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Help with constipation


naturegirl
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I was hoping that since I haven't gotten anywhere talking with my son's pediatrician, the Hive may have some advice. My son is six and has had trouble with constipation off and on for years. Several months ago he has started to get really bad stomach aches. I took him to the doctor and they X-rayed his stomach and they could tell he was very backed up.

 

I started tracking how much fiber he got in a day and made sure he was getting at least 25 grams a day. We stopped going out to eat. I also started giving him yogurt every day and making sure he drank at least four cups of water in addition to his cup of juice in the morning and his cup of milk at night. After a couple of weeks it looked like it was working and his constipation and stomach aches seemed to clear up. 

 

But now it's back again, and the diet that worked before doesn't seem to be working. The doctor recommended Mira-lax. This has never been helpful for him in the past, but even if it was I don't consider it to be a good long-term solution.

 

So what have people had success with? I'm looking for anything that may help with the constipation short term so I can get him cleaned out. Also, foods that are a good source of fiber. My son is very picky, so he doesn't eat a whole lot anyway. But I'd love to hear about plain foods that are high in fiber. He will eat a decent number of vegetables, all raw, but no fruit.

 

I also want to try to figure out some long-term solutions. I feel like every time I think we have this problem under control it creeps up again. Also, I want to be able to go out to eat as a family. His whole life I've always brought a vegetable with us when we go to a restaurant. So even when we go out, he is always eating the peas or spinach or whatever else I've brought from home, so there at least some fiber that he is getting from that. But trying to make sure he gets 25 grams of fiber a day, there is no way he can just get three or four grams of fiber for one meal (as he would when we go out) and still make what he needs in a day.

 

Anyone have any suggestions or advice to offer?

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I have a child who has suffered from constipation since birth.  I have found the most helpful information from Nationwide Children's Hospital in Columbus, OH:

 

http://www.nationwidechildrens.org/constipation

 

Not all constipation problems can be solved by increasing fiber.  (In fact, with some motility issues,, increasing fiber can make the problem worse.)  You say that he won't eat fruit.  The sugars in some fruits can be helpful in addition to the fiber.  Is there any fruit that he will eat?  Raisins on oatmeal?  Apple raisin muffins?   Pumpkin is high in fiber and can be added to pancakes and other baked goods.

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I have a child who has suffered from constipation since birth.  I have found the most helpful information from Nationwide Children's Hospital in Columbus, OH:

 

http://www.nationwidechildrens.org/constipation

 

Not all constipation problems can be solved by increasing fiber.  (In fact, with some motility issues,, increasing fiber can make the problem worse.)  You say that he won't eat fruit.  The sugars in some fruits can be helpful in addition to the fiber.  Is there any fruit that he will eat?  Raisins on oatmeal?  Apple raisin muffins?   Pumpkin is high in fiber and can be added to pancakes and other baked goods.

 

Thanks for the link. I'll check it out. I may be able to sneak something like pumpkin into pancakes. I'll have to look for some recipes.

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Thanks for the link. I'll check it out. I may be able to sneak something like pumpkin into pancakes. I'll have to look for some recipes.

I have added canned pumpkin to a number of different pancake and waffle recipes-everything from add only water mix to whole wheat and oatmeal pancakes made from scratch.  I usually add about 1/2 a can to a recipe that makes pancakes for 3 to 4. 

 

What about an apple cake or pear cake?  

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I have added canned pumpkin to a number of different pancake and waffle recipes-everything from add only water mix to whole wheat and oatmeal pancakes made from scratch.  I usually add about 1/2 a can to a recipe that makes pancakes for 3 to 4. 

 

What about an apple cake or pear cake?  

 

When you add the pumpkin to pancakes do you replace the liquid or add it in addition to the liquid?

 

An apple or pear cake may work. I'll look into that, thanks.

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Will he eat nuts? Both the fiber and the good fat in nuts should help some. Pecans and almonds are very helpful here, and pecans are easy to candy lightly with maple syrup if that will help get them into him. 

 

He will eat nuts. Maybe I should focus on getting him to eat those more and in greater variety. I tend to give him peanuts quite often, but I probably need to think about getting him more variety. Thanks.

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Will he drink water with a bit of lemon? That can help. The other thing if you have fluid and fibre sorted, it can be that a little more movement, especially long walking can help to get things moving.

 

I've read that water with lemon is suppose to be good. I may try that. I would love for him to get more movement in. Unfortunately between cold season and the weather, we haven't gotten outside nearly as much as I would like, so that may be contributing to his current problems. 

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I had one that suffered from major constipation starting after an out of state move.  He went on to have issues for 1-2 years with withholding and so forth.

 

A few things.  We used Miralax.  I was reluctant and didn't want to use it long term really, but at the time, it was the best option.  Upping fiber did nothing to help my child.  FWIW, I have another child who sometimes gets a little constipated, and in contrast, if we stay on top of it, lots of berries, cut back dairy, etc. he does fine.  Anyway, the child that had the worst issues with it did do better if we eliminated bananas and dairy in general, but that wasn't enough. 

 

Another thing is to have them attempt several times a day on a schedule, and have them use a stool to support their feet, giving them a more secure base. 

 

I still think we stopped the miralax too early.  He had lingering encoperesis issues from probably age 3-4 as a result of the ongoing constipation.  It really is a long process to bowel retraining, and I wouldn't take it lightly, because the repercussions can last.  That said, there was a recent NYT story about ongoing concerns with long term Miralax use.  You may want to consult with a GI doctor for some guidance.

 

Fiber isn't a fix all for all cases of constipation.  You may need to explore other means.  And even when they seem to have normal BMs on a fairly regular basis, it is important to consider whether there are still lingering issues.  Kids with chronic constipation often have overstretched bowels that can hold a lot of stool, so sometimes only the soft stuff is eliminated.  If it is a chronic problem, it really can take a LONG time for them to return to a true normal.

 

You could ask an MD about a magnesium supplement possibly?

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Psyllium and flax didn't help my child at all, so like anything YMMV.  I just bring that up to emphasize fiber won't fix every case of constipation.  My child ate plenty of fiber and it did nothing for him at all.  Cutting dairy, increasing liquids, cutting bananas helped a small amount.  If you've been trying fiber for a while and it isn't making a noticeable difference, I'd consider whether you need to add some additional things.

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When you add the pumpkin to pancakes do you replace the liquid or add it in addition to the liquid?

 

An apple or pear cake may work. I'll look into that, thanks.

I usually just add it without making any adjustments to the liquid.  If it appears a bit too runny after I add the pumpkin, I just add a bit of flour until I have the correct consistency.

 

If your son won't eat any fruit--fresh or dried, I think I might try to explore if there is something else going on.  If he refuses apples, oranges, grapes, applesauce, raisins, pears, etc that is a variety of flavors and textures.   I don't know his age and the last thing you want is for food to become a battle.  It took me a long time, but I finally learned to listen to my child's body  

 

I would not necessarily be afraid of longer term use of Miralax.  It can take a long time for the problem to straighten itself out.  (I will say however, that Miralax did not work in my child's case.)

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How much liquid is he really drinking? At least 40oz/1liter? If you don't really know fill up a bottle at the beginning of the day and have him drink only from it. You can see how much he's really getting and how much is missing. 

 

If he'll eat muffins you can get a lot of fruit and fiber in there. 

 

Senna/senna-lax/etc. is a slightly more natural stool softener that is available over the counter. Also, if it has gone on too long it may be too impacted for miralax/water/fiber to work. A glucose suppository can be done rectally (and by that I don't mean you have to insert it rectally but just kind of squirt it in there from the outside) which will soften the impacted bottom of the stool and the rest slides out because you've been taking care of water/fiber/etc. This does happen. We start treating as a reaction and the treatment can't get to the bottom of the colon. 

 

Lastly, is it possible he's dealing with a lot of anxiety? Some people just don't deal with change well or are more anxious. If he's an anxious kid you may want to talk to your pediatrician about therapy, diet, exercise, natural supplements, etc. 

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One of my kids used to have problems whenever he ate cheese or yoghurt.  Other dairy foods didn't cause a problem. Now that he is older he can eat small amounts of cheese as long as he has plenty of fiber.   Other child had a hard time telling when he had to go to the bathroom which resulted in bouts of constipation.  After a few discussions about signs to look for and going regularly, he improved. 

 

I sometimes add flax, prunes and even beans to brownies.

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Psyllium and flax didn't help my child at all, so like anything YMMV.  I just bring that up to emphasize fiber won't fix every case of constipation.  My child ate plenty of fiber and it did nothing for him at all.  Cutting dairy, increasing liquids, cutting bananas helped a small amount.  If you've been trying fiber for a while and it isn't making a noticeable difference, I'd consider whether you need to add some additional things.

 

This is a good point. I've been focusing on fiber, but I probably need to look at other strategies as well. Thanks.

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Fiber isn't a fix all for all cases of constipation.  You may need to explore other means.  And even when they seem to have normal BMs on a fairly regular basis, it is important to consider whether there are still lingering issues.  Kids with chronic constipation often have overstretched bowels that can hold a lot of stool, so sometimes only the soft stuff is eliminated.  If it is a chronic problem, it really can take a LONG time for them to return to a true normal.

 

I think this is a good point. He's had issues for so long, this may take years to actually resolve. I've read about bowels getting overstretched and I have a feeling that is what is going on with my son. So I think I need to remember that even if it seems like his bowel movements are back to normal, I need to keep watching it for a long time. 

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Also want to add that gardening helped my kids branch out into eating new fruits and veggies.  Sweet peas, green beans and lettuce are now all staples since the kids grew them.  Also they have blueberries and raspberries from the garden but don't like store purchased ones.

 

This is a really good idea, thanks. Maybe if I have my son choose what he wants to grow he will be more likely to eat it.

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If you're giving him juice, start mixing a little prune juice with it, plus a tbsp of psyllium husk fiber. Let it thicken a bit and have him chase it with more water. If it is a motility issue with his muscles, that will help immensely.

 

This is a good idea. I hadn't thought to mix the prune juice in with his regular juice. I will try that. Thanks

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