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Dear Dr. Stoll,
My 2 1/2 yr. old has had only 1 BM per week for the last 3 weeks. She's actually been withholding for about 6 months, and the length of time she withholds just keeps getting longer.
We've been giving her 1 tablespoon of mineral oil every night for the last two weeks and her stools have been soft. Now I'm trying to figure out how to give her metamucil. (I also thought from reading the protocol that the MO had to be established first before adding the metamucil.) I've put it in her juice and she drinks a little, then leaves it sit and the juice gets stiff. I bought some of the metamucil wafers and she's eaten a couple so far (one last night and one this morning; she didn't finish the one before lunch today. Then she got put in a time-out for some other reason and threw up.) She tends to lose interest in food when it's given to her too often, so I'm guessing she will not eat these wafers for very long.
Re throwing up, this was the second time she's thrown up in the past week, so I'm even wondering if she will have a BM this week. The first time she threw up, there was food in the vomitus from 3 days before, which seems like a long time for food to be sitting in a person's stomach.
I have several questions:
1) Is there some other way to get Metamucil into her? I saw one woman's methods in the archive, but I've tried the juice method and that doesn't work. How can it be mixed with food so it goes undetected?
2) Is there an alternative fiber choice to psylium? In one of the articles I saw someone mention fiber-con. She's used to chewing vitamins, so if there were a chewable tablet, she might do that long-term if that's an alternative.
3) One woman wrote that her doctor prescribed constulose. I thought in your reply you said that this is fiber. Did I read that correctly? I have a prescription for it for my daughter, but I only start giving it to her after she hasn't had a BM for 3 days. (I haven't been giving it to her the last 2 weeks that she has been on MO.) Should I try getting a larger prescription (mine is only 15 ML so it runs out in a few days!) and try giving her just this on a regular basis and drop the MO and metamucil? The constulose usually works after about 2 days.
I'm at my wits end about what to do. We've talked to our doctor and the advice nurses many times and they keep suggesting the same things - mineral oil (but not for more than a week because of it leeching minerals from the body), milk of magnesia (didn't help), increasing fiber and fluids (we give her lots of fruits, whole wheat bread, vegies, etc. try to keep her eating healthy). They also have suggested metamucil, but there's the problem of getting her to take it. She likes the constulose and will willingly take that. We've also tried glycerin suppositories and Babylax when the problem first started. I would use those if she hadn't had a BM after 4 or 5 days (that frequently seems like it would be a relief looking back!) It is too traumatic to use those methods. She screams and screams when we put one in. So we've given up on suppositories as well.
After about 4 or 5 days now, she will go around saying "my poopy hurts", so I know she is having the urge to go and then she looks for something else to do to get distracted and forget about going. We keep telling her the only one who can make it better is her. By the time a week has passed and she does have a BM, it's usually with much crying because she simply doesn't want to do it.
Please give me some ideas on where to go next!
Thanks
E's mom
In Reply to: Chronic constipation in 2 1/2 yr. old posted by E's mom on January 24, 2001 at 16:45:32:
Give her plenty of water, may need to flavor with jello or other but the more water she drinks the better. A glass with nondrip spout or a cute bottle with straw, easy to hold and wag around.
Prune juice is good. Have a teaparty using small cans of warmed prune juice (warm in hot water), add straw. Serve a good tasting cookie with it. Nothing like mommy and daughter having a teaparty. Mommy has the same thing to eat and nothing said about what the prune juice will do. It is just a delicious drink. Set a pretty table, child size or use a TV tray with pretty placemat and napkins. Make it a special time. Maybe have more than one teaparty per day.
Apricot nectar works for some people.
Prunes are also good.
Add ground flax seed to oatmeal or other cooked cereal for breakfast, does not change the taste. Purchase flax seed at health food stores, grind in blender to almost powder consistency, store in closed jar in refrigerator.
Have a special time of day to sit for a while on the potty, once in the morning and again in the afternoon. Read a book, grunt with her for encouragement. Establish a habit of going to the bathroom on a scheduled basis and she just might start having BMs. Praise her for being a big girl whether she does a job or not. Sooner or later she will relax more.
The throwing up is most likely caused from the backlog of stools not being passed on a daily basis. There is such thing as getting "locked bowels" from not going to the bathroom. Impacted is what it is referred to these days and it will be no fun for a doctor to do the removal.
If she will eat a sandwich, spread a little flax seed on it too or mix in with whatever you put on it.
Avoid feeding her constipating foods such as banana, peanutbutter, chocolate, there are others too.
She is not eating because at this young age she realizes it will make her poopy hurt. A family sitting at the table together regardless of how young is better than everyone eating at different times. Make it a family practice to eat together. There is no need for a clean your plate attitude either.
Hope you find something to work soon.
Marie
In Reply to: Re: Chronic constipation in 2 1/2 yr. old posted by Marie on January 24, 2001 at 17:55:06:
Hi Marie,
Thanks for your quick reply. I'll give some of those things a try.
As for the not eating part, I meant that if I give her the same food for too long she doesn't want it anymore. Example: I tried giving her prunes and she loved them, so I gave them to her all of the time (with meals and snacks). She got burned out on them. She does sit with us at mealtime and we've never had a clean your plate attitude.
Thanks for the encouragement.
E's mom
In Reply to: Re: Chronic constipation in 2 1/2 yr. old posted by E's mom on January 24, 2001 at 20:36:02:
You can try magnesium.It will soften the stool and increase the urge to go.Break open a capsul and mix it in milk or blend it into a milk shake.You can change the flavor of the ice cream so it wont it boring.If you like you can also add ground flax seed into your milk shake.Also magnesium can be absorbed through the skin by adding epsom salts to bath water for a long soak.Mineral oil prevents the oil-soluble vitamins:A,E,D,&K form being absorbed.These vitamins are good for lining-types of tissue,like in the digestive track.And dont use lotions that have mineral oil in them.You are better off to use flax seed oil,safflower oil, or walnut oil that you can buy at the grocery store.I buy these only in small quantities at the store,and use them up before they go bad.These oils have essential fatty acids that your body needs.Do not heat them.I mix a few drops of essential oil with a small amount of oil and rub into skin.Peppermint oil is great for tired feet,lavender oil is good to relax and for sleeping.Get a good book on alternative health treatments.It will save you money and pain.
In Reply to: Chronic constipation in 2 1/2 yr. old posted by E's mom on January 24, 2001 at 16:45:32:
I have a friend who since her daughter was born (and just turned 4 in Dec) had this same problem. At first dr's told her to use suppository's...long term use has bad effects. Then they told her to put molasses in her formula (as a baby until she was eating) - really no help. She kept doing research and bugging her dr. Poor little girl but my friend was persistent. also - the fact that she is not having bowel movements and storing it is not good. I believe it can be toxic.
Finally, she brought her daughter to a chiropractor - when she was around a year old. She went for several visits at first, and now brings her once a month - immediately after a visit and for next 3-4 weeks she is fine.
I am not positive that she is still going, but it did work.
(and I don't believe in using chiropractors).
In Reply to: Chronic constipation in 2 1/2 yr. old posted by E's mom on January 24, 2001 at 16:45:32:
Hello Dr. Stoll,
I would really appreciate if you could also give some advice on this problem.
Thanks!
In Reply to: Chronic constipation in 2 1/2 yr. old posted by E's mom on January 24, 2001 at 16:45:32:
Hi, E's mom.
At this age she is fascinated with the effect her actions are having on the adults in the house. This is even the cause of her "vomiting". Just think how she has all of you running around frantically.
ANY fiber will work even the constulose. You have to separate whatever you use from her actions AND the BMs!
Sprinkle a little metamucil over ALL of her food. That will make it so little that she will not be able to tell the difference. If she refuses to eat it anyhow, remember that at this age the leading cause of death is kids drinking lye, gasoline, kerosene, eating aspirin, etc. Taste, or texture, has NOTHING to do with it!
Offer her only the food with sprinkles of metamucil either on top or mixed in. If whe does not eat it, throw it out and give her nothing to eat until the next meal with the same offering. She will very soon eat even cardboard. You cannot hurt her by starving her whereas you CAN damage her by not resolving this problem.
Just think, if she can run the house at this age, what will things be like when she is a teenager???
It is NOT necessary to use the MO before the metamucil. The MO is just to be sure that NONE of her BMs are too painful. However, within a few days to a week (after the correct dose [of fiber] for her has been reached) she will no longer be ABLE to withold. Even though this phase will be messy, it will resolve the problem IF you persist.
Let us know how she does. This is a totally unnecesssary problem.
Walt
In Reply to: Chronic constipation in 2 1/2 yr. old posted by E's mom on January 24, 2001 at 16:45:32:
i am a 33 year old female who's had constipation most of my life. metamucil will not give the urge to defecate.it is not a stimulant, just fiber. metamucil for me makes the constipation worse in that it causes much gas ,requires you to drink a lot of water.a doctor told me to drink 1 glass water before ,1 glass while taking the product and at least 2 glasses of water after. metamucil can actually make constipation worse . i have had times where it feels like sand paper coming out .very painful. it can be a great irritant to the intestines and cause inflamation. a cellulose product like citrucel is more pleasant to take .tastes like orange and doesn't cause gas and sand paper effect like the other. please note that these products can cause choking in that they can swell in the throat if there's not enough liquid taken with it.
my experience over the years is to have a warm beverage upon awakening such as tea and to have a set time to sit on the toilet for a while in peace.sometimes taking a walk helps too.i guess gravity is helping.try offering plain water throughout the day not milk ,juice or anything.just water.try getting some books and a video on potty. i've seen books on animals as well as people .it will show her it is normal and natural.
In Reply to: Re: Chronic constipation in 2 1/2 yr. old posted by Laura on January 26, 2001 at 21:16:12:
Laura, have you tried taking mineral oil at bedtime while at the same time taking your metamucil whenever you normally took it? It usually takes the combination of both of these for this problem. Maybe your consitpation has other causes, such as dietary sensitivities. Have you considered a trial elimination of dairy and wheat?
I agree with you regarding the danger of the fiber swelling in the throat if you don't drink enough fluid with it. I had this happen to me to a lesser degree once and it was painful. Walt, can you please comment on this risk, which is also clearly posted on the labels...
I think it's a bit drastic to have to drink 4 glasses of water to get down one dose of Metamucil... Wouldn't 2 be more than enough (one with Metamucil in it and a 2nd plain to chase it all down?)
In Reply to: Re: Fiber swelling in the throat, risk of choking with Metamucil - WALT? posted by kmd on January 27, 2001 at 00:17:37:
Hi, kmd.
I take about 1/2 cup of metamucil twice a day.
First, find a pint jar with a screw lid. Put your dose in it dry and then add the water to fill the jar. Put the lid on tight and shake it well enough to get all of it in suspension. Immediately chug the suspension.
I have never heard of anyone who had to take even half as much as I have to but everyone is dose specific. You just take "enough". Anyone who has to take less than I do will have an easier time of it than I do and I have never had any trouble.
Walt
In Reply to: Chronic constipation in 2 1/2 yr. old posted by E's mom on January 24, 2001 at 16:45:32:
I have been reading your post and it reminds me of my children. Although we were able to get rid of the problem when they were younger. it seemed to clear up when we took them off of the milk bottle. I remember going through all of the stuff you are with mineral oil and foods and so on. I would like to tell you that I had a friend who was a nurse and I remember her telling me about a condition with the muscles in the rectum. They do not form properly and do not have the ability to push the stool out like it should. Therefor they becom constipated and packed up. I was almost to the point of having this checked out when we were able to clear ours up. But for you this might be something for you to have checked out. I can remember the pain my daughter went through during those times and my heart goes out to you. We were forced to dig the stool out of her a lot of times because it would get so big and hard and dry. It was heart breaking to watch her suffer.
If this has been going on all of her life, you really need to see a doctor who deals with the rectum, not sure what they are called. Hope this gives you some help in case the other things don't work.
Kim
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