Dear Amy,
Not to worry you but, until I learned how to resolve the functional causes of this condition, I have seen patients who were still witholding at the age of 10. I have never heard of it continuing until adulthood. SO, this COULD be a much longer "haul".
Your idea about giving the metamucil is a good one so long as it works. The idea is to mix it with as many things as you can so that you finally get to an effective dose. Remember, the effective dose is whatever produces 3-4 bowel movements a day. After a few months of that frequency you might gradually reduce the dose until it is no longer necessary.
The emulsified MO is OK. The only thing is for you to understand that it is 50% water (that is what it is emulsified with). That means that you need twice the actual volume you are using to get the actual dose of MO needed. The correct dose is just less than that needed to show oil floating around in the toilet water. You may never find that out until she gets back to stooling in the toilet.
The timing of this is perfect for a psychological problem. However, once witholding gets going, the physical pain of a movement keeps it going long beyond the psychological trigger is no longer contributing. That is why the protocol I have used so successfully works. One needs to first get rid of the pain and then let time take its course.
By the way, I am a littel worried that you classify her as a "picky eater". That tells me that she is running the family far beyond her expertise--and she knows it.
You do not let her decide whether to play in the traffic. She is not old enough to decide what she should eat either.
Children are trapped inside growing bodies. If you do not let her decide what to eat, she will eventually eat whatever you put before her. Depending on how long you have let her decide what to eat, it COULD take you a couple of weeks to get back in control of this factor that you MUST be in control of. It would not hurt her to eat nothing for a couple of weeks while her stubborness tested out your resolve. If you only offer her wholesome food, it will not last more than a couple of days. If you give in, it could be forever. If she wins THIS one, what will she do when you tell her she can't stay out all night with her boyfriend at age 14?
Children WANT and NEED guidance for those things you KNOW they are not competent to decide for themselves. When you do not give that firm guidance, the child thinks: "My life is in the hands of an incompetent, ME!" That is a VERY stressful thing and contriburtes to problems like this.
Walt
In Reply to: Re: WITHOLDING IN 3 YR OLD posted by Walt Stoll on March 02, 1998 at 10:48:24:
Thanks for the advice. Now my question is how do we go about reforming our child who has been a very light and selective eater ever since she was weaned from the breast? I offer her fruit, vegetable, protein and carbohydrate at each meal except breakfast, where she eats cheerios and milk..ok in my book...but she eats only the pasta or potato, and occasionally fruit (although she eats a lot of bananas). She does each cheese (has never taken milk) and cottage cheese (note how all of these are nice, binding foods!! Yikes). We do not have junk food with the exception of popcorn and goldfish crackers...and the very occasional cookie. She is 3+ yrs old, weighs 26 lbs and is 36" tall. Her record for witholding is 14 days! Although I'm happy to say she has gone 2x in the last 3 days...today even in the toilet! Obviously she is stubborn, manipulative and very bright...I'm willing to be the bad guy here...I'm the one who doses her with all this MO etc...so I don't mind putting a few more regulations into place...but how do I force these foods down? Do I not offer the carbohydrates? Sorry so long. Luckily my 16 month old twins, although petite as well, eat everything in sight!!
Amy
In Reply to: Re: WITHOLDING IN 3 YR OLD posted by Walt Stoll on March 02, 1998 at 10:48:24:
Just a question about the wisdom of using Mineral Oil. Isn't this a petroleum derived product-hence the name- and doesn't it flush oil soluable vitamins from the system. I was a constipated child and often got doses of MO. I can tell you that taking the MO in and of itself was a very stressful thing for me. Would you not recomend some magnesium? In the proper dosages the effects are quite natural. Magnesium is often lacking in the Standard American Diet (SAD I call it).
I believe my weak eyes, oily skin and hair, erratic menses, and poor energy levels (vitamins A and E) was related to a lack of these vitamins in my diet (as well as stress) coupled with their removal by MO. I began craving nuts and whole wheat bread by age 8. Not a bad thing except my family didn't want to buy something different just for me, and nuts were only for Xmas holiday baking at our house. Wheat germ was kept in the cabinet and was quite rancid by the time I found it. Thankfully I left for college at 17 and was able to buy my own food. The kid who hated (overcooked) vegetables became a "vegetarian health nut"! I am sure my mother still thinks I did that just to spite her. She was only doing what the advertisers told her about the BEST things to feed her family. It is a wonder any of us survived Wonder Bread. I am constantly amazed at the human body's ability to carry on. I am not surprised by all the disfunctional symptoms of our society and all the money being made by the chemical companies at our expense.
Well I have ranted enough. I just cringed at the thought of that 3 year old girl being given doses of mineral oil. There must be something that is effective and health nurturing.
In Reply to: Re: WITHOLDING IN 3 YR OLD posted by Amy Feins on March 02, 1998 at 19:57:04:
Dear Amy,
It looks like, if we don't do something else quick, she is going to get better with just what you are already doing (grin).
ALL kidding aside (and I was only partly kidding with the above) you are already doing much better than most people with their "picky eaters". Congratulations!
I would do several things about her diet, however:
1. No white pasta (only whole grain).
2. Until this problem is gone at least for 6 months, no fruit.
3. No unpeeled potatoes (peeled potatoes are refined).
4. The popcorn is a whole grain & is fine!
5. I would kill the goldfish crackers for 6 months but not worry about the "very occasional cookie".
I would continue to gradually increase the metamucil until she has several bowel movements a day. Once the problem is obviously resolved, I would very gradually reduce the metamucil till there was one or two soft movements a day & keep it there for about 6 months. By that time, you should be able to gradually eliminate both the metamucil AND the MO. At the first sign of problems go back to the doses you were using before you cut anything the last time.
Remember, ALL children this age are stubborn and manipulative. It is just their way of trying their wings. It is OK for them to be that way as long as you protect them from harming themselves. For that goal you must be absolutely consistant.
Sounds like you are doing a much better than average job. Stick to your guns!
Walt
In Reply to: Re: WITHOLDING IN 3 YR OLD posted by Laura on March 02, 1998 at 20:15:22:
Dear Laura,
Wonder Bread is just plastic in the shape of bread. I grew up on it too.
The occasional use of MO doesn't do much and should not be used. It does nothing until it works itself all the way through the 35 feet of the GI tract anyhow since it is not absorbed. MO should NEVER be taken at any time except at least 2 hours after the last meal of the day AND right at bedtime so there will be no more meals till morning. That way the loss of fat soluble vitamins will be minimal. Since fat soluble vitamins are stored in the body, every day that MO is not taken, those vitamins are kept to use for the days that the MO WAS used EVEN if the rules above are not followed.
MO is likely to be a problem only if used every day, at the wrong time of day, for years. For this problem, done correctly there is no risk & the MO can be discontinued in 6-12 months-----years before it could cause any problem.
I hope that assuages your concern. I wish there were something else that would work but the very qualities of MO that you are concerned about are the ones needed to resolve this problem.
If you had not been so stubborn as a child, the vegies in your diet probably would have prevented the constipation and your poor mother would not have had to resort to the MO (grin).
Thanks, Walt
In Reply to: Re: WITHOLDING IN 3 YR OLD posted by Walt Stoll on March 04, 1998 at 12:57:45:
Just one last question about this scintillating topic(heyby the way, she's going every day on the toilet now!) Why no fruit? I would think that would be an unconstipating type of thing.... I won't even get you started on whether or not this is a good time to fight her on her latest escapade..which is coming in to our room around 1am and sneaking into bed w/us....ahhhhh parenthood.
Thanks
Amy
In Reply to: Re: WITHOLDING IN 3 YR OLD posted by Amy Feins on March 05, 1998 at 15:28:18:
Dear Amy,
Congratulations! See how easy it CAN be to resolve this.
Something you said warned me that she might have candida complicating this problem. Fruit is just a fun way to eat sugar. There is practically nothing in fruit but sugar & fiber. 200 years ago there was a lot of healthy things in fruit but no more.
Eliminating fruit has another benefit for a "picky eater". It avoids empty calories that the child will fill up on while you are trying to just offer healthy foods. Fruits are no longer healthy foods.
Walt
I read your excellent article on the above. My daughter is 8 and has constipation problems. I am a bit concerned about your reference to the possibility of "accidents" as this would be a problem re school etc. Was your treatment aimed at a younger age and if so what would you recommend for this age?
In Reply to: constipation in children posted by Andrew Stephenson on March 10, 1998 at 19:32:44:
Dear Andrew,
At age 8, the chance of accidents would be greatly reduced--if not eliminated altogether.
HOWEVER, just to be sure, if you are willing to take longer--just to avoid any accidents for certain--just start with a lower dose of the metamucil like stuff & gradually (every few days) double the dose till she has 2-3 movements a day.
This will work as well for her. She may need to stay on some dose of the metamucil for years once the problem has been resolved for a year or so.
Walt
Have you heard anything about using this as a laxative.
I am asking for my friend with Transverse Myelitis.
I just wondered if it is considered safe, etc.
thank you! Barbara in Louisville
In Reply to: Cascara Sagrada posted by Barbara Dusel on March 19, 1998 at 15:52:43:
Dear Barbara,
Cascara is a gentle laxative. However, with this condition, I would first try the combination of metamucil & mineral oil discusssed many times here for witholding constipation in children. Use the search feature to find it.
Your friend can always give up & use the cascara, However, she will find that increasing doses will be needed as the time goes on & that a true laxative habit will occur with this approach.
Walt
I need to develop a behaviour modification programme to encourage a 5 year old boy to start using the toilet. Can anybody point me in the right direction
In Reply to: Re: witholding stools in small children posted by Ken Maxwell on March 24, 1998 at 07:46:54:
Dear Ken,
Of course, the entire resolution will depend upon WHY this is a problem. Is there a bacic physiological cause or is this entirely psychological with the atttendant physiological complications that inevitably occur after years of psychological witholding?
Is this only stool or urine also?
Walt
My almost 4 year old has experienced this problem with constipation since he was probably 2 years old. He would stool only every other or 3rd day. Because his diet is very poor, very limited foods, no fibre, no vegetables, apples only without skin etc. trying to increase his fibre was very difficult.
He progressed to the very large, constipated stools with fissures and bleeding. We saw the G.P first who recommended milk of magnesia then senekot then a variety of mineral oil products. This did not work and the senekot caused stomach cramping etc. Once stopped, he would revert to the same problem only his bowel became so lazy that his stools were huge and painful. The cycle continued. We saw 2 paediatricians with the same recommendations. Same problesm. Finally, we found a paediatric gastroenterologist at the Children's Hospital of Western Ontario in London, Ontario and he has a full bowel routine that he uses to treat this problem.
Golytle or P.E.G. solution, is a gastric lavage treatment used for bowel cleansing. He uses 2 - 3 tablespoons each drink for 1 day until the bowel is clear. Then he recommends 2 tablespoons each day or enought to produce 2 loose stools daily.
We have been using this for 3 weeks now. My son only needs 1/2 to 1 tablespoon daily to produce 1 stool a day, loose, small size, no pain. We have had no further stomach cramps, no bleeding etc. This routine is for 6 weeks then it is decreased and fibre increased until the stool continues daily without intervention. I hope this will work. My only worry is if this is like a laxative and causes the "lazy bowel" syndrome? The paediatrician says it is not however, the pharmacist says it is. What do you think?
So far, this program has been the best. The one thing you have to watch is not to give too much that produces incontinence. This has happened twice and my son gets upset. This is more my fault, I need to taper the dose.
Comments would certainly be appreciated.
Thank-you
Megan
My grandson was diagnosed with Hirshsprung Disease when he was a baby. He had the full surgery done when he was a year old. He is now eight years old and still has a lot of problems. He has very loose stools and has a hard time controlling his bowels. He tries but still has accidents, which is very embarrasing for an eight year old boy. He also gets a lot of painful rashes. Do you have any suggestions?
In Reply to: constipation in 3 - 4 year olds posted by megan on March 28, 1998 at 18:33:59:
Dear Megan,
I have no idea what is in Golytle or P.E.G. I must know it by what is in it. If you could share what the actual stuff is that is in these names............
There is no mystery about how to resolve this problem. Physicians actually charging people for advice should be ashamed of themselves for "not knowing". I would bet that, if one of their kids had the problem, they would soon figure it out.
I am more concerned about your child's diet choices. Since when is a child this young competent to decide what he will eat? That is the parents' jobs.
Children are trapped inside these little growing bodies. If nothing but nutritious foods are available, that is what they will eat. If refined garbage is available that is what they will eat since the entire processed food industry has had more than 100 years to titillate the tastebuds of children to eat anything that overwhelmes their tastebuds so they cannot taste anything else. Do not let yourselves be screwed every day by these manufacturers who care not a whit about the health of your family.
At this age, you still have total control (probably your last opportunity to do so) of your child's diet. If you offer nothing but nutritious food, & he eats none of it--so what? Giving him what he wants has already caused him to be sick. If he was so stubborn as to eat nothing for 2 weeks, what harm in that??? When he is hungry enough, he will eat. When he is thirsty enough, he will drink. NO fruit juices during this time. They are just sugar water anyhow & will put off his eating what is good for him.
Of course, the hooker is that the adults (and the rest of the family) have to only eat healthy stuff too. It is not a good example for the rest of the family to be eating junk while the little kid gets to eat real food. Usually THAT is what prevents reasonable solutions to this problem.
Remember, one of the leading causes of death in this age group is the fact that they will drink kerosene, gasoline, bug spray, liquid plumber, etc. Taste has nothing to do with this, it is a control mechanism the child uses to control the parents.
If you do not give in, this problem will be over in a few days. If you give in even once, you CAN prolong both your miseries for months. DO NOT START RESOLVING THIS PROBLEM UNLESS YOU MEAN TO FINISH IT.
If this problem is NOT resolved at this age he will be the next generation of colon cancer patients, etc. Go to the library & just read what the lack of fiber causes.
I know you do not care to hear what I am saying. However, it needs to be said. I am not here to make you like me. I am here to give you the best advice your present Doc has not been willing to take the time to tell you.
Walt
In Reply to: hirshsprung disease posted by N. Spenard on March 28, 1998 at 20:51:29:
Dear N.,
Hirshsprungs never causes rashes. Therefore this is NOT just Hirshsprungs. Only the surgeon and the pathologist who examined the post surgical tissue knows if this was truly Hirshsprungs or not. You need to have ALL of these records in your home so you can answer questions like I would have to know the answers to to help you figure out how much of this was due to the surgery, how much due to the original diagnosis and how much is due to the intestinal condition that is causing the rashes.
Go to your library & ask them for a copy of the November 17th, 1997 issue of Newsweek. You will find at least a likely cause of his present condition while you are getting his records. Besides, he needs these records in his home medical files for the rest of his life----before they are destroyed. After all, they are about him, not about the docs who took care of him.
When you have more information, write again & refer bask to this note so I know what you are talking about.
Walt
My nephew is being biopsied for the same disorder. We know nothing about it. Can you direct us as to where we might find help. Thank you JMills8836@aol.com