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Dr. Stoll,
My son is three years old and is having extremely painfull bowel movements which has lead to withholding. I only recently figured out that he was withholding causing constipation not visa versa. This started after a bout of the flu lead to constipation with very hard stool and blood in his stool. Anyway, his doctor is not that concerned, he has put him on 20mg colace bid, it is softening his stools but not significantly. He is also only going every 3-4 days. He is petrified to poo, please help. It is breaking my heart. Should I increase his colace?, change medication?, Seek counseling for him?
He is also taking acidophylis(sp?) twice a day. Should I be taking him to a pediatric bowel Dr.?
In Reply to: stool withholding posted by Kathy on June 01, 2001 at 20:58:52:
There is a lot of detailed information in the archives and the glossary. You should look there first before posting a question.
In Reply to: Re: stool withholding posted by Sure on June 01, 2001 at 21:08:28:
i have a suggestion.......try making him drink alot of water each day atleast 3 glasses and i bet he'll start pooing (smile) more frequently and less painfully....let me know if it works.
In Reply to: stool withholding posted by Kathy on June 01, 2001 at 20:58:52:
just go to the link to Dr. Stoll's article below. Drinking more water won't help him at this point...and I can't imagine getting a little 3 year old to drink more water anyway!
Hope this helps
In Reply to: Re: stool withholding posted by Sure on June 01, 2001 at 21:08:28:
I have read all of that information and more, my question is regarding the Colace, should I start another drug (MO & Metamucil) or continue and also should he see a specialist at this point?
In Reply to: Read this posted by anon on June 02, 2001 at 00:34:11:
Hi,anon.,
Would you please tell me how you got the stool withholding article to come up on your post so that Kathy could easily go to it? Needless to say, I am not at all experienced with computers. Does it have something to do with the "Link Title"? If it's too much trouble, I understand. Raisa
In Reply to: Re: stool withholding posted by Kathy on June 02, 2001 at 08:18:06:
Hi, Kathy,
If you type "Colace" in the search box at the top of this page, there will be questions answered by Dr. Stoll.
I had asked him that question about my granddaughter.
If you don't get your answer there, please let me know, and I will look for it. Raisa
In Reply to: Re: stool withholding posted by Raisa on June 02, 2001 at 10:24:55:
Hi again, Kathy -The name of the fiber tablets I told you about is FiberChoice. The fiber is a vegetable fiber, called FRUCTAN. It contains no artificial sweeteners but does have a little dextrose in it. As I had told you, it is chewable, and it is not necessary to drink water with it. Metamucil works better, but my daughter uses this when she can't get my granddaughter to take the Metamucil. My granddaughter loves them and has had up to 4 a day. she started withholding at around 2 years old. She is now doing much better. I wish you luck. Raisa
In Reply to: Re: stool withholding posted by Raisa on June 02, 2001 at 10:24:55:
Reisa,
Thank you for being so helpful. I still cannot find anything on colace. I am new at this computer thing so maybe I am doing something wrong. I increased my son's dose of colace (me, not my Dr.) and he had 2 soft stools today with very little blood and pain. I think I will add the fiber chewables to the colace. YEAH! a little headway!
In Reply to: Re: stool withholding posted by Kathy on June 02, 2001 at 20:04:25:
Dear Kathy:
If the Colace is working, then it can be given instead of the Metamucil, I understand. You have to give lots to make the stools soft.
To find those posts I mentioned, type in "Colace" at the top of this page in the "Search" box. Then you will see copies of posts called "Withholding Stool". The first "Follow up" will be a post from me about Colace and there are 2 more after that with answers from Dr. Stoll.
As I said, my daughter and I were as frustrated as you are. You will see which doses are best for your son.
Write again if you have questions--I had a hard time with the archives, too, when I first started. Raisa
In Reply to: Re: Read this posted by Raisa on June 02, 2001 at 10:11:02:
Hi Raisa,
Go to the actual article (or whatever location you want to send the person to) and copy the url location from the address field at the top of your window.
Then go to where you post your message and paste it into the "Optional Link URL" space just below the Comments box where you type your message...
You can name the link whatever you want by typing that name into the "Link Title" field right below where you pasted the URL.
I hope that wasn't too confusing!
In Reply to: Re: stool withholding posted by Raisa on June 02, 2001 at 21:06:44:
Kathy, I was wrong. I meant to say you can give the Colace instead of the MO.!!! You must not give the MO and the Colace together because that could be toxic to the colon.
You can give the Colace together with the Metamucil and the Fiberchoice tablets; I know you are making sure that she drinks lots of liquids, too. Sorry about my mistake!!
Hope you found the post on Colace! Raisa
In Reply to: Re: stool withholding posted by Raisa to Kathy on June 03, 2001 at 08:16:30:
Hi again - Forgot to congratulate you on your success with your son! Did the doctor say that the bleeding was coming from a fissure? My granddaughter had a fissure, but it healed rather quickly. She didn't complain of pain, but there must have been some. My daughter also saw a hemorrhoid, a few times; but it has disappeared. Things aren't perfect at all, but we are slowly getting there. This, I know, is that my daughter refuses to do as Dr. Stoll recommends and only offer her healthy foods (which my granddaughter avoids). Therefore, she is not getting enough fiber, even with the tablets and metamucil (and mineral oil).She will be here for two weeks this summer, and I'm going to spend that time trying to change her eating habits! Wish me luck. Her mom will be here too. Raisa
In Reply to: Re: Read this posted by anon on June 02, 2001 at 23:58:41:
Hi again, anon:
Thank you so much!!! I tried it by sending a link to myself from the archives, and it worked! I appreciate your taking the time to explain it so clearly. Raisa
In Reply to: Re: Read this posted by Raisa - to anon. on June 03, 2001 at 17:09:19:
nmi
In Reply to: Re: stool withholding posted by Raisa to Kathy on June 03, 2001 at 08:33:48:
Hi Raisa,
Concerning diet: I went shopping and got only high fiber snacks and juices made out of fruits & vegis only. I have decided he does not get to choose his snacks anymore. So far he is eating them when he has no other choices. I also started a rewards program for the Psychological side of things. He has a sticker calender & when he goes he puts a sticker on it. He loves it & it helps me keep track of when & how often he went. How long do you think it took your granddaughters fissure to heal? I do not want to get my son checked as I am pretty sure he has one and there is no treatment other than what I am allready doing. I don't want to traumatize him any further. I am quite please with him averaging 2 BM a day at this early point with colace, prunes, & more fiber. Light at the end of the tunnel??
Kathy
In Reply to: Re: stool withholding posted by Kathy to Raisa on June 04, 2001 at 11:19:22:
Hi, Kathy - Well, it sure sounds like it!! I wonder if that calendar would work for my granddaughter! I'll email your post to my daughter. I wrote her yesterday (she lives 8 hours away by plane!) and will talk to her today, as usual. I mentioned that you were having success with Colace--could you please tell me how much you are giving him? Maybe you already did, but I'm afraid that if I go to your original post, I'll erase this post :-] . Also, what hi-fiber snacks are you buying? My daughter found that her daughter loves sunflower seeds, and for a while she would eat prunes. She also puts bran in everything. Actually, my granddaughter has been having several small BMs each day, but they are soft pellets. When I talk to her, I'll find out if this is still happening and then ask Dr. Stoll if this is showing improvement. Congratulations, again! Raisa
In Reply to: Re: stool withholding posted by Raisa on June 04, 2001 at 11:58:58:
Kathy - I forgot to ask whether or not your little boy is potty trained? I don't know whether the calendar thing would work, since my granddaughter is still in diapers (she shows no interest in using the potty, even though she sees her friends using it, but this is certainly not the time for us to push it, don't you agree?). Raisa
In Reply to: Read this posted by anon on June 02, 2001 at 00:34:11:
Hi, Anon.
Just NEVER offer soft drinks or fruit juices and watch the child start asking for water.
Walt
In Reply to: Re: stool withholding posted by Raisa to Kathy on June 04, 2001 at 12:05:50:
Hi Raisa. I give my son 20mg of colace 3x/day but I think I may increase it to 4X/day but I don't know how much is safe. His BMs are still a little firm at this point. I have also doubled his prune juice to 8 ounces a day because he had no BM today. I also would like to know the safety of giving MOM to a 3 year old. Does it make their bowels dependant? I thought I might give it after a day with no success. I am still contimplating switching to mineral oil. I will speak to his Dr. tomorrow about this. I would really like Dr. Stoll to answer these questions but so far no response. The snacks I am using are high fiber rye bread crackers (plain), popcorn, dry bran flakes with raisins, whole wheat toast with honey, and the juices are V8 splash juices cut 1/2 with water. I don't know if all of these are good or not but I'm trying! My son has been fully toilet trained for Pee for about 3 months but NEVER would poop there. I am confidant this is where the trouble started.
Kathy
In Reply to: Re: Read this posted by Walt Stoll on June 04, 2001 at 17:08:45:
Are you saying I should never give my son fruit juices at this point? Not even apple juice? Could you please read my post to Raisa from Kathy on June 4 @ 8:00pm concerning my questions regarding colace dosage. Also, when I read articles about stool withholding I never see colace spoken of as a med for this problem, should I try something else?
Also how long does it take a fissure to heal? And, if I suspect one is a physical necc.?
Thanks! Kathy
In Reply to: stool withholding posted by Kathy on June 01, 2001 at 20:58:52:
Give him lots of prunes! to loosen it, not medication.
Prunes and prune juice do marvels!
In Reply to: Re: stool withholding posted by Kathy to Raisa on June 04, 2001 at 20:13:02:
Hi, Kathy - Sorry you didn't find anything in the archives under Colace to help. Dr. Stoll told me that it would take a lot of Colace to do the same thing as the Metamucil could.
I think it is a trial thing.
I have since talked with my daughter,and she says that the Fiber Choice tablets can be crushed and put in juice (she always makes the juice half-water). She has to crush the tablets and then strain them so that my granddaughter can't tell they are in the juice. Giving 4 tablets a day (some just chewed and some in juice) has made her stools very soft. She still gives the mineral oil. My granddaughter doesn't put on an act anymore and just "poops", but it still happens only about every three days. She even says she wants panties for her third birthday (June 11th). Of course, what she'll do then, who knows?
Dr. Stoll probably thought you got the answers to your questions from the archives. I'm sure he'll answer your last post. He reads all posts and answers in 48 hours.
My daughter would like to know how you get your son to take the Colace, which has such a bad taste? Raisa
In Reply to: Re: Dr. Stoll! posted by Kathy on June 04, 2001 at 20:20:36:
Hi, Kathy.
Nutritionally, ALL fruit juices are no better than sugar water. The only thing they have in them is calories.
Colace is just like fiber, the correct dose is what works.
Fissures heal in about 4 weeks when there is no longer ANY hard stool.
Walt
In Reply to: Re: stool withholding posted by Raisa on June 05, 2001 at 19:45:44:
Hi Raisa,
He takes the colace because I have explained to him that it will help his poops not hurt so much and he is very willing to do it. He takes the colace and then immediately drinks water or juice to wash it down. I am lucky he is cooperating. Do you happen to know how much fiber is in one tablet? I am wondering how much fiber my son needs.
Kathy
In Reply to: Re: Dr. Stoll! posted by Walt Stoll on June 06, 2001 at 09:20:51:
Thank you for your answers Dr.
I have another problem, my son had some bloodwork done and it shows that his hemoglobin & Iron are a bit low. He is quite pale and a bit lethargic. He takes a multivitamin with iron but I know iron can be constipating. Can you suggest any foods that are high fiber, high iron that will not make his problems compete? I am hoping this is only due to diet. What could be another cause if any?
Thanks, Kathy
In Reply to: Re: stool withholding posted by Kathy to Raisa on June 06, 2001 at 09:57:46:
Hi, Kathy:
I just read your post to Dr. Stoll. Do you think your little boy's low hemoglobin count is due to his rectal bleeding from the fissure? What did the pediatrician say? Did he give you something to use to heal the fissure? As I told you, my daughter saw an occasional drop of blood in the diaper, but now the fissure has healed. Of course, she could get more if her stools get hard again, I know.
I've put below the web page for Fiberchoice. It says that 2 tablets equals 1 packet of Metamucil (about l T of Metamucil). Also, they have much more information on Fiberchoice. Just click below (if I did it right; otherwise you just type it in)
I know that my granddaughter would never take the Colace. Last summer she was taking the milk of magnesia, but then it gradually got harder and harder to give and wasn't working well; and finally she refused it. She will take the mineral oil in juice (diluted with water), and, as I said the crushed fiberchoice tablets plus eats some. She has been taking four tablets a day, which would equal probably about a tablespoon and a half of Metamucil. Raisa
In Reply to: Re: stool withholding posted by MAI on June 05, 2001 at 04:50:50:
Thanks, MAI.
Just so she remembers that prunes are a laxative and treats them as such.
Walt
In Reply to: Re: stool withholding posted by Raisa on June 06, 2001 at 12:06:30:
Raisa,
Thank you for the information about Fiber Choice! Before this I didn't know how it compared with psyllium. I wonder if it is as effective. It does sound healthier, though.
In Reply to: Re: stool withholding posted by Wendy on June 07, 2001 at 09:14:53:
Hi, Wendy!
I was so pleased so see that they had some new information about FiberChoice on the website. My daughter now buys it in 500-tablet bottles!
Actually, my daughter has found that if works very well if she gives my granddaughter 4 tablets a day(sometimes crushed and put in things). I, and she, think the psyllium probably works better, but my granddaughter can tell immediately if it's in the diluted orange juice or any food - and also it gels before she finishes the drink (that's how she got the clump of it and since refuses it). The only trouble is that she still waits three or four days sometimes. But, it is never painful and she doesn't make a big fuss about pooping.
How is your little girl doing? Raisa
In Reply to: Re: stool withholding posted by Raisa - to Wendy on June 07, 2001 at 11:36:31:
She's doing okay, but I can see that we're not ready to cut back on the metamucil and MO. It's also rather a chore to force her to drink enough water, which she needs more than ever as the weather gets warmer. I understand that this problem gets worse in the summer so we have to be careful. Someday I'll substitute some fiberchoice for the metamucil, but I don't think we're ready yet. But that was really great information!
It sounds like your granddaughter is doing well. Some expert said that a pattern of having an easy stool every three days is not a constipation problem but having a hard difficult one every three days is. So if she's not uncomfortable, there's probably nothing to worry about. I'm glad to hear that all is well! Take care.
In Reply to: Re: Dr. Stoll! posted by Kathy on June 06, 2001 at 10:04:34:
Hi, Kathy.
There are many causes of anemia and "low iron". What has been done to check them out? It is pretty rare for a boy to be anemic. How old is he?
Walt
In Reply to: Re: Dr. Stoll! posted by Walt Stoll on June 08, 2001 at 09:23:04:
Dr. Stoll,
Nothing is being done, the Dr. did not seem very concerned. I am changing his diet though. How long would it take to see results from diet change if any? He turned 3 in February.
Thanks, Kathy
In Reply to: Re: stool withholding posted by Raisa on June 06, 2001 at 12:06:30:
Hi Raisa, I seriously doubt my sons low hemoglobin would be from a small fissure, but I am watching closely. I am just keeping his stools soft to let the fissure heal. There is not much more I can do.
The good news is I think my son is not withholding anymore! He is having 1-2 small soft stools daily without much discomfort. They are passing easily (in minutes instead of days) and no blood. He loves his calender and gets excited about having a BM so that he can put a sticker on it. I have very casually asked him if he would like to POOP in the toilet instead of a diaper, he says he is not ready yet, but I am hopeful it will not be too far off (within 6 mo I hope!)
Anyway, in case you would like to know the combination I have settled on is this 20mg colace 3x/day 8-10 ounces pf prune juice daily and only high fiber snacks & more nutritious meals. Water, not much juice at all. The great thing is he is so much hungrier than he used to be since his bowels are moving regularly, which means he is more interested in eating these new things.
Take care, Kathy
In Reply to: Re: Dr. Stoll! posted by Kathy on June 06, 2001 at 10:04:34:
Hi, Kathy.
IF the doctor is right, iron supplementation will resolve the problem within a month and the problem will never recurr.
Let us know what actually happens.
Walt
In Reply to: Re: stool withholding posted by Kathy to Raisa on June 09, 2001 at 22:00:17:
Hi, Kathy - Congratulations!!! You must be so relieved!
I'm hoping that when my granddaughter and daughter visit me this summer we can conquer this. As I said, it's much, much better, but that's not enough. She refuses to drink prune juice (Dr. Stoll says to be careful of prunes because they are a laxative and therefore should be treated as such).
She is also not as cooperative as your son and will not take colace either. She loves saurkraut and will eat lots, but it doesn't help (it sure does if I eat it!). My daughter is going to ask her pediatrician about Constulose. I read in the archives that that has solved the problem in quite a few children. Her orange juice is always diluted with almost half water.
I did not mean at all to be an alarmist about your little boy's hemoglobin. You said in your post that he looked pale, and you sounded worried. Certainly a small amount of blood from a fissure would not cause this! Then when you said later that his doctor was not at all concerned, I was sorry I had even suggested that. Sorry. Anyhow, looks as if you have things well under control. I'm so happy for you!
In Reply to: Re: stool withholding posted by Raisa - to Kathy on June 10, 2001 at 09:18:01:
Hi. I have been reading your posts and thought I would share any info that I may have that would be helpful. My 3yr 4mo old daughter started having this problem when she was approx. 1 yo. We tried everything with her: prune juice, prunes, milk of magnesia, enulose syrup, colace, you name it we tried it. It got to where she only had bowel movements if we gave her suppositories and we would have to give enemas. Our pediatrician even did a barium enema to rule out herschsprung's disease. This is one of the most frustrating problems I have faced with as a parent! But about 3 months ago, I stumbled upon this wonderful website! We immediately started giving her mineral oil (I don't really measure; just a dollop in her milk) and 1 fiber choice tablet a day. This seemed to do the trick; she has regular bowel movements without making a real fuss or "performance" as she once did. I still get nervous if she goes more than a day without one, but we usually get her back on track. She still has accidents sometimes, but this is the best I have felt about it since she was very small. I understand that this is a more common problem than most people think and I don't know why more doctors can't help parents more with this problem. We have a wonderal pediatrician, but she did virtually nothing (save for writing a couple of scripts) and offered little guidance with this problem, as have other peds. Thanks to everyone on this board for sharing your stories!
In Reply to: Re: stool withholding posted by Traci on June 16, 2001 at 14:15:15:
Thanks, Traci.
In Reply to: Re: stool withholding posted by Traci on June 16, 2001 at 14:15:15:
Hi Traci: Sounds as if you have definitely succeeded in solving your child's withholding problem. Congratulations!
My granddaughter is doing much, much better,but my daughter still can't get it to the point where she poops every day.
Once she pooped three times and said "I wonder why I'm pooping so much!". My daughter said the she couldn't think of anything different she had given her.
My daughter has to grind up the fiber choice tablets in order to put lots in her food and drinks. (the Metamucil jelled too much). She usually has 4 tablets a day! She still gives her the MO. Now that peaches, etc. are in season I'm hoping that she'll eat more fiber. Surprisingly, even saurkraut has no effect on her - too bad because she loves it.
It's hard for me not being there (besides missing them terribly) so that I can help push the fiber foods, etc. My daughter is pregnant and is also constipated and takes Colace but says milk of magnesia works better for her. She was constipated when pregnant with her first child too. I know this is normal, but she's always had problems occasionally with this. So, perhaps it's somewhat genetic.
But, as I've said before, Dr. Stoll's method of curing the withholding is the very best way, and I know that eventually we will conquer it. Before I found this site, we were at wit's end, wondering whether something was wrong with her physically! My granddaughter just had her third birthday last week. Thanks for your encouraging post! Raisa
In Reply to: Re: stool withholding posted by Raisa on June 18, 2001 at 11:06:02:
Just wanted to add my input to Raisa's. I too found Dr. Stoll's MO and Psyllium protocol very effective for my daughter. I think that Fiber Choice is probably healthier and perhaps after awhile of continued success we'll take a chance and switch to that. Right now I don't want to mess with what's working!
Good luck - it's the best way to fix this. Believe it or not, before I found this site I didn't even know that there were many other children that suffered from this same problem!
In Reply to: Re: stool withholding posted by Raisa on June 18, 2001 at 11:06:02:
Congratulations Raisa and Wendy!
Walt
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