Constipated 2 y.o. Any tips and tricks?

[J B L]

Hello all,

Our little girl hasn't managed a proper poo since last Sunday and even then it was golf ball sized with pretty much the same consistency.

The GP on monday gave her some Movicol to take twice a day. Said it should have cleared in 2 days but nothing has come through. She's still quite brave and tries to push but clearly struggling and I'm afraid she'll be reluctant to push in the future by fear of pain.
The other thing I am concerned about is an occlusion.

She eats well (well, not this past few days), greens, fruits etc... She'll go through several glasses of prune juice a day and we are making her move as much as we can.

So, it's been a week and we can see her discomfort growing. Before we go to A & E, anyone's got anything we could try to make her go and bring her some relief?

Thanks for your help.

[wiffmaster]

Lactulose.

Comes in liquid form and is not particularly unpleasant taste wise. Will have her sorted out within a few hours. Will be able to buy it OTC from any pharmacist.

[bexVN]

I was going to say prune juice but you're already doing that, otherwise gentle tummy massages, leg cycling and plenty of water. If you've tried all that with no joy and on top of that had medication from the doc who said 2 days then I think it's time to seek more help.

A&E may seem drastic but if she continues to strain unproductively there could be a risk of tears etc. As it's the weekend I don't think it's wrong to consider going to them.

[J B L]

That's what was given to us once but the GP said it won't be strong enough. Will try again.

The GP said what she gave was stronger anyway (we asked). The previous bottle was a bit old so we'll get some tomorrow. Can't hurt. Cheers.

[bexVN]

So has she had lactulose before?

We px it for animals but with caution. It works by absorbing fluid via would normally be taken up by the body, so softening the stools but it can also make the bowel lazy if used too much.

If you get some ask for the pharmacists advice first re length of use etc.

And there was me worrying when my 2yr old didn't pass anything for 24hrs!

[wiffmaster]

J B L said:

That's what was given to us once but the GP said it won't be strong enough. Will try again.

The GP said what she gave was stronger anyway (we asked). The previous bottle was a bit old so we'll get some tomorrow. Can't hurt. Cheers.

It worked for me when I didn't go for 11 days (two general anaesthetics in three days - don't ask!). There again, I paid little attention to the recommenced dosage and just took a few 'shots' every couple of hours. But that's probably not a great idea with a two year old. Keep up her fluids/electrolytes (I'm sure a two year old would love that still Lucozade you can buy) and see if the lactulose can shift it.

[Hoofy]

Milpar? Lots of water? Lots of exercise? She'll st herself by lunchtime.

[davethebunny]

Vaseline and your little finger

[mph1977]

wiffmaster said:

Lactulose.

Comes in liquid form and is not particularly unpleasant taste wise. Will have her sorted out within a few hours. Will be able to buy it OTC from any pharmacist.

If movicol is not working lactulose will NOT work - lactulose is remarkably ineffective unless used properly - it has NO purgative effect - any incidental relief from constipation is due to 'popping the cork' as the greater volume of bukled soft stool comes into the rectum.

lactulose, like movicol aims to bulk the stool by drawing and holding extra water in the gut lumen.

sometimes it is necessary to admit children as a day case, sedate them and perform a manual evacuation to resolve the initial constipation and then the use of movicol, lactulose or fybogel as a prophylactic measure may be indicated to maintain a softer, bulkier stool.

[Pints]

davethebunny said:

Vaseline and your little finger

+1
This also helps stop the tears.

[mph1977]

Pints said:

davethebunny said:

Vaseline and your little finger

+1
This also helps stop the tears.

great ...

i presume you are fully aware of the risks associated with performing manual evacuations before suggesting this, however jocularly you do so ...

[Pints]

mph1977 said:

great ...

i presume you are fully aware of the risks associated with performing manual evacuations before suggesting this, however jocularly you do so ...

Let's all calm down. I wasn't suggesting an evacuation (and certainly no attempt at being jocular - hardly appropriate with a 2yo).
I had in mind simply ensuring the area was kept suitably greased for when it did eventually happen more naturally.
I'd have thought the words I used would have suggested as such.

[K77 CTR]

Speak to the out of hours doctor before going to A&E. If they feel hospital is appropriate they will refer to the right people rather than be seen by junior dr and then be referred to right dr.

[J B L]

Thank you all for the replies.

We tried all the NHS options already. I was expecting the wisdom of PH to shine through as a last resort.

Out of hours doctor said to go to hospital. By then the little one was fast asleep so we left it at that.

Still nothing this morning, here we are off to hospital to see what can be done.

[Pot Bellied Fool]

Good Luck OP.

Hope you get it sorted. By coincidence, our 2 yo has been in the same position this last week, bought some OTC Lactulose after consulting a pharmacist and last night saw a poo of epic proportions. And she too was happily guzzling plenty of fluids, veg etc. I guess it's not that an uncommon occurance as things develop.

Hope by the time you read this, you're upto your arms in soiled baby wipes!

[J B L]

I wish.

Called NHS direct who told us to go to A&E but couldn't book an appointment with any doctor there (although they did it in the past for other things but apparently it wasn't possible this time...).
Went to Coventry, 6 hours wait so spent another 1.5h on the phone and finally managed to speak to a proper pedaetrician (Sp?) who said the Movicol treatment given by the GP was incorrect and the dose should have been much higher from the start.

So we are now back from A&E and she's bravely guzzling down 2 doses of Movicol disolved in prune juice (+2 again this afternoon). If that doesn't do the trick we ought to go back to the GP tomorrow and request an enema. Fingers crossed I get them stinky (not in a good way) this evening

[mph1977]

J B L said:

I wish.

Called NHS direct who told us to go to A&E but couldn't book an appointment with any doctor there (although they did it in the past for other things but apparently it wasn't possible this time...).
Went to Coventry, 6 hours wait so spent another 1.5h on the phone and finally managed to speak to a proper pedaetrician (Sp?) who said the Movicol treatment given by the GP was incorrect and the dose should have been much higher from the start.

So we are now back from A&E and she's bravely guzzling down 2 doses of Movicol disolved in prune juice (+2 again this afternoon). If that doesn't do the trick we ought to go back to the GP tomorrow and request an enema. Fingers crossed I get them stinky (not in a good way) this evening

Emergency Departments do not offer appointments, I would suspect that inthe past such appointments have been either for primary care or because speciality doctors did not have a suitable place for seeing assessment patients.

quite why nither NHS (re)direct nor the OOH primary care service couldn't have organisaed a paeds assessment appointment i don't know.

[Mave]

We've found that a long bath in warm water deep enough to cover the tummy, and feeding warm water also helps, it seems to hel[p the muscles relax.

[Coco H]

Had this with my youngest when he was a baby. He went 8 days once. He ended up on movicol and suppositories from about 3 months old. We had to keep him on for about 3 months.

[SWAT78]

Has she blown yet, OP?

Still yet to experience the joys of parenthood myself. Threads like this one make it sound so appealing...!