I read your suggestions about this subject. I have a 2 and a half year old girl who had a hard stool and is witholding bms now. This has been going on since October. We are doing a poop calendar and marking bms on it with stickers. We give her mineral oil every day, and a suppository on 3rd day without a bm. I will try the metamucil idea. My question is. I assume that a dose of a tablespoon 3 times daily means a tablespoon of dry metamucil (then add that to the water/juice). I am anxious to try this. I have been to an encopresis clinic, but she is not encoprisic, she is just fearful. Please add any other suggestions. Are there any books for a kid her age to help motivate her and reduce fears. I have heard of one called "Everybody Poops" but cannot find it. Thanks.
My Grandson is 1 and he has been having constipation problems since he was 4 months old. Tests have been run for hirshsprung disease..negative. He gets Mineral oil and syrup in every bottle (juice and milk). At least once a week, he has to have a suppository and if that doesn't work..a enama. It hurts him so bad that he trys to withhold his bowels. We have went to several Dr.s and he isn't getting any better. Help..any suggestions??
In Reply to: One-yr old constipation posted by Jean on February 05, 1998 at 19:33:32:
Motility disorders aren't generally well known outside the realm of the few sub-specialty gastroenterology clinics studying them. For information about motility disorders (in particular; Chronic Intestinal Pseudo-Obstruction, or CIP, contact the American Society of Adults with Pseudo-Obstruction, Inc. (ASAP) at asapgi@sprynet.com (this organization is NOT just for adults) or visit their temporary web page at www.swiftsite.com/gi-motility/webpage97.htm. This organization can supply information about the disorders and provide a list of doctors investigating them around the country.
In Reply to: witholding stools in small children posted by Alice Strand on February 04, 1998 at 16:21:41:
Dear Alice,
Yes, I DO mean the dry stuff. So long as you use the artificially sweetened stuff those dosages are valid. The regular is half sugar so you would need twice as much.
Once you find the dose that she needs, she will be unable to avoid having a BM since the volume will work itself right through. Soiling could be a problem at first until she loses her fear, so be patient.
Walt
In Reply to: Re: One-yr old constipation posted by William Alford on February 06, 1998 at 01:19:07:
Dear William,
Thanks for the resources. This MAY become necessary for this case. However, at this age, I would recommend first trying what cannot possibly hurt him and, if that doesn't work, perhaps the additional expenditure would then be the next best bet.
At any rate, knowledge would certainly help the parents and grandparents understand what message the body might be sending about these more basic causes. If only the symptom is resolved, what will the next message be? It certainly will be louder and perhaps even more difficult to deal with.
Walt
In Reply to: Re: witholding stools in small children posted by Walt Stoll on February 06, 1998 at 11:17:12:
Clarification: 1 tablespoon of dry stuff is 3 times the adult does of 1 teaspoon 3 times a day. I'm just making sure once again that you want us to give her 1 tablespoon of dry 3 times a day because 1) It seems like she will have no appetite for regular food at all if we are giving her that much (she is 2 1/2 years old). 2) We cannot get her to drink the metamucil mix fast enough --it goes to jello before she gets it in her. I have tried mixing it very thin also, but she still does not like it, and if its mixed thin, she will be drinking so much of it to get the 3 tablespoons, she will have time for little else.
What we have found that she likes is the metamucil "cookies". She likes them and we give her lots of liquid with it.....but I am wondering if it will work the same. 1 cookie equals 1/2 the adult dose of 1 teaspoon of dry stuff. Now you say to give her a tablespoon of dry stuff 3 times a day (3 times the adult dose of 1 teaspoon). Does this mean we should be trying to get her to eat 18 cookies a day? I think we will start with 3 cookies a day and see how that goes, however, it does seem to have affected her appetite, even at this low amount. I have been giving them to her after meals...we will see how this works and get back to you. THanks.
Dr. Stoll, About a month ago I stumbled upon this site looking for help with my (5 1/2 year old) daughter's consitpation, or what appeared to be that. With your advice, I started giving her about 1/2 tablespoon of mineral oil mixed with milk (her favorite beverage) before bed. I expected her to complain and fight, but she has been soo cooperative. AND, the best part is that she is having regular bowel movements! She tried to hold out a few days, but she figured out quickly that she could go without pain. And not having messes in her panties or a wet bed and wet panties every day has made her feel so much better! I can't believe what a simple solution this has been and how quickly it has helped! We could have bypassed so many months of trouble had I known that this was the route to take, rather than trying Milk of Magnesia when the problem got unbearable.
So thanks over and over for a clear explanation of childhood bowel withholding!!
KK
In Reply to: One-yr old constipation posted by Jean on February 05, 1998 at 19:33:32:
Why is the kid constipated at one? I was not constipated until I was at least seven. I fell sorry for the kid, I mean that can't feel to good, don't you know. Well Bob dole has posted his thought on the matter, so, I must no leave.
In Reply to: Re: witholding stools in small children posted by Alice Strand on February 09, 1998 at 09:40:51:
Dear Alice,
You have to know that I have held the hands of many parents through this trying time. It will not be as effective to try to "hold your hand" over the internet. It works a lot better face to face.
First, I need to remind you of several things (Since I know you know them already.): Children this age will drink kerosene, bubbling lye, gasoline, etc. As a matter of fact, these things are major causes of death in children this age. The taste of anything at this age is NOT what deters them from swallowing anything. It is only the "terrible twos" stage of having just learned to power of the word "no". The more you want it, the more your child will say no.
Since metamucil is not absorbed, it has no calories & cannot "hurt her appetite" whereas the "cookies" would. She would need 18 of them & probably would not need any more calories than that.
She could go several weeks without ANY calories without hurting her. By that time you COULD have the problem well on the way to being resolved if she had 3-4 easy to move stools a day during that time.
I have NO IDEA how much metamucil she needs to resolve this. The dosage is too individual to even predict. All I can say for sure is that one cannot be hurt by taking 100 times as much as is "recommended" since it all comes out the other end. The worst thing that could happen is vast diarrhea which would stop within a couple of days of stopping the overdose.
You CAN start with a smaller dose, but if it is not enough to cause 3-4 stools a day, you will then have to increase the dose (gradually) until that point is reached. This gradual increase in dose could take months. If you are willing to drag this out, why not do it? Dragging it out will not bother anyone but you. I recommend the larger dose so the results are immediate (within a few days) and then the dosage can be greadually REDUCED till the end point is reached. All during this tome the treatment would be effective. The only problem with that is that she might have lots of messes without being able to control the loose stools. If she is still in diapers this might not be a problem. If she is not, she might have to go back to them for a few months.
It doesn't matter how you get it into her. You could mix a little into everything she eats. The ONLY thing that matters is getting enough into her that she will have 3-4 movements a day.
There is one truism about children this age: That is that they are trapped inside their little growing bodies. If they refused to eat green beens, you could withold everything else until they got hungry enough to eat cardboard. This would only take a few days & the child would not be harmed in any way to go without food for that long. The child would think the green beans were the ambrosia of the gods--just like metamucil.
You will have to figure out how to get enough metamucil into her each day. If you will be dilligent about it, this should be well on its way of resolution within a couple weeks at the longest (after you figure out how much is necessary to have 3-4 movements a day.
No one said is would be easy. I am just saying that it will work.
Walt
In Reply to: thank you! posted by Katheen K. on February 09, 1998 at 11:28:33:
Dear Kathleen,
Thanks for the testimonial. For some reason testimonials change more people's minds than anything I can say.
Now, you can do something for me. Look at today's notes & talk to Alice. Her note is titled "Witholding Stools in Small Children". I hope you will keep your communication on the BB so others can see it.
This problem is so easily solved IF the parent can have the faith that they are doing the right thing. Just think what people go through, year after year, without any physician telling them these simple facts. Just think of the damage done the child because of its going on for years.
Walt
In Reply to: One-yr old constipation posted by Bob Dole on February 09, 1998 at 17:33:08:
Dear Bob,
There are several valuable notes about this problem right here on this BB today. If you still have questions after sharing with these parents, write again.
Walt
i have a three year old girl who has a problem with constipation and it isn't getting much better.I took her to the doctor about a month ago and i'm using mineral oil now.She still has the problem and rarely will say oh i have to go she just holds it in.I have let her decide to go anywhere she would like and that sometimes makes it easier.i know this sounds crazy but the bath is sometimes the most popular place!!>This is now a huge issue among my other family members especially me the mother.,A nurse told me i shouldn't talk about it with her but i can't help it.What can you suggest????
In Reply to: constipation with my three year old posted by nancy roth on February 19, 1998 at 12:23:43:
Dear Nancy,
Use the search feature for this BB & read everything you can find about this subject. At this stage of your particular problem, the key is to add enough metamucil to create 3-4 movements a day. You may have more tub deliveries till this is over but it still is your best bet.
If you have studied underwater birthing, you know how less painful under water birthing is. Now you understand why she has most of her movements in the bath.
Once you have the above information under your belt, if you still have more questions, write again.
As she gets well, please share your experiences with this BB. Just think how many others you can save from your present misery. This is a totally unnecessary condition.
Walt
In Reply to: witholding stools in small children posted by Alice Strand on February 04, 1998 at 16:21:41:
Hi Alice,
I haven't been back to this board for a couple weeks and saw Dr. Stoll's reply to my Thank You message above. I hope you'll come back to see my comments.
Both of my daughters went through the bowel withholding problem. But I didn't understand it as "withholding". Instead, I thought they were being "constipated" caused by improper diet. To my way of thinking, there is a big difference just in the way I thought about this problem. And believe me, the only way to describe it is as a stressful problem!
Thankfully, our older daughter grew out of this, but only after several years of struggling. It wasn't until January of this year that I read of the mineral oil/metamucil solution for our younger (5 1/2 year old) daughter.
As I told Dr. Stoll in my Thank You message, I can't believe how fast and easy the mineral oil alone has changed my daughter's life! Being older than your daughter probably helps because I can reason with her somewhat, and she realizes (but doesn't necessarily verbalize) that she isn't comfortable. I was concerned that she would fight me about taking the mineral oil. I mixed it in orange juice a couple times, and she even took it straight once! There never was any fight AT ALL. And this is from a very strong-willed child! (I now mix it with milk...her favorite beverage.) I just explained that I knew she had pain when she went to the bathroom, and this "medicine" would help her not be sore. I told her that I now understood that the reason she was having so much trouble with toileting was that she was afraid of having pain and that the withholding was also causing pain and causing her to wet her panties and bed all the time.
The next day after the first dose of mineral oil, she produced a very large, soft stool and has continued to do so almost every day since. This has been about 5 weeks. She has still had some problems, but gets back on-track by the following day. The amount of stool varies a lot, but as long as she's doing some every day and not wetting, I feel like we've conquered the battle! I haven't added the metamucil because we got results so fast. I do see a little oil slick sometimes, but I continue with the same dosage that I tried at first: 1/2 Tablespoon in about 1/3 cup milk right before bed.
I sincerely hope you can get the mineral oil/metamucil dosage right for your daughter. I know it will change your lives. We did the sticker chart route, too, before. But it wasn't successful because the children with this problem can't control their behavior. Maybe you could change the goal of the sticker chart to be that she would get stickers for cooperating with the mineral oil and after so many stickers, you could get a nice prize. The money you spend on the prize will be well worth it once you don't have to deal with the results of the withholding!
Sorry this is so long. I hope there's some helpful info here and some encouragement!
Best wishes,
Kathleen
I have a 3 yo girl (12/28/94) with chronic withholding and encopresis. We have tried the MO route but we are having difficulty getting her to take it. Also the metamucil. Do you have any suggestions regarding administration. We have tried giving the MO in her juice, but she drinks the juice down to the MO and avoids getting it. The metamucil becomes very thick quickly, before she can drink it down. Do you have any other suggetions for administration?
Thanks
In Reply to: Re: witholding stools in small children posted by Kathleen on February 25, 1998 at 11:23:05:
Dear Kathleen,
Thank you for your wonderful caring note. It is this kind of encouragement parents with this problem need to actually try what works in these cases.
There was no need for you to consider the metamucil-like stuff since you obtained results so quickly. The only reason I have described what I did is that THAT approach ALWAYS works. Many people will get results with a lot less.
Your insight into the problem is just the part that I did not share since there is really no way I know of to convince people of this without their having the experience you have had.
Namaste` walt
In Reply to: chronic constipation posted by Lynn on February 25, 1998 at 16:20:59:
Dear Lynn,
Use orange juice (just about the same dose you are trying with the MO) straight from the fridge. The MO should be from the freezer (medium weight). Put in about 1/4 tsp of baking soda and blend the devil out of it. Try that for the MO. The quicker you can get it to her the better.
Also, remember, children will drink lye or gasoline if you are not looking. The more you let your child know that it is important to you, the less likely she would take even ambrosia.
For the metamucil, use very little at a time & give it MANY times a day.
There are some recent notes about this process that you might find with the search feature.
Let me know if you need more help.
Walt
Our 3 yr old has been witholding for over a year (since the arrival of her twin siblings.) We have used Children's Senkot and suppositories with traumatic and no doubt painful treatments of this. She is a very picky eater, and threats of suppositories etc. do little to get her to eat her fuits and vegetables. We have been using "Kondremul" and emulsified MO...for several months with improved results, and I started the metamucil this week after reading your article. Is the emulsified MO ok? She takes it right down. The metamucil she refused until I mixed it with applesauce and then she'll eat it and then drink a cup of water right afterward..is that ok? It has been several days with no result....but then again she doesn't eat very much either. I would also like to do some reading on the psychological reasons for this and what we can do to help her get over it! Is it a first child thing? She is toilet trained for urine but will only poop in a diaper. We have never forced the toilet training issue at all. Will the diaper use diminish as she gets more comforatble moving her bowels? Sorry for all the questions but its been a long haul.
Thanks