What Worked for Us

[Guest guest]

Hi Everyone,

I've followed this board for a couple of years. Our son is now 5 1/2. Since he

started solid foods at 6 months, he has been severely constipated. He was

eventually diagnosed with encopresis. We dealt with constant soiling and

chronic constipation for about 4 years. I am SO happy to say that for about the

last 9 months, he has been very regular and his constipation has been completely

resolved. I just wanted to post what worked for us, in case it might help any

of you with your kids. I know how frustrating dealing with constipation and

encopresis can be!

Just some background on our son: He was diagnosed with a milk allergy as soon

as he began consuming milk products (between 6 and 7 months). He has since

outgrown that allergy, but I believe that this (coupled with him being a very

picky eater and consuming barely any fruits and veggies) contributed to his

chronic constipation at a very young age. Around age 3 1/2, he was also

diagnosed with a peanut allergy. Other than these food allergies, he has no

other known health issues. Our pediatrician put us on Miralax when he was

around 16 months. He never had any adverse side effects to the Miralax, but it

did make his stools very liquidy and I was very hesitant to use it on a regular

basis. Over the next 4 years, the constipation got worse and worse. Often, he

would go approximately 5-7 days without pooping, and then it would be so hard

and backed up that it would require laxatives or suppositories. Sometimes we

would give him Miralax for a period of 5-7 days, sometimes we would give him a

Magnesium based laxative. You name it, if it's an over the counter laxative for

kids, we've tried it! Some worked better than others for us, and many he

wouldn't even take because they tasted so badly. We also used suppositories and

liquid glycerine suppositories (Pedialax brand) occasionally, which was always

very traumatic, and sometimes didn't even work!

When he was about 4.5 years old, we were on vacation in Arizona and he started

complaining about abdominal pain. It had been about 7 days since he had gone

(which was not unusual for him). He kept sitting and trying to go, but nothing

was coming out. Finally he started pooping clear mucus/liquid. This really

freaked me out and I made an appointment for him to see a pediatrician in

sdale, near where we were staying. This doctor ended up changing our lives

and resolving my son's issues!

He diagnosed my son with encopresis. I was somewhat familiar with this term

from this forum and from my internet research. He told me that my son's colon

was severely stretched out from chronically being filled with poop. He

explained that in a normal person, poop passes down into the colon, and when the

poop travels down, it stretches the colon and that this stretching sends a

signal to your brain and gives you the urge to poop. In an encopretic person,

however, the colon is so chronically stretched out that the child loses that

sensitivity and the urge to poop and never has that feeling, even though they

are constantly filled with poop. He told me that in order to correct my son's

problem, I had to " recondition " the muscle of the colon. He explained that this

would not go away in a week or two and that I could NOT continue to spot-treat

the constipation occasionally every 2-3 weeks when things got to a crisis

situation. Instead, he instructed me to keep my son COMPLETELY cleaned out for

6-9 months continuously. He said that if my son went even a day without

pooping, I needed to take action. After 6-9 months, he said the colon would

start to regain its muscle tone and that my son would again be able to feel

normal urges to poop. This was really new information to me, because before, we

were really just treating things day by day, but had no long term plan. He

explained that my son would soil because he didn't even feel it coming out. His

colon was so stretched that poop was just constantly leaking out. He said that

it wasn't my son's fault, that he truly could not feel this happening due to his

stretched out colon. This information really helped me because prior to this, I

would become very frustrated and angry when my son would have poop accidents,

even despite telling me that he " didn't have to go " . I always felt that if he

just paid closer attention to his " signals " , he could make more of an effort to

make it to the bathroom. Little did I know, he didn't even feel the urge to go,

or even the poop coming out.

The doctor prescribed a regimen for us, which was to go home and give my son two

enemas a day for the next 7 days (one morning and night) to completely clean him

out, and then after that, we were to pick any laxative that worked for him and

give it to him every single day in a dosage that will keep him going. He said

that suppositories would be completely ineffective for my son because the colon

was so stretched that he that tiny suppository wouldn't make any difference at

all (this was, in fact, our experience). He explained that in our son's case,

an enema would be needed to stretch the colon significantly enough to stimulate

the colon to go. He also said that my son's body was creating that clear mucus

to try to lubricate the colon and get the poop out and that this was just a side

effect of his severe chronic constipation. He said that after the initial

clean-out, in the event that my son went a day without going, we were to give

him an enema to get things moving again. He said this problem would NOT fix

itself overnight and would require 6-12 months of " therapy " to recondition my

son's colon. Although I didn't like the sounds of all the enemas, I did like

that someone was finally proposing a real plan to help my son instead of just

giving us the usual B.S. that we had been hearing for the last 4 years!

I have to say, the 7 days of administering enemas twice a day were awful. My

son cried a LOT and at times, I felt like crying too! Thereafter, we used a

combination of " Buddy Bear " laxative and Fletcher's Root Beer laxative every day

and we also gave him 2-3 Gerber Apple/Prune Juices every morning, first thing.

Occasionally, we did use Miralax for periods of 2-3 weeks at a time as well. I

know that some of your children have had extreme reactions to Miralax, and I am

certainly not suggesting that you need to use Miralax to accomplish this plan.

I think any laxative can work, if given consistently and after an initial

clean-out is accomplished. He assured us that our son would not develop any

sort of " dependence " on any laxative, and we have not had any issues with that -

and we used Magnesium-based and senna-based laxatives for the entire 9 month

period, daily. The doctor warned us not to even TRY to wean him off of any of

the laxatives for at least 6 months, and we didn't.

After about 6 months, I started to ease him off of the laxatives slowly. During

this weaning off period, we definitely had some minor periods of constipation

where I would have to put him back on the dosage that was previously working for

him to get him going again. We also had to use enemas about 2-3 more times

during the 9 month period, but those instances were very limited. I did make

sure he drank the Gerber Apple-Prune Juice every morning (which he still does).

I also would let him drink any fluids he liked (juice, water, even occasionally

some root beer at restaurants). I also saw in my son's case, that he would get

more stopped up when I would give him lots of milk to drink, so I try to limit

him to one small glass per day. I don't know whether the Gerber juice had any

magic or whether it was just the extra fluids, but it seems to help. We also

incorporated scheduled sitting on the potty approximately 10 minutes after each

meal. During this time, he would never have the urge to go and he would almost

always say " I DON'T HAVE TO GO! " and then he would get on the potty and poop. I

would always remind him that his body was learning to feel how to go again and

he just had to sit after every meal, whether he felt like he had to go or not.

If he didn't go at all for one day, I would up his dosage a little that night

before bed on the laxative and then have him try again in the morning after

breakfast. On the rare occasion that he didn't go the next day, we did an

enema. Like I said, this was only 2-3 times during the 9 month period.

I am SO happy to say that after a year, our son is completely free of

constipation. He is still a very picky eater. He doesn't eat a lot of fruits

or veggies. We do still have a very regimented schedule of sitting after each

meal. He does approximately 2 solid poops every day without any struggle or

strain. He isn't straining or soiling his underpants at all anymore. I still

need to remind him to go and sit after every meal, but he is getting better

about going on his own and it isn't the power struggle that it once was because

he gets in there, poops quickly without any drama and gets out. He isn't having

any accidents or soiling any more, which is a HUGE victory for us. He is

COMPLETELY off of all laxatives. I do give him the occasional dose of " Buddy

Bear " chocolate chewable laxative (if he hasn't gone all day) at bedtime. This

has happened only maybe 4 times in the last 5 months.

I'm sorry for the long post. But like many of you, I spent ENDLESS hours

researching the internet for some solution to my son's problem. I was

frustrated with my son, and our pediatrician. I was wondering if my son had all

sorts of underlying health issues. I hope that this explanation of my son's

encopresis and the plan that helped him overcome it can help some of you with

your kids. If you have any questions, please feel free to ask me. I am sure

this isn't the solution for everyone, but it did work for us.

Take care,