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Forum Name: Pediatric Topics

Question: Chronic Constipation in 3yr old


 annemarie - Mon Feb 07, 2005 6:07 pm

Our 3 year old daughter suffers from chronic constipation. We can't remember exactly when the problem became apparent but it has gradually gotten worse over the last 2 years. She was breast fed for 9 months and she never suffered with it during that time. She did get it occasionally even before starting potty training so we don't think that triggered it, although it may have made the problem worse. She has always been a fussy eater which we're sure was the main cause originally but think fear of painful bowel movements is now the most contributory factor. We are fully aware of the dietary changes required but unfortunately in the past she wouldn't eat the recommeded foods. We have tried prune juice, califig, mixing linseed with porridge, bran, peaches, pineapple, pears, increasing her fluid intake which has proven reasonably effective when successfully consumed. Unfortunately it becomes a constant battle to get this combination of foods into her, to the point where she goes off the idea of eating. We have even tried taking her off cows milk and replacing it with soy and goats milk but this has proved uneffective. We have tried laxatives on the advice of our doctor, 10 to 20 mls of milpar and 10 to 20 mls of duphalac every day. This actually works when we can get her to take them but yet again we can't force them on her, expecially the milpar. We have tried mixing it with milk and the like but to no avail. She throws a fit even if she sees the bottle. We don't normally let her go without a bowel movement for more than 5 or 6 days without interveening because of the difficulty in passing large hard stools, stomach cramps and emotional distress. In this case we would resort to using a glycerin suppository. However the suppository doesn't even get a chance to work as the insertion alone is enough to stimulate a BM. Plus, when it comes to giving her a suppository, it is a stressful and traumatic time for all concerned. Lately her appetite has increased so yet again we are going to try re-assesing her diet. In general she has a healthy appearance. She has good muscle tone, is above average height for her age and is of average weight. There are no problems with her development physically or mentally. She has lots of energy most of the time until she becomes constipated again. We feel that it has become, predominately, a psychological issue but would like medical advice on whether this case would govern the need for internal examinations for diseases such as hirschsprung's etc.
 Dr. Heba Ismail - Tue Feb 08, 2005 3:35 pm

Dear annemarie,
I agree with you that the underlying cause to this constipation problem is probably physcological, known as ' functional constipation' resulting from prolonged withholding of stools for fear of inducing pain, resulting in harder stools and more pain, together with progressive dilatation of the colon, gradually accomodating a larger volume of stools with longer periods of constipation. Hirschsprung's seems unlikely as you've mentioned the problem at least didn't appear during the first 4-6 m of age.
I don't believe the condition requires further investigation, as that would be even more traumatizing to her, unless, of course, her doctor doubts the diagnosis for any reason.
You seem very aware of her condition and I encourage you to continue with what you're doing. I don't believe I can add much except that may be it would help to try and set regular times for defecation, especially after feeding, as that usually moves the guts a little bit, and try to find a way to give her the laxatives, it would help alot.
 britface - Thu Mar 10, 2005 9:00 pm

our daughters also suffer from cronic constipation. we have used a laxative called glycolax for our youngest that is 1 year old. we mix it in her milk in the am. i don't believe that it has a real flavor or changes the taste of the milk. our daughter does not act like she even notices it is there. The amount you give your child is gauged by how it affects her. our 1 year old was prescribed 2-3 tsp 2x a day. But it only takes her about 1/5 of a medicine measuring cup 1x a day. i believe it works wonderfullly. our first daughter had a very restricted diet up until she was 3 1/2 because of constipation. beware of bananas, white bread and cheese. i hope any info i have given you helps you out. good luck.
 nonpoopers_mom - Thu Sep 29, 2005 6:08 pm

My son has been constipated very often i started having to use Benefiber it completely dissolves and does not get thick. But right now that is not working so I bought some chewable chocolate exlax and am waiting for the results. You might want to try it especially if she likes chocolates!

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