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Derval,

Our son has had chronic constipation and after the Dr.'s kep telling me to keep

giving him lots of pitted fruit and less milk products I got a little fed up

because 1) he wasn't getting the calcium and vitamins he needs from milk

products and 2) this regimen wasn't really working that well. When they

diagnosed him with MDS another Dr. gave us a perscription for Mirolax which he

says is used to regulate constipation in a lot of toddlers and after a few years

the problem often goes away. However, I'm still new to all this and I'm sure

there are some ailments related to the MDS that I'm not aware of that may

require more treatment and/or testing. That's what's so great about this group

- there are so many resources! Anyway, that was my experience in case it helps.

, mom to Aidan (2 MDS) and a (7 mos.)

rourkedeva wrote:

Hi,

My friend has a daughter aged three (four in November) with MDS,

unfortunately she is not currently online and therefore I am

accessing your website for information on her behalf. Her daughter

experiences prolonged constipation which appears to cause her lower

abdominal discomfort and unsurprisingly is seriously affecting her

mood. She often goes for 8/9 days without a bowel movement.

My friend has been seeking medical assistance but to date this has

not been successful.

I would be very very grateful if anyone could offer some

advice/direction.

Many thanks for your time.

Derval

Won't you please consider adding your personal story on the MDS website today?

http://www.mosaicdownsyndrome.com

*************************************************

Become a member of IMDSA at http://www.imdsa.com

*************************************************

MDS MESSAGE BOARD - http://www.mosaicdownsyndrome.com/discus

*************************************************

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WE have gone through this since our Dorothy started on formula at 1 month. We

have gone through Karo Syrup, Kondremul, and now Miralax. She has to take

something daily in order to have a bowel movement. WE have learned to live with

this. You could also use prune juice as an additive to help push things along

so to speak! lol. The pediatrician only helps so much. We go to a gastro

specialist periodically for advice. This seems to help greatly. unfortunately

there

are no easy answers for each case is different. Good Luck!

Alice Poholsky

cell

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All of your questions and replies hit home for me...

There is a bowel disease, called Hirschsprung's, my MDS son has it...

it is when the nerve cells don't travel the entire length of the bowel in

utero. In 's case, it was severe enough to cause a total blockage, but I

belong to another e-group for Hirschsprung's, and you would be shocked to hear

how many people have to fight with their doctors to get them to take their

childs constipation seriously. Many many children with this disease present

as having severe constipation...but can pass some feces.

Now here's the kicker... there IS a correlation between DS and

Hirschsprung's...they find that 2-3% of children with DS have Hirschsprung's!

Unfortunately it can only be diagnosed by a rectal biopsy...because they

have to test for the presence of nerve cells... but initially an x-ray is done

which usually shows the area of blockage, and an enlarged colon from

compacted and backed up feces.

Many websites have great info on Hirschsprung's now! I dont think links

work thru the e-group, but please, look it up and see what you all think about

your individual circumstances!

~ANGEL~

Mom to 11 Mosaic Down Syndrome/Hirschsprung's Disease

Lance 15, Tyler 12, 9

Jaeda 8 & Shayne 2

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My daughter also had constipation problems - what worked best for her was giving

her a tablespoon of mineral oil after every meal. This can be increased or

decreased as needed. She had difficulty passing stools, and this really helped

a lot. My daughter did not mind the mineral oil at all. Don't be alarmed if

there is orange coloring in her underwear, sometimes this would happen and I

would slack off on the mineral oil.

Now, my daughter eats plenty of vegetables and has been off the mineral oil for

about 3 years and has not had a problem - I think as kids get older, the

constipation gets less and less.

Let me know if I can be of any further help.

Charlotte Siegmund - mom to Katy -12 - MDS

Query for a friend

Hi,

My friend has a daughter aged three (four in November) with MDS,

unfortunately she is not currently online and therefore I am

accessing your website for information on her behalf. Her daughter

experiences prolonged constipation which appears to cause her lower

abdominal discomfort and unsurprisingly is seriously affecting her

mood. She often goes for 8/9 days without a bowel movement.

My friend has been seeking medical assistance but to date this has

not been successful.

I would be very very grateful if anyone could offer some

advice/direction.

Many thanks for your time.

Derval

Won't you please consider adding your personal story on the MDS website today?

http://www.mosaicdownsyndrome.com<http://www.mosaicdownsyndrome.com/>

*************************************************

Become a member of IMDSA at http://www.imdsa.com<http://www.imdsa.com/>

*************************************************

MDS MESSAGE BOARD -

http://www.mosaicdownsyndrome.com/discus<http://www.mosaicdownsyndrome.com/discu\

s>

*************************************************

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Derval -

Welcome to our family! What a wonderful friend you are to take the time to help

your friend out with this problem! I strongly suggest that your friend take her

daughter to a specialist.

Also, please feel free to print this out for your friend and her doctor.

Feel free to ask questions any time on behalf of your friend!

Sincerely,

Kristy Colvin

IMDSA President

Constipation and Down Syndrome by Len Leshin, MD, FAAPCopyright

1996-98,2003 All rights reserved

Constipation is usually defined as the presence of hard or thick, pasty stools

which cause discomfort as they are passed. In severe cases, the child has an

inability to pass the hard stool on his/her own.

The direct cause of constipation is not enough water in the stool. This occurs

because of the diet not having enough water-retaining elements (fiber) or

because the stool is kept in the rectum too long, allowing the colon to reabsorb

more water than usual.

In children with Down syndrome, two factors exist to make constipation more

likely: low muscle tone and decreased motor activity. Both of these make the

colon more likely to retain stool for longer periods, leading to loss of water

from the stool.

If left untreated, constipation can lead to (1) rectal fissures: tears in the

rectum leading to bright red blood on the surface of the stool and on the toilet

paper, but not mixed in with the stool; (2) impaction; (3) stretching of the

rectum leading to the loss of the sensation of the need to have a bowel

movement. This last problem can further lead to the weakening of the rectal

muscles (sphincters) and cause the child to have bowel movement accidents (in

medicalese, " encopresis " ).

The usual treatment of constipation is dietary: increasing fiber, fruits and

vegetables. In bottle-fed babies, the introduction of a stool softener is used,

such as corn syrup (Karo), malt barley extract (Maltsupex) or lactulose

(Diphulac). Lactulose is also used in children and adults. All of these soften

the stool by adding water to the stool. Another way of adding dietary fiber is

through products such as Metamucil, Citrucel, or fiber wafers. Increasing the

amount of fluids the child drinks is helpful; and in older children, decreasing

the amount of constipating foods (milk products, bananas, white rice) may also

help.

For babies who are having a hard time passing a stool, the use of glycerin can

be helpful. These can be found as solid suppositories or in liquid form

(Babylax), and are useful as occasional measure. For severe constipation, your

doctor will usually recommend a medicated suppository or enema; please do not

use these without consulting your doctor first. Likewise, avoid other laxatives

unless your doctor specifically recommends them. The treatment of encopresis is

long and involved, and I won't go into that here.

Two special conditions require further mention in children with DS: Hirschsprung

disease and hypothyroidism.

Hirschsprung disease is a condition in which a segment of colon directly above

the rectum is formed without nerve endings. This condition makes it impossible

for that segment to push the stool along into the rectum; the stool backs up

just above the rectum and only enters the rectum when enough stool backs up to

push the front along (like a train caboose pushing the engine). These babies

typically do not pass stool in the first 48 hours of life, and are chronically

constipated. Children with DS do have an increased risk of having Hirschsprung

disease, and sometimes it can be very difficult for the doctor to tell the

difference between Hirschsprung and the normal stooling pattern of a baby with

DS. The diagnosis is made by first performing a barium enema on the child, and

if that exam is suspicious, confirmed by a rectal biopsy. Treatment is the

removal of the segment of colon without the nerve endings (the length is

variable from child to child). The traditional treatment was

performed in two stages: the first surgery attached the ending of the colon to

a specially made opening (colostomy), and then reattachment of the rectum was

performed months later. Now, however, many surgeons are removing the involved

segment of colon and reattaching the good colon to the rectum in one procedure.

This surgery solves the problem of constipation, though children without long

segments of colon may have problems with diarrhea and malabsorption for the rest

of their lives. Parents of children with Hirschsprung disease may be interested

in a parent organization called the Pull-thru Network at www.pullthrough.org.

Constipation is also one of the signs of hypothyroidism, another condition more

common in children with DS. Because the signs and symptoms of hypothyroidism can

be well hidden in children with DS, a regular thyroid screening blood test is

recommended every one to two years, even if the child is growing well.

rourkedeva wrote:

Hi,

My friend has a daughter aged three (four in November) with MDS,

unfortunately she is not currently online and therefore I am

accessing your website for information on her behalf. Her daughter

experiences prolonged constipation which appears to cause her lower

abdominal discomfort and unsurprisingly is seriously affecting her

mood. She often goes for 8/9 days without a bowel movement.

My friend has been seeking medical assistance but to date this has

not been successful.

I would be very very grateful if anyone could offer some

advice/direction.

Many thanks for your time.

Derval

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