Chronic Constipation in Toddler

He needs to be seen by a Pediatric Gastroenteroligist. My daughter has a bowel disease and has seen this specialist almost her entire life and will continue.

You seem to be on the right track with getting water in him and trying to balance his diet. We learned the balancing needs to be with EACH meal. There must be fruit or vegetable consumed each time food is eaten.

His body is going to depend on the suppositories to have a bowel movement. You really need to get away from that. With his lack of weight gain and lack of hunger and then not pooping, you really need to get him to the Pediatric Gastro Specialist. This is something he can not control. This is not something he is making himself do. The quicker you can get him seen, the better.

If you have already worked w/ your doc to rule out any other problems I suggest seeing Nancy Glass Quatrin @ the Encoptesis Treatment Center in Edmonds. Our pediatrician referred us there when my son was a toddler w/ chronic constipation. Best of luck to you!

Just from reading your post. You probably know all that I'm going to say;-))

It sounds like it is a spiral effect. His gut is all off balance. I would get to a GI specialist before some other more serious problem arises.
He probably doesn't like food because it hurts to eat them.. like prune juice probably gets his little gi tract moving that hard stool and that hurts. Does he get a BALANCE of fluids and fiber? Another thought.. not all probiotics are equal. We used some that my MD advised for my sons GERD to use had them shipped to our house. BioGaia
http://www.childrensprobiotics.com/faq.aspx
It sounds like the doc might have to stop all foods execpt a very small few to get him back on tract.
the fact that he has hemorrhoids sounds like you need a second opinion. Maybe he has something going on his colon and a problem with reabsorption of water?? That's why I suggest a specialist and more tests.

My daughter is 12 and has chronic const. all her life. Same thing as a baby where you'd hold them while they screamed until it was over. Gloculax is what her Dr. finally gave her. It's tasteless and goes in their water or juice daily. I don't know if you're going to a GP, pediatric dr. but if you're getting no results even though they're monitoring him I'd go to a specialist. Your case seems a little more severe than my daughters. A CT scan will actually show blockage. One time my daughter had severe lower abdominal pain and took her to the ER they thought it might be her appendix and did a CT scan only to find blockage plain as day. It may be nothing he's eating and something else in the mechanics of his muscles surrounding the colon or intestines. Meaning they aren't manipulating correctly. I don't know. But the more (no apple juice) fluids you can do the better. Do white grape juice. Water it down. She didn't like juice much either but w/the glucolax and grape juice it was mile tasting and she loved it. And all that pasta, rice stuff like that will actually bind up more than promote a BM. I mean think of the BRAT diet when they have diarhea. Bananas, Rice, Apples and toast. They do that purposely to harden the stool. So if that's what he's eating you may be hindering it. Less pastas, rice, grains, more fruit, vegis. And if you're not already seeing one I'd go to a specialist for the digestive system (can't remember what they're called). Good luck to you and you can email me if you have more questions I know what you're going through. They're in so much pain but you can't help and it sucks.

L.

Wow I feel for you. My niece who is 4 is just like this. They have done every test they can and find nothing wrong. Basically they tell her she is just holding it on purpose because she's scared it's going to hurt when she goes. I'm not sure if I believe this or not. However they have found dairy products play a huge factor in it. They limt her on cheese and milk mostly since that is what she loves. They give her miralx when she needs a little help going potty. This use to be a prescrition but is now available over the counter I believe. I'm not sure on the age though. I'm not much help but wanted to share what I do no. And like your son she is very small for her age and is usually in the 20th precentile or so. Also they do prune juice but I know you said your son dosen't like this. how about apple juice instead?

A few simple ideas that I didn't see reading the first 10 or so posts: Try feeding him oatmeal for breakfast (homemade) mixed with apple juice. Apple juice gives many kids diarehhea, so it should help loosen stools. Also I gave my daughter Karo Syrup when she was constipated. I have even used it for myself. 1/2-3/4 of a teaspoon should be plenty. It usually works within 4-5 hours! I know it is pure sugar, but it's gotta be better than chemical laxatives which are addictive( the more you use them the more you need them). Also milk intolerance (not a true allergy) can cause constipation. Have you tried eliminating all dairy products? Gluten intolerance, again not a true allergy, can also cause constipation. I have had constipation all my life. Now that I am not eating gluten (found in barley, wheat, and rye flour) my constipation is gone. If he isn't gaining weight as well, I would ask the Dr. to test for Celiac disease, he can do so with a blood test. I do not have celiac, I have a gluten intolerence. Many allergists don't acknowledge that intolerences exist and will give an allergy test which will be negative. I know wheat bothers me as everytime I eat it I get diarehhea and terrible stomach cramps.
Please feel free to email me if you have more questions.
B.

I'm so sorry you're going through this - it's so heartbreaking to see your little one in so much pain!

My son's constipation wasn't quite this bad, but close. We upped his fruit intake (especially right after a bm, as he was most willing to eat then), went to mostly water with juice instead of milk or formula (against recommendation, but it was better that he clean his system out so he could eat the nutritious foods than try to eat them when he was hardly eating at all), and added Fleet's Pedialax stool softener (I can only find it at Rite Aid and Walgreen, though other pharmacies carry more of the Fleet line) to whatever he was drinking, once a day. The directions say to start with a certain dose (2 tbs I believe) and adjust up or down, but as he was not even twelve months at the time, we started with 2 tsp, which ended up being perfect for him. Now, at 19 months, we're down to one dose (of 1 tsp) about once a week, if he's had more milk or cheese than his body can typically tolerate. He has a bm once a day usually, sometimes it'll stretch to once every second day, especially after having cheese and such.

I know this might not work for you, as the problem sounds more severe, but I'm hoping it will.

Good luck!!

Although there are wonderful suggestions from other moms already, I started taking our now 3 year old to a chiropractor when he was an infant and started experiencing the constipation problems. He still sees Dr. Doug Rody (at Rody's Chiropractic in Puyallup) whenever he gets stopped up. With the amount of running and jumping, his lower back gets kinda tweaked in just a way that his insides feel it. After getting an adjustment (which he will be the first to tell you it doesn't hurt), he has a bowel movement an hour or two later and then is regular, usually a twice a day kid. I was skeptical at first, thinking that kids are supposed to be all moldable and bounceable:) But when a chiro knows how to work on kids, and uses an "activator" it isn't scary at all and is well worth it!

My son, who is almost 2-1/2 has almost the exact problem. It's so painful, and now is interfering mightly with potty training. What has worked for him are those Fleet laxative strips. They are these grape flavored strips that dissolve almost instantly in his mouth. He doesn't like them... but they work (for him). He is also on MiraLAX as needed. The doc said to start at 1/4 of a capful once a day, and go up or down as needed. My boy got to a point where this caused diarrhea, so now we just give it if he has not pooped in over 24 hours. Problem is that he hates it in water. But, mine loves juice. Is there any liquid besides water that your boy will drink? Does he take breastmilk from a bottle?

Hope this helps.

my daughter went thru this and my hubby took her to urgent care, they said to completely limit added sugar, no milk or dairy, give fruit, applesause (un sugared), she doesnt like prune juice either but they have the baby kind that is apple prune, that works really good, so does white grape, or red grape, canned fruit not in syrup, unsugared cereal without milk, no meat, we did this for 3 days. and it finally worked and now her diet is modified and she is eating healthier.

Hi L...my son had the horrible constipation problem and the holding it in problem too since he was about 6 months old. I tried everything as well and finally resorted to Miralax in his bottle/cups for about a year and a half and it was so hard to get the right amount. Either is was too much and he would have diareah or too little and it wouldn't help at all. Finally at about 19 month I started putting him on the potting as soon as I would see him strain. At first he did not like it, but once he figured out that sitting on the potting, and with gravity and everything working with him, it didn't hurt to go. Eventually he would yell poop and head to the potty on his own. All of our poop problems faded. The trick later was to get him to go pee in the potty. Hope this helps a little. Hang in there. I know how hard it is to watch your baby struggle with this and be in pain.

I've posted in detail to this question before...so I'm going to keep this short.

Background: Our family is born with either adult sized intestines or twisted intestines. With obvious results with the adult sized ones.

Essence: Whatever you decide to do....Be gentle. Put yourself in their place, the extreme pain, everytime you had to go to the bathroom...and treat them how you would want to be treated.

Don't make threats. Don't get angry. Be gentle. They're learning to face fear and pain, and they have control over when it's going to happen....so learning to choose to make it happen more frequently is going to be a feat of astronomical proportions.

So.

Be gentle with them.

I have twins and my one son had severe constipation and we put him on Miralax everyday, and wow he poops daily. We buy it at Costco since it's kinda spendy. The doctor said he may have to be on it for years but it was safe!!! Hope it works for you....

Hi L.,

First Kudos for not vaccinating. It is tough to stand by your guns on that one, but great job for protecting your child from the toxic ingredients in them.

I too have heard that dairy products cause constipation, and my son too was an extremely picky eater and didn't gain weight for almost 2 years. He was stuck at 25lbs FOREVER! I simply stopped taking him to the doctor because one, I didn't want the standard lecture on vaccinations, and 2, I didn't want to hear how underweight he was and be made to worry. I knew in my heart he was growing fine, and he was cognitively where he needed to be. Fruits fruits fruits. Apple juice in a bottle did give my son cavities, but it sure helped him poop. Fruit is loaded with fiber and water. If dried fruits are used, encourage water drinking. I know this is a heartbreaking problem. It is so hard to see your children crying on the potty in pain, or refusing to go because of the pain they know is coming. I was able to disguise veggies in my son's favorite foods. But all those grains could be helping his constipation. Cherries are yummy and great for helping us poop. He definitely needs a probiotic. See if you can find another source other than yougart if you can. Health food stores may be helpful. Keeping him active will also help move things along. Coconut products are natural laxatives also, see if he will drink coconut milk, just make sure it doesn't have preservatives. Trader Joes has the only one I have found without them. Cooking in coconut oil is fantastic for all of you too. It is the only oil stable enough to not turn to a trans fat with high heat and should be the only oil cooked with period. Coconut cream is really yummy if you can find it. I order mind from tropicaltraditions.com. But you may be able to find it the food coop or something like that. any veggies you can get him to eat are wonderful, and fruits fruits fruits. Try the odd ones if he doesn't like the regular ones. You might find a great one he likes and will eat. Watermelon, star fruit, mango, you just never know what they will take a fancy to. If you have a juicer, try different combinations of fruits. My heart goes out to you and your little one, best of luck and I hope something I have said helps.

Hi L.,
Sorry your little one has to suffer so much. I haven't had such a problem with my son but found this guide on Dr. Sears' website: http://www.askdrsears.com/html/8/t081100.asp. Hope you'll find a solution soon.

If you can get him to drink it, try dark Karo syrup mixed in water in his bottle a couple times a day. Its the old fashioned standard treatment for constipation in babies and young children. Might help, can't hurt.

I don't know what your doctor has said about it, but too much fiber doesn't seem like a good idea because young digestive systems aren't equipped to handle fiber very well, especially if he is not getting ALOT of fluids. You might try going back to more gentle foods like rice cereal and pureed foods, arrowroot cookies and so on. I can see that you are trying to feed him a very nutritious diet, but at this point the important thing is to get him eating and gaining weight, even if his preferences aren't what you would consider the best nutrition. Also his brain development depends on enough fat in his diet, either through whole milk or putting a little olive oil in his foods; he may not be getting enough from breast milk at this point.

A little about me;
Mother of nine

My heart goes out to you and your son. This sounds SO miserable for him!

It sounds EXACTLY like what I went through with my daughter before my Naturopath diagnosed her with Celiac disease. I recommend Naturopaths over MDs for food allergies. They treat a "borderline" illness as an illness, not as NOT an illness. The terrible constipation, and the other symptoms you described are exactly the symptoms my daughter had until we cut out wheat. She still has some constipation, but not like before. Something in the digestion is not right - you need to have allergy tests to determine what. Wheat gluten can strip the celia right off the intestines causing the body to no longer absorb food. As a result, the children (like my daughter) end up underweight and TERRIBLY constipated. This has also caused seizures for my daughter and if I hadn't taken her off the wheat, it would have ended for her in autism. This is a VERY SERIOUS food allergy.

You said you have done "food elimination". The question is, how long? For Celiac Disease, you have to actually have them off the wheat for about a month - 3 months to see a turn around becuase the celia has to grow back before you can see a difference in the diet.

I pray and hope for your sake it's not Celiac disease, but that is one of the most destructive diseases to the digestive tract. Vaccinations don't necessarily cause it, it could be caused by the host of genetically modified foods that are out there, it can be genetic, it can be due to a lot of different factors, none of which have anything to do with what the parents did or did not do.

My daughter didn't have her first vaccines until she was 6 mos.

I was told if put a little sliver of soap in his bum he will poop, that way you're not putting unnessisary things in his system. Good luck, my little girls eatting habits sound like your sons, she's 1 next week, they are a mystery...

Hi L.,

My 8 yr old has always had this issue. We are now treating him for Encopresis. This is chronic constipation. When he could finally go, it would be so big it would stop up my toilet. We went to someone who specializes in this and we just went through the "cleanout". The big ball in the colon is gone! Now we have to keep him at a good consistency. The constipation issue actually stretched out the colon and we have to give it time to get back to normal size. Miralax is not over the counter. We give one capful (17mg) each night and increase by one teaspoon if it is not working well enough. The specialist said that 1 tsp requires 2 oz of fluid. Take a small amount of hot water and put the teaspoon of Miralax in it until dissolved. Then add his favorite drink. It can go in his bottle. There is no flavor at all. We also do the mineral oil as well, but with the other so that the 2 combined keep him flowing and there is no buildup in the system. Good luck to you. Hope this helps.

Hi L. -

It is obvious that this is a concern of yours by the many remedies you have tried, however, if you give the body a "chemical" product, such as a laxative, that makes it eliminate the body will become reliant on that product and not work on it's own. Unfortunately, this is a side effect most MD's forget to mention. The body will eliminate only what it doesn't use, so, if he is not eliminating, his body may be utilizing all the solid food that he is taking in. I could suggest something like trifala (Ayurvedic 3 herb blend) or guggul (another herb) or a combination of the two to draw in natural moisture from the digestive tract and soften the stools. Neither of these herbs will "make him" go to the bathroom. The flax seed oil is good, however the taste isn't so great. Does he like grape juice? Any juice that is blue, red or purple is full of antioxidants (especially if you get the 100% juice). Let him drink as much as he wants, even let him go to the store with you and pick out what he wants (within reason). Letting him have a little more control over what he eats is sometimes all it takes to purk up an appetite.

If you have any other questons, feel free to drop me a line.

Sincerely,

M. M. Ernsberger, HHP
Herbalist
Hypnotherapist
Life Coach

My son has had the same issues. Here are some things that helped us: probiotics(I put powdered probiotics in juice), flax oil (instead of mineral oil), and tea. Licorice tea is good, so is chamomile. A warm cup of tea and a warm bath will usually stimulate a BM. Also keeping things moving with lots of fluids, flax oil, fiber, exercise, etc. You can massage his abdomen to stimulate his bowels also. There are also some homeopathic remedies you can try but you should consult a naturopath. Chiropractic care can help too.
We also removed dairy from my son's diet. Once he stopped nursing, he had problems with fluid in his middle ears, ear infections, etc. I don't know if this was related to the constipation but the ear infections have gone away since we stopped giving him dairy products.
Have you tried making smoothies for him? you can sneak things into smoothies to get them to take it, like the oil and probiotics. Or make popsicles with fruit juice to get him to take fluid.
I understand how you feel. My son is seven now and I finally feel like its under control but we still have to make sure he has his nightly bath and tea to keep things moving. Good luck!

Hi L.

Here is the best stuff I know of on the market... Herb Lax

http://www.shaklee.net/beyondorganic/product/20144 this is a small bottle, not expensive and if it works I would get the bigger bottle to have on hand. It is totally natural which is the best part, and it really works.

You might want to also look at a probiotic, like OptiFlora
http://www.shaklee.net/beyondorganic/product/20639 which is all natural and guaranteed.

For sure I would try the herb lax, it has been on the market for close to 50 years and anyone who has tried it swears by it for getting regular.

My niece was cronically constipated, she just didn't poop and she was miserable. We started her on 1/2 an herblax then up to one and it totally fixed her problem. She now takes optiflora a few times a week and rarely needs the herblax.

J.

I recommend an herbal therapy. The other stuff might be too hard on his body. Go to your local health food store (not a vitamin store, they seem not to know as much) and ask about herbal remedies (like a detox). I think you are doing great with his food options, so keep up the healthy choices. He might have trouble with digestion, so if you are adding laxatives and it builds up in his system they could be problems. I would see another doctor, or an herbalist. All the best. Poor little guy.

Hi L.,

I just got done reading all of the responses. I seem to keep coming back to your question because I can relate. My son just turned 13 months and he has been constipated most his life. It didn't matter when he was strictly breastfed, or when he started solids. He is always backed up and it gets to the point where every 5 minutes or so, he's screaming in pain because he can't get anything out. Just last week it looked like he was having a seizure because he was in so much pain, shaking, exhausted, he couldn't even more. So, I switched pediatricians because I felt his first one wasn't doing enough. She said she was hoping to find the right food combo to fix the problem. His current doctor said to use Miralax, and I know you have already have a few responses with that information But, I wanted to tell you that despite what some think, Miralax doesn't make the child feel the need to go--it just softens the stool by bringing water into it. It's non-habit forming and his doctor even went as far as to say she thinks it should be in the water--it's that safe. I hope this helps. I wanted to find something more natural for him, but after 11+ months of constant pain, I'm glad we are now using Miralax.

As soon as my daughter started solids she began having horrible constipation. She would cry so much while trying to have a bm. She would tear and bleed. It was awful. Doctors just said to give her prune juice and such. So, we would and she would get diarrhea and then become constipated again. Finally we found a doctor that prescribed Miralax. It worked great and was very gentle. Eventually she outgrew the need for it (or her system developed more). I think you can now get Miralax without a prescription. I strongly recommend it if you haven't tried it already.

Hi L.,
My son is now 5 1/2 yrs old. we had the same problems tried everything nothing worked. because of the constapation and his stools being so hard it hurt, he would hold it in, and when he did let it out I would cry with him because I knew the pain was so bad. Finally our Ped. Doctor put him on RX form of myalax. It has worked wonderful. First the dosage was high to get his stools soft as a milk shake, then as he learned it didn't hurt to poop, we lowered the dosage, he goes everyday now even if we don't give it to him for a day or 2, but he can't go very long without it because he will get stopped up again. I think you should give it a try, it has no flavor can be mixed in water, milk or juice, when I get stopped up because I also because of meds I take, get clooged up, I take some in water.
Please for the shake of your baby give it a try, it is alot better for him then having to us supoatorys.
Good Luck
R.

I found my youngestwhenage 2 would control the only thing he could- controling his bm.when found having him walk helped bring on a bm. Also phillips of magnisium on occassion. We also found grapes and peaches soften bm and allow natural timing within hrs, not days.

I can tell you're really trying hard to get to the bottom of this (no pun intended). You've tried most things any well educated parent would try, and what most Naturopathic Docs would recommend for general constipation. Kudos to you. If your son is not responding, I think you need to sit down with a Naturopathic Doc and tell them all this. You have already done alot of the ground work, so they should have a head start, and you should have fewer visits. But there is obviously more to your little boys case, and they are trained to investigate what we might not think of. They also think differently from MD's. I ask myself, well even if Miralex works, why does the body need this assistance? Pooping, eating, and sleeping are the most basic needs of the body. If at 17 months this is not working quite right, we need to know why. Its important, I can see you know that. Keep looking, cos its a very basic function that needs to work well.
If you want a recommendation, see Dr Jason Zabell at Urban Wellness on SE Division and 49th, wwww.urbanwellnesspdx.com

I have some of my own ideas but I am not qualified yet. Contact me if you want to know what I did for my son.

L., I suggest you ask the doctor to run tests on his bowels and intestines...

L.,

I am sorry for your situation. Your son must be in constant discomfort/pain.

We had a small degree of this with our son. To get a BM, we had to induce it somehow. I was lucky that he would take juices. On his 2 yr check, the doctor didn't like tne birthmark on his back...or the explanation I had gotten from his previous pediatrician. He was diagnosed with Spina Bifida Occulta (least severe form and easily correctd). He had surgery, and since his BMs have stopped being a problem.

I am not saying that your son has this. I am suggesting you ask for further testing for other causes since you have exhausted your normal options. Stomach, intestines...anything can be adding to this situation.

Good luck and God Bless,
T.