.  

 

 

 

 

[Tiramisu]

Her ped did say she'd throw up from drinking all the Gatorade, but since she didn't drink it all maybe I should call to see what they say.

 

Haven't read all replies yet, but I have a very healthy friend without constipation who had to do a cleanse for a colonoscopy and threw up with the Gatorade mix. She was recommended to use the other option. I think it was Crystal Light. Yes, it's artificial. 

[Tiramisu]

No, this is great!  I definitely want to find an alternative to Miralax because I just don't like using it.  I'll definitely look into your suggestions!  Thanks!

 

Our ped GI also recommended probiotics and flaxseed oil.

[trlt]

Yes to all the above (with usual disclaimer that I am not a medical professional and not giving advice).

 

I have one who was constipated from birth. Seriously, the pediatrician said they'd never seen a breastfed constipated infant.

 

We changed pediatricians when my dd was an infant because he acted like we were crazy that dd was constipated since she was breast fed. The new pediatrician listened and gave us ideas but it wasn't until she was 5 that we found a solution that worked for her (minus miralax, which we didn't want to use). It was a long, frustrating time. I still get angry when I think of how we were treated by the first pediatrician, who was highly regarded in our area.

[Tiramisu]

Poor sweetie, and I know from experience this is really tough as a mama.

 

For immediate help we used glycerin suppositories.  Not sure if you mentioned that upthread.

 

For the long term she really needs help to go every day.  Because her bowel is stretched, her body will not perceive when she needs to go at the appropriate time.  She's likely to continue to overstretch her lower bowel.  It will take months and months in a row of Miralax or some other remedy to clear her bowel regularly and give her time to heal.    

 

We used Miralax for a year or two to get past stool withholding.  I wasn't crazy about it either.  Upthread it sounds like there's an interesting, more natural solution.  But please do something, every day, for a year to give her bowel time to heal.  It's very common, it's nobody's fault, and it needs to be a simple, physical solution to get around the psychology of withholding and give her body time to heal and return to normal perception and response.

 

Amy

 

This is correct. Miralax should be used daily for several months for the bowel to regain it's tone.

[Tiramisu]

Hi Bean,

 

We went through what you are going through right now. My dd was older, though, when we had to do the clean out. She was a teen. I think if we had been diligent earlier, she would have been better off, because the constipation issue was long term. The good news is that after the clean out, she was really a different person; she looked better, she felt better, she had more energy. The clean out took a week and was uncomfortable. You wouldn't want to do this without a doctor's okay.

 

Dd was instructed to take dulcolax and ten cups of Miralax for three days. There was a specific protocol, but I can't remember exactly what it was in terms of the timing of the pills and the liquid. In any case, we had to continue beyond the three days because we didn't get results. What started happening is that loose stool came out but there was still impacted stool higher up. It was stressing me out, but the doctor told us to keep at it because when it broke up, we would know by the smell, and it would be like a log jam breaking up. That eventually happened and she's been better ever since.

 

Remember, a real clean out can take a long time but it's worth it. Regain tone after with consistent Miralax use.

 

:grouphug:  :grouphug:  :grouphug:

[catz]

Our ped GI also recommended probiotics and flaxseed oil.

I have IBS. I use probiotics daily and I actually have some ground up flax seed daily (this would work well in a fruit/veggie smoothie). These 2 things make a huge difference for me. I know you're in a crisis situation now, but ultimately, I'd be looking to help her have a healthy gut for the long term. ((( hugs )))

[MBM]

 

Now, one more thing.  I came across this too late, as the children were not really having problems anymore.  But, considering how much our family spent on Miralax, I would have bought this in a heartbeat, just to see if it worked.  http://www.squattypotty.com/   Healthy colon, happy life.   :)

I actually did not buy it, so I cannot say if it works.  But, I honestly wished I had tried it out when we were having serious problems.

 

 

The link does have videos like, "Grandma and the Squatty Potty." I'm not sure I want to get that visual stuck in my brain! LOL.

 

http://www.squattypotty.com/Articles.asp?ID=250

 

They also sell the "Turdle Loo" and "Swoosh Your Tush." Nice to see their marketing team has a sense of humor. :D

 

We used Metamucil for at least two years. That is loads of fun to get a kid to drink (not).

[Tammyla]

Prune juice...Drink a cup or big glass of the stuff and stay near a bathroom until the stuff works its magic. 

[bolt.]

My formerly-chronically constipated DD9 is taking 1 tsp (5mL, not 'a generic teaspoon') daily of lax-a-day (probably the same as mirilax: glycol 3350?) and will do so for about 6 months before I begin a plan to very gradually decrease it, 1/8 tsp per month ir two. This should help her regain the musculature of her bowel/colon/sphincter and may take 18 months or more.

 

Currently that exact daily dose is perfect for continual, regularly occurring, manageable poops... Though they can be urgent, they are no longer unfelt/uncontrolled. She now reports that she can feel the "need to go" sensation, which she could not identify for herself before.

 

Forgetting a day is not usually a problem, but 2 days off resumes the difficulty (both the constipation and uncontrolled/unfelt soiling).

 

I think this method is more successful and more strategic than waiting for such difficult levels of constipation, then attempting to clear it through extreme measures. I think of it as physiotherapy for the guts. I don't think occasional high doses of the laxative are likely to lead to regaining muscle tone, and I think the amount of laxative consumed, total, is probably less overall with the daily dose.

 

This is the first time DD9 has had reliable bowel control at all. She likes feeling in control.

[Bootsie]

One thing to remember is that for a young child who has experienced chronic constipation, the feeling of being constipated may be "normal."  If that is what they have experienced most of their life, they don't know what it is like to experience anything else.  The way a chronically constipated child reports feeling may be different from that of how a child who experiences constipation for the first time.  

[Terabith]

Any update?

[HappyLady]

Any update?

 

 

Her ped said my DD really needs to get fully cleaned out (my DD just couldn't do the Miralax/Gatorade method) so she prescribed lactulose syrup.  I haven't started her on it yet because I want to research it first.  She said it's the best alternative to drinking all that Gatorade with the Miralax.  If anyone knows anything about it, I'm all ears.  

[AK_Mom4]

DD12 was on lactose for a couple of years. She cannot tolerate even small doses of Miralax without stomach pain but Lactulose was just fine. She had no side effects and it was very gentle - no cramps. It just made her bowels move about an hour later so we planned for that. She was on a very small daily dose. It was easy to wean off too. We just started giving it every other day when she was ready and her body took over by itself.

 

Warm baths used to help dd when she would have stomach cramps from constipation.

[Bootsie]

The lactulose works by fermenting sugars and producing gas (similar to what apple juice does).  It works differently than Miralax in that Miralax causes water to be held in the stool.  Miralax is often preferred because it has "no taste" and doesn't produce gas.  But, I haven't seen any health concerns regarding the use of lactulose.

 

Was it the quantity of the gatorade/miralax, the gatorade taste, or the miralax that your daughter had trouble with.  The Miralax is not supposed to have a taste--but my child could always tell if I put a drop of it in any drink.  Is there something else that it could be mixed with that she would tolerate better?

[KungFuPanda]

My son is in a wheelchair and when he started 'skipping days' we were advised to put him on miralax. We had to play with the amounts because the recommended capful was overkill. He could taste it in plain water, but it didn't offend him in flavored drinks., though he always knew it was there. Half a capful daily is what got him back on track. If I put it him his hot tea, he didn't even know he was taking it.

 

For DS, there was a psychological component. Getting onto the toilet for BMs is a hassle for him and he needs help. (He needs no help at all to pee.) He would just choose to hold it and become constipated. Once we got him straightened out I told him if he went everyday he wouldn't have to take miralax. I keep him on track with a constant flow of fluids and fruit. I don't know why, but it worked because he made the decision to do it. He NEVER would have been that rational at 6.

 

I know your DD can't take that much Gatorade. Can you put a higher concentration of miralax into a small cup of hot chocolate? Will she eat popcorn? What about dried fruits like dates, apricots, raisins, and fruits? Is she drinking enough to pee frequently? Since she's so young and can only drink a little at a time, you may have to really stay on top of getting fluids into her more frequently.

 

I hope you get it all straightened out as soon as possible.

[HappyLady]

 

Was it the quantity of the gatorade/miralax, the gatorade taste, or the miralax that your daughter had trouble with.  The Miralax is not supposed to have a taste--but my child could always tell if I put a drop of it in any drink.  Is there something else that it could be mixed with that she would tolerate better?

 

 

It was the quantity she had to drink.  They wanted her to drink 64oz in 4 hours.  In the first hour she could only manage to drink 10oz.  After that she refused any more.  I think under normal circumstances she could have drank more, but her belly was so bloated and uncomfortable that she just didn't want to put anything else in her system.

[marbel]

 My kid took lactulose for a while. It did not help, which is why we moved to Miralax.  But I know it helps others.
 

[Tiramisu]

My son is in a wheelchair and when he started 'skipping days' we were advised to put him on miralax. We had to play with the amounts because the recommended capful was overkill. He could taste it in plain water, but it didn't offend him in flavored drinks., though he always knew it was there. Half a capful daily is what got him back on track. If I put it him his hot tea, he didn't even know he was taking it.

 

For DS, there was a psychological component. Getting onto the toilet for BMs is a hassle for him and he needs help. (He needs no help at all to pee.) He would just choose to hold it and become constipated. Once we got him straightened out I told him if he went everyday he wouldn't have to take miralax. I keep him on track with a constant flow of fluids and fruit. I don't know why, but it worked because he made the decision to do it. He NEVER would have been that rational at 6.

 

I know your DD can't take that much Gatorade. Can you put a higher concentration of miralax into a small cup of hot chocolate? Will she eat popcorn? What about dried fruits like dates, apricots, raisins, and fruits? Is she drinking enough to pee frequently? Since she's so young and can only drink a little at a time, you may have to really stay on top of getting fluids into her more frequently.

 

I hope you get it all straightened out as soon as possible.

 

Oh! This reminded me that our ped GI told us that she's found her patients do much better when they take the Miralax as a concentrated shot followed by a chaser of a drink of choice. This may be an option for the OP once the clean out is done.

[Bootsie]

It was the quantity she had to drink.  They wanted her to drink 64oz in 4 hours.  In the first hour she could only manage to drink 10oz.  After that she refused any more.  I think under normal circumstances she could have drank more, but her belly was so bloated and uncomfortable that she just didn't want to put anything else in her system.

My child was never able to drink that much at one time.  We would continue trying to get the Miralax in, even if it took a longer period than what was recommended.  Thus, even if it was best to get 64 oz in 4 hours--64 oz in 24 hours was better than not doing it at all; and we found that putting the Miralax in a variety of liquids helped more than in just one flavor of Gatorade; eg. some in apple juice in the morning, Gatorade at lunch time, etc.  

 

We found that while there may be a medically recommended dosage and method of delivery, getting cooperation and lowering the stress on the child was more important than strictly following the standard protocol.  

[treestarfae]

Magnesium to relax the muscles. Prunes/prune juice. Change diet to more fruit and veggies. Drink water. More exercise.