oneangelwaiting Posted November 12, 2015 Share Posted November 12, 2015 When my ds7 moved in with us at the age of two he was constipated. Apparently it had been a chronic problem which we weren't notified of. I initially thought perhaps it was the change of diet, being in a new home, being uncomfortable, etc. and would work itself out. Long story short, he'd poop about once every 5 or 6 days, it was a huge 24 hour ordeal complete with screaming and enormous amounts of poop. Sought medical advice, was dismissed (their doctor was not good, but I had to take them there because that was what bio mom wanted). Kept pursuing it, finally got referred to a GI specialist. He was tested for a bunch of different things, everything was negative. Basically they said once he was constipated once his body stretched out causing poop to just build up which resulted in poop getting packed into the colon making it hard to get out, and the cycle was just repeating itself. We did about 2 years of stool softeners and also required him to sit on a toilet after every meal time. Eventually he got very regular and after dinner every night was poop time. He was weaned off of the stool softeners over a long period of time, and has been off of them about 2 years now. I know it's a lot of history but I am going somewhere with this I promise! So for a while we continued having poop time after meals, and it was fine. Eventually he started to push back about not wanting to do it, not needing to poop, etc. DH and I decided he was old enough to be in charge of his own bowel movements and was old enough to understand what happens when he holds his poop in. We had talks about what happens physically, the problems and pain it causes, and how important it is to go to the bathroom when you feel like you need to go. The past few months he's pooping less and less frequently. A few times he's been constipated, and talking with him about it he says "when I'm playing I just don't want to stop to go poop so I just hold it." We've gone over and over why it's a problem and how it makes him feel and he seems to understand. Today he's very constipated, running to the bathroom about every 5 or 10 minutes but not able to get much out. I anticipate this will continue the rest of the day, he will hopefully be able to poop tonight finally. He's eating fine and drinking and functioning fine before anyone asks :) My question is, as his parents what do we do? We know it's a choice he's making to hold his poop until he literally can not hold it anymore. Do we allow him to suffer the consequences? Do we go back to having poop time? Do we keep track of his bowel movements and if he hasn't had one in a few days then tell him he needs to go try to poop for a while? I feel like he's old enough to understand and I just do not see how he isn't seeing that if he takes five minutes to go to the bathroom when he needs to he'll avoid the days of sitting on the toilet (sometimes for an hour or more!), he'll avoid the pain, etc. Any thoughts on this are appreciated! Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted November 12, 2015 Share Posted November 12, 2015 I have a 7 year old boy and I would make him sit on the pot and poop. He's not cognitively mature enough to understand the long term consequences versus the short term gain. In fact, when he's playing, I doubt it even crosses his mind that holding poop will end up being a long term problem. He just won't think of it...their brains can be THAT focused on whatever they are doing. They really do live in the moment. I would get him a set of calvin and hobbes comic books that are just for toilet reading or a fun iPhone game that it only for toilet time. 10 Quote Link to comment Share on other sites More sharing options...
sarasue7272 Posted November 12, 2015 Share Posted November 12, 2015 I think he has shown you that he isn't ready to do be in charge of this. Re institute potty time, and maybe check out this kids book about constipation. http://www.amazon.com/gp/product/099087740X/ref=pd_lpo_sbs_dp_ss_2?pf_rd_p=1944687562&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=076277360X&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=1A3CMXYGS1SY05HXKC37 2 Quote Link to comment Share on other sites More sharing options...
Guest Posted November 12, 2015 Share Posted November 12, 2015 I would return to the poop time you had instituted before, but only after he gets relief from this episode. (IOW, don't re-institute poop time only to have all that negative association of pain.) Secondly, I would also give him nuts (assuming not allergic) every single day and have him sip a water bottle all day. The nuts provide magnesium and magnesium makes you go. A lot of people become constipated in part because they barely hydrate and I think this is especially true for kids. If the stool is soft and the magnesium is doing it's job, holding it will be less likely because it doesn't stay in so readily. natural Calm is also a mag supplement I give my son or take myself that helps keep things moving regularly. 3 Quote Link to comment Share on other sites More sharing options...
Pink and Green Mom Posted November 12, 2015 Share Posted November 12, 2015 We went through this with my oldest (he was 4 when he was adopted and we could not believe the size/girth/amount of poop he passed the first day he was with us). Anyway, if he is more interested in playing than potty then I think he is not developmentally ready to take over. I would go back to re-instituting potty time daily. This child is 7, correct? I think we were closer to 8 or even 9 before my son was able to appreciate that trying daily was a lot better than holding it and going through the pain of big poop. Your son will get there eventually. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted November 12, 2015 Share Posted November 12, 2015 I'd also maybe go back to stool softeners for a while. If you are using those he won't be able to just hold it in, you know? 3 Quote Link to comment Share on other sites More sharing options...
oneangelwaiting Posted November 12, 2015 Author Share Posted November 12, 2015 Ok thank you guys! I just really struggle with the feeling that I'm being a micro manager, or not letting my kids make the decisions that they are capable of making and thereby handicapping them for life! Thanks so much for the book recommendation also, that looks great. Back to poop time we go, starting (hopefully) tomorrow. :) Sent from my SCH-I545 using Tapatalk Quote Link to comment Share on other sites More sharing options...
dirty ethel rackham Posted November 12, 2015 Share Posted November 12, 2015 I would re-institute the stool softener regime and scheduled potty time after meals to take advantage of the peristaltic action brought on by eating. 7 is too young to be in charge of taking care of a medical problem. This child may have a slow-moving bowel and this could be a chronic problem if not managed. I had a child with encopresis and I had to monitor bowel habits until early teens. 3 Quote Link to comment Share on other sites More sharing options...
FO4UR Posted November 12, 2015 Share Posted November 12, 2015 Kefir. We had bad problems with my youngest, and I think hers might be CP related, but the Kefir seriously helps. Plus, there are no bad side-effects b/c it's a healthy food product. And, I would institute the potty time again. :iagree: There are major long-term effects from constipation as a child. In fact, if he struggled for his first 2 years of life with it, he might be living some permanent side-effects already. :crying: Teach him to love good quality yogurt and kefir, and drink tons of water, and enjoy a few minutes of reading time on the potty daily. 1 Quote Link to comment Share on other sites More sharing options...
TammyS Posted November 12, 2015 Share Posted November 12, 2015 In addition to poop time, I'd also do some things that make it harder to ignore his need. 1. Make sure he's getting plenty of fiber in his diet, especially "wet" fiber from fruit and vegetables. Consider a daily smoothie with greens. 2. Make sure he's hydrating well. 3. Make sure he's getting a lot of physical exercise. Google runner's trots. 4. Have him take a warm bath daily, instead of a shower. This will assist any "beginnings" of constipation and possibly increase his urge to go. Good luck. 3 Quote Link to comment Share on other sites More sharing options...
MomatHWTK Posted November 12, 2015 Share Posted November 12, 2015 You may need both physical and psychological intervention to get him fully recovered. There can be serious consequences if untreated. :( http://www.mayoclinic.org/diseases-conditions/encopresis/basics/definition/con-20029758 1 Quote Link to comment Share on other sites More sharing options...
bolt. Posted November 12, 2015 Share Posted November 12, 2015 I have a 10yo girl with similar issues, and I, too, have trouble with the idea of dictating to her when she must poop. My solution is that I keep her on a very low dose of lax-a-day (same as mirilax, as far as I know) along with prunes and probiotics -- so that it can't be successfully held for long enough to re-cause the original problem. I talk to her a lot about the convenience of 'now or later' -- "Is it better to go now, before you start play, or during play?" / "If not now, when will be better? What will be better about it?" She also wears panty liners to help with 'held it so long that it came unexpectedly' moments. It really helped when I stopped veiwing this as a childhood problem that would go away -- like some kind of extended potty training issue -- and started viewing it as 'maybe she's got these guts for life, and needs to be scaffolded towards an effective long-term strategy'. I think that was when she was around 7. It was the second great epiphany -- the first was around 5, when I realized it wasn't actually a potty training issue at all, and I decided to believe what she was telling me about it. 1 Quote Link to comment Share on other sites More sharing options...
Bootsie Posted November 12, 2015 Share Posted November 12, 2015 This can be an ongoing and frustrating problem for everyone involved. I would suggest seeing a GI specialist that specializes in constipation--they can be difficult to come by. A good counselor/psychologist that has experience in this area can also be helpful. While you have had times where he has not been constipated, he may be a child who is going to tend to struggle with constipation--and once the cycle begins, it is very hard to undo it. The last thing you want to do is get into a power struggle. The best help we found was through Nationwide's Chidren's Hospital in Columbus, OH: http://www.nationwidechildrens.org/constipation. They have a lot of online information and advice. Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted November 12, 2015 Share Posted November 12, 2015 Bring out the Miralax and do a one-time dose and reinstitute potty time. If it is a continuing issue, I'd go in to the ped. You don't want to have things get so bad that you end up in an encopresis clinic, iykwim. Quote Link to comment Share on other sites More sharing options...
LifeLovePassion Posted November 12, 2015 Share Posted November 12, 2015 I found this on pinterest http://www.mommypotamus.com/constipation-candy/ We have also used natural calm with good success 1 Quote Link to comment Share on other sites More sharing options...
JumpyTheFrog Posted November 12, 2015 Share Posted November 12, 2015 About half of poop is dead bacteria, so anything that feeds the gut flora should increase volume and decrease transit time. I second the vote for kefir (if he can handle dairy). Magnesium at bedtime may be useful. I'd also push probiotics, lots of water, and lots of *soluble* fiber from fruits and veggies. Finally, an elimination diet may reveal some intolerance that is causing or making the constipation worse. 1 Quote Link to comment Share on other sites More sharing options...
MyLittleBears Posted November 12, 2015 Share Posted November 12, 2015 Has he been tested for intolerances? My ds had a bowel movement only a couple of times a week and always constipated. It turn out he was dairy intolerant. We eliminated that and things improved a lot. Also, giving him probiotics would work to get the gut healthy and stimulate movement. May a probiotic daily for about 3 months. Quote Link to comment Share on other sites More sharing options...
Jen in NY Posted November 12, 2015 Share Posted November 12, 2015 OP and PPs ... it sounds like you are dealing with encopresis, which definitely needs medical intervention for the physical symptoms and consequences. It is also sometimes exacerbated by anxiety (if your child has OCD or anxiety tendencies), so if you think that might be the case it might be worth looking into addressing those things, too. At some point, it's just beyond what a kid can handle or control. We went through this, too, and it wasn't an easy fix. :grouphug: :grouphug: :grouphug: Quote Link to comment Share on other sites More sharing options...
kentuckymom Posted November 12, 2015 Share Posted November 12, 2015 Just chiming in to say, no, you're not alone in this struggle, and, no, 7 is not old enough for a child with a history of chronic constipation to manage his own bowel movements. Go back to the potty time for sure, and go back to the stool softener if that doesn't fix it. My DS (10 years old)had chronic constipation that caused encopresis for many years. After years of us thinking it was his fault and the doctor not taking our concerns seriously we finally saw a GI specialist last spring. She put him on ex lax and also referred us to a psychologist who specializes in this issue. After a lot of work, we've finally reached the point that he's close to weaning off the exlax and we're no longer seeing the psychologist. However, we still have to dictate when and for how long he uses the bathroom. I anticipate that we will continue to need to do that for at least another year, even though he doesn't really like it. He does, however, like not being constipated and not having poop in his underwear, so we remind him of that when he tries to fight back. Quote Link to comment Share on other sites More sharing options...
Joules Posted November 12, 2015 Share Posted November 12, 2015 You've gotten lots of great advice. I have one more suggestion. Look at his posture for potty time. There is more and more evidence for the biomechanical advantages of squatting to poop. Sitting with his legs hanging down like kids are apt to could make things worse. Some of it is explained here: http://www.squattypotty.com/5-problems-with-sitting-on-your-toilet/ though you don't really need to buy something to switch positioning. Fair warning: If you search the site, the unicorn video is only for those who have been told they have a questionable (warped?) sense of humor 😀 3 Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted November 12, 2015 Share Posted November 12, 2015 You've gotten lots of great advice. I have one more suggestion. Look at his posture for potty time. There is more and more evidence for the biomechanical advantages of squatting to poop. Sitting with his legs hanging down like kids are apt to could make things worse. Some of it is explained here: http://www.squattypotty.com/5-problems-with-sitting-on-your-toilet/ though you don't really need to buy something to switch positioning. Fair warning: If you search the site, the unicorn video is only for those who have been told they have a questionable (warped?) sense of humor 😀 My son has no poopiing issues, but he kind of crouches on the toilet to poo. So weird, but he undresses from the waist down and perches up there. Quote Link to comment Share on other sites More sharing options...
Farrar Posted November 13, 2015 Share Posted November 13, 2015 My ds have had some mostly minor issues with this over the years (it used to be a huge problem when we traveled until we worked out a travel routine). In addition to all the good advice you've been getting, our experience is that this waxes and wanes over the years and the ped implied to us that's common - as kids grow their bodies have to adjust and kids who have had issues in the past may have them crop up again. She's a super hippy type ped, but she was like, don't worry about how much Miralax you use. It won't hurt to stay on it and there's no reason not to use it when you need it. Don't wait. In other words, weaning him off isn't necessary. Also, note that the consequences aren't just in the moment. If he's having trouble going, it's not just a one time and then over thing (at least not for him because it's a chronic problem). Every time he's stretching out his system and making it worse for the next time. You want to head that off. I wouldn't even let my older kids be in charge of that and this kid is just 7. Quote Link to comment Share on other sites More sharing options...
Farrar Posted November 13, 2015 Share Posted November 13, 2015 You've gotten lots of great advice. I have one more suggestion. Look at his posture for potty time. There is more and more evidence for the biomechanical advantages of squatting to poop. Sitting with his legs hanging down like kids are apt to could make things worse. Some of it is explained here: http://www.squattypotty.com/5-problems-with-sitting-on-your-toilet/ though you don't really need to buy something to switch positioning. Fair warning: If you search the site, the unicorn video is only for those who have been told they have a questionable (warped?) sense of humor 😀 Oh, I totally second the squatty potty. Best thing ever. Doesn't look weird in your bathroom (at least, that's what I'm telling myself). Quote Link to comment Share on other sites More sharing options...
bolt. Posted November 13, 2015 Share Posted November 13, 2015 Also, it's probably time to start changing your vocabulary around this. He's a big kid, so it might be time to start saying, "Use the toilet" and perhaps introduce ephamisms that aren't babyish or humiliating. (For example: we say, "Gut troubles." And , "Laundry issues." As ways of taking the sting out of the problem.) Also (in case you are like me) a reminder that people who aren't toddlers don't like it when they overhear their parents discussing their poop with others out loud, in public. (It took me reficulously long to clue in to that.) Quote Link to comment Share on other sites More sharing options...
Classic Mom Posted November 13, 2015 Share Posted November 13, 2015 I have a child who has struggled with this and I know how difficult it is. First, you need to contact a pediatric GI doc to work with you to address this problem. Second, if he is severely constipated at this point, he is going to need a clean out with mag citrate or miralax (see GI doc for dosing information based on weight). Third, he probably will need an on going toileting program and meds (stool softener, miralax, laxatives, etc.) to prevent severe episodes of constipation. One way to monitoring bm's in kids that gives them some independence is to use a cell phone camera- they take a picture when they poop and text it to Mom to verify that they are going every day. (It is sounds strange, but it is much better than needing to have a parent verify each visit to the bathroom.) Fourth, he should be worked up for underlying causes of constipation (Celiac disease, Hirschsprungs, thyroid issues, bladder issues, etc.) It is most likely that it there is not a medical cause for the constipation, but it is important to rule out a medical cause. Hope this is helpful. Quote Link to comment Share on other sites More sharing options...
oneangelwaiting Posted November 13, 2015 Author Share Posted November 13, 2015 Thanks guys. He's already been through the whole gamut with the GI specialist (testing for celiac etc) as I mentioned and has been off meds for 2 years now with mostly no problems until the last few months. We did have several follow up visits to ensure everything was moving along properly and to monitor his meds etc. He did finally poop (hooray!), and seems to be feeling about 100% better. We'll reinstitute a regular bathroom time and if he continues getting plugged we'll make further changes. Definitely not our first rodeo with this and we don't want to have to go through the 3 year process of meds, cleaning out, maintaining, doctor visits, etc. which we have been through already. The comment about his body changing and possibly resulting in problems again made a lot of sense. We shall see if regular potty times fix the problem or not, here's hoping they do! Sent from my SCH-I545 using Tapatalk Quote Link to comment Share on other sites More sharing options...
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