Chronic constipation in 10 year old, laxatives don't work
My 10 year-old child is in misery. He's had all the blood tests (all normal, no celiac), an abdominal X-ray (which detected "large amount of stool"). We've consulted with a Kaiser pediatric gastroenterologist, we go to acupuncture, he takes multiple doses of Miralax, plus Exlax, plus Chinese herbs. He did an enema once, which had some effect, but not much. He does Ducolax suppositories, and no effect. He did a 2-day cleanout using Golytely--and has not had a BM other than a few drops since then (10 days and counting). He doesn't want to go to school. He's cramping all the time but can't use the bathroom. The GI doc says in her message, "I know it's frustrating." He barely eats anymore. A sprained ankle that has put him on crutches for the last 2 weeks is exacerbating the situation. I'm thinking about bringing him for a colonic (not the open method, so the tube is very thin)--I know that they are not intended for kids, but nothing else is working. Would appreciate any advice.
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I had a similar situation with my child. We were referred to UCSF Urology where we worked with a Nurse Practitioner on the issue. He was put on a nightly enema regimen for an extended period of time. The enema frequency was gradually decreased until he was able to move his bowels without them. It worked really well.
This sounds terrible for both of you! Have you tried blood tests for food intolerances? Not the standard food allergy tests (IgE), but the ones that measure for food sensitivies (IgG and IgA)? We went through an awful ordeal with our daughter when she was 2 and having major skin flare ups all over her body and horrible constipation. All kinds of topical medications and even antibiotics for months did nothing to help. Miralax was not helpful and we didn't feel comfortable having her on it indefinitely. We tried Chinese herbs, increased fiber, we tried ALL the things... Doctors and dermatologists and specialists kept saying it wasn't food related since her allergy tests were negative. Then we finally found a doctor who ran a different set of labs that specifically checked for food sensitivities and we discovered she was intolerant of wheat, dairy, egg and pea, among a few others. We eliminated those from her diet and her issues were mostly resolved in a few months. It took a while to completely stabilize, but now 2 years later, we've been able to re-introduce all of those foods and she tolerates them fine in small doses. Might be a long shot, but perhaps worth checking out. I'm so sorry - I hope your little guy feels better soon!
Have you checked whether he has any nutrient deficiencies? Being deficient in B12 or D can cause constipation. I was malnourished before I found out I have celiac disease, and boy, let me tell you that those nutritional deficiencies can really cause a lot more problems than people would expect.
Also, have they checked for small-intestinal bacterial overgrowth (SIBO)? Hypothyroidism? Constipation is a common sign of hypothyroidism.
I wish you the best of luck!
Generations of my family have struggled with constipation. It can be so painful and stigmatizing. After all the OTC stuff, we finally went back to basics which really helped. Eating brown rice, corn, popcorn, peanuts, peanut butter every day. Do not eat any carbs made with white flour or any processed alternative flour, whole wheat only. Gluten free doesn't help and may hinder. Massage and relaxation exercise. Since it has been a long time, and your child's bowl movement may be impacted, you may need to use a rubber glove and help it out but that can be painful. It is all trial and error until you find what works. Good Luck!
So sorry you and kiddo are going through this!
My 8yr old just would NOT be poop trained. This went on for years. Tried EVERYTHING and nothing worked. We finally did the fleet pediatric glycerin suppository DAILY for a month. That got him used to the idea of pooping daily in the potty. Then we reduced that to every other day, then once every few days, now rarely, in the meantime we sit on potty daily after dinner, so now he generally does a poop every day. If not, we ask him if he wants to use the suppository or if he wants to try again tomorrow. No doctor liked the idea of daily enema, but you know what, it’s fine and he saw the benefit so he was on board. The baby version called liquid glycerin suppository is better because it is glycerin based, unlike the bigger bottle which was more problematic for longer term use, and the baby version works for him so it’s fine. So now he is more or less there. Best of luck!
Prune juice...?maybe give it try. also prunes and apricots (fresh and dried)
It could be a food sensitivity (to dairy, gluten, etc.). When you say he barely eats anymore, what DOES he eat? My child was dealing with encopresis ~7-8, and we ended needing to do child-size enemas each night to get things moving and get him going regularly. But exercise, both soluble and insoluble fiber in the diet, and water intake are all really important. If he's on crutches, do some floor exercises with him. Movement helps. Sometimes there is not an overnight miracle, but a consistent effort to build flora in the gut to help with motility. Look into "Heather's Tummy Fiber," prokinetics such as Iberogast, and feed him "jam" made of blended stewed prunes and peaches on oatmeal. Good luck.
I just posted a similar question. I don’t have any answers but just wanted to say that I’m in the midst of it too and it’s awful. Therapy might be a good option (for him).
There is an Ayurvedic remedy called Triphala. It is a poly medicine consisting of 3 different herbs. It is gentle. One herb fights inflammation, one lubricates, one softens waste. I am an adult, but it can't hurt to ask a knowledgeable health store individual if it is safe for younger folks. I swear by it, and also had a friend who had lung cancer, was on oxy, and was also miserable. She had tried multiple remedies. Her partner was an acupuncturist and nothing helped. She tried Triphala and viola! Success.
Important to note that it is not a spasmodic and could take up to 3 days to work. Of course, water is extremely helpful.
"Triphala is a powerful herbal remedy that consists of Haritaki, Bibhitaki and amla. It is used in traditional Ayurvedic medicine to prevent disease and treat a number of symptoms, including constipation and inflammation."
Again, I am not a practitioner, just a person who's been there.
hi--my daughter and i both struggle with constipation. I had no idea my daughter was backed up until her pediatrician saw her tummy and recommended we try psyllium husk once a day. As soon as we did things began to clear out for her. We stir a tablespoon of organic psyllium husk into our morning oatmeal or porridge. That stuff moves things along really well. It doesn't taste super good but we add maple syrup to the oatmeal and it helps. Also make sure he drinks lots of water. And this probiotic also helps me--it came recommended from a friend who is a nutritionist--she says most probiotics don't survive our digestive tract. but when i take this regularly it really helps keep things normal. it's called SporeBiotic--start with a half capsule a day and after a week work your way up to one capsule. (you should also try eliminating dairy and gluten--both really stop people up--even if he doesn't have celiac he could be gluten sensitive). Also, I remember post c-sections that prune juice worked really well for me too. You might want to avoid bananas as they can slow things down. I would talk to a nutritionist--they can give you a lot of food recs like these that should help.
Here's a suggestion:
While I am an adult, I have had constipation issues since childhood.
After trying lots of types of remedies, the thing that really works is a two-step process:
First, go on a hike (one mile or more, hill work is even better than on a flat trail).
Second, eat a LARGE bowl of hot soup, broth-based rather than cream. As my gastroenterologist says, exercise signals your guts to do stuff.
Hope this is helpful.
I’m sorry you and your son are going through this. What is his diet like for breakfast, lunch and dinner? (When he eats)
Another thing you can try is Natural Calm for kids. It's magnesium supplement you can buy at pharmaca. That particular form of magnesium helps move things along as well.
Try a gluten free diet. Your child could have a gluten intolerance but not celiac and that won't show up in blood tests. My child was very similar and none of the Western docs we ever saw had anything helpful to say -- Gi specialists, testing, etc never helped. Miralax didn't help. But a gluten free diet solved everything! Your child may also have other food intolerances - dairy, corn and soy are other common ones. But start with cutting out gluten. Best of luck!
Smooth Move tea has been the only solution for me. I buy it in bulk on Amazon. I experimented with different frequencies and # of teabags to find what works for me (presently 2 bags every 2 days). Definitely recommend experimenting starting on a Friday afternoon, so you have the weekend to be close to home. Also, FWIW, after plane trips is a notorious "stopped up" time for me, so I drink tea before and during a plane ride, and that first evening. I use as little liquid as I can stand (a measured cup or so), since I don't really like the taste. Best of luck.
Hi there, I am so sorry your son is going through this! What you are describing is very similar to what I experienced when I was a teenager. I was constantly constipated and bloated which made me feel miserable. And just as you mention in your post laxatives didn't help. I even ended up in the hospital once because I didn't have a bowel movement for more than two weeks and was in a lot of pain. I had ultrasounds and a colonoscopy done when I was 20 but the only diagnosis I ever got was: there is a lot of stool and gas! After years of suffering I decided to try an elimination diet and it turned out I had "just" lactose intolerant for all those years! I eliminated dairy from my diet and I never had any issues again (plus lactase pills also help). This was 15 years ago when food intolerances weren't really a thing but I am surprised your doctor hasn't tested your son for it (or maybe they did?). Good luck and I am sure you will figure it out!
It sounds like OT/PT might be good. There is a pediatric pelvic floor PT in Walnut Creek. A daily combo of mag citrate gummies (new chapter), exlax, and probiotic help our kiddo. Exlax dose may need to be higher in your child's case. We also play close attention to hydration, fiber intake (both soluble and insoluble), the med routine, timed sits (really important, about 10 mins, about 20 mins after each meal), and exercise. OT may help with the inability to go if there are interoception issues (feeling too much or feeling too little of the sensations around pooping). You might also consider therapy. And Chadd/Attitude has an article about ADHD and constipation-- they often go together, so if there are other signs of ADHD it might be worth pursuing the dx.
Try Welch's 100% Juice White Grape Peach. It works unbelievably well for my child. Also Siggi's nonfat drinkable vanilla yogurt.