DS' constipation issues **Update**

[LarsMal]

Well, things finally seem to be moving! I took DS back to the ped last week. She did another rectal and said she didn't feel much in there, so the enemas must be helping him. She said to just keep pushing the Miralax, along with the Pedia-lax chewables or strips, until things started moving. It took about 3 or 4 days, but he's had BMs two days in a row- YAY!! Man, do they STINK!!!! So disgusting, but at least it's coming out!!! I finally got the Miralax in him by dissolving it in an ounce of water and then adding his soymilk to it. Drinks it right down.

Thanks for all your helpful advice. Hopefully he'll start getting back on track now. Phew!

************************************************** ********
I feel horrible for poor DS. He has been having constipation issues for about 3 weeks now. We went to the ped when it first started, she did an exam and told me to give him an enema. Fine, got it out, no prob. We were then supposed to follow up with Miralax daily, glycerin suppositories as needed.

NOTHING is working for this poor child. I finally gave up on the Miralax because he won't drink anything I put it in, and now he just won't drink anything because he thinks it has medicine in it. The Miralax is supposed to be tasteless, so I don't know why he won't drink it.

I tried two days of glycerin suppositories- nothing
Fleet Pedia- Lax- tried the overnight dissolving strips, supposed to produce a movement in 10-12 hours- NOTHING
Chewables- movement in 1/2 - 6 hours- NOTHING

The only thing that works is an enema, and I can't just give him one every few days. That can't be healthy! And he's really starting to fight it.

By day four his mood starts to change (like today) and he's just miserable. I feel horrible for him, but I don't know what else to do.

I called a gastro ped- they can see him in mid-September- Ummm....NO! I told her it was urgent and she said, "Then have your ped call us and tell us that." So I called my ped, on Monday, never heard back. He had a BM on Monday so I didn't call back again until yesterday. Left another message and the nurse called back to say, "Well, there's a note in his chart to bring him back in if things don't improve, so bring him in on Monday."

Grrr...so....Bring him in for another copay so we can tell you to go see a specialist, and then maybe we'll help you get him in faster. Yet I've lost another week that I could've gotten him in somewhere.

I'm just so frustrated and I feel so helpless. I don't know what to do to make him comfortable and make him go. You'd think so many days of laxatives would make something happen.

Ugh...

[MMMommy]

I totally understand b/c both my girls had constipation problems. Their pediatrician had put them on a prescription laxative (Polyethylene Glycol 3350, NF Powder for Solution). You just mix a little into whatever they are drinking, and it worked like a charm. They were on it for many months and eventually didn't need it anymore. You might want to ask your pediatrician about it to see if it might work for your son.

[JTsMom]

Wow, I can't believe you guys are still dealing with this! Not that this is a permenant solution, but have you tried the liquid glycerin? I think it's called Baby Lax. I've had good luck with it. The downside is it might burn for a second going in (according to the package) but it migh be worth it.

Have you tried putting the Miralax in a smoothie? I'm thinking that might be thick enough to cover it up. We make them with yogurt, 1/2 a banana (I wouldn't use that in your case though) and a couple of strawberries. I'll bet you could use prune juice and strawberries for a little extra oomph. Maybe just play with different fruits until you find something that he'd like.

[JTsMom]

One more idea- have you seen this?

http://www.askdrsears.com/html/8/T081100.asp I though I remembered seeing good stuff on that site when DS had constipation problems as an infant.

[LBW]

My oldest had terrible constipation issues that lasted for years. I feel for you, because I know how frustrating it can be. The wait at our Peds GI is similar to yours. There's just no way to get in to see them sooner. One thing you can try is to ask the office staff to put you on their cancellations list. That way, they'll call you if an appt opens up. You can call them every day or two to see if there is an opening.

You really should try to get him to take the Miralax. It's what our Peds GI prescribed a couple of years ago before it was OTC, and it's probably what your Peds GI will recommend once you get in to see him/her. (I'm pretty sure what the pp recommended is the generic form.) It does wonders once it starts working. Just don't let him know it's in what he's eating or drinking. You can add it to applesauce, pudding, jello...whatever it takes. It does take a few days to begin working, but I'd be surprised if you didn't see results.

I'm assuming you are already limiting dairy, and other constipating foods, and getting as much liquid in to him as possible.

[lmintzer]

Sorry you are going through this. My oldest had extreme constipation problems beginning at age 3. Long long story.

Only have sec here, but just wanted to give you a heads-up about Miralax use. It is a very safe and effective drug (esp. if your child isn't too backed up to begin with). BUT, it does not work unless it is taken with a lot of fluid. People sometimes make the mistake of putting it in a sippy and letting their kiddo nurse it over the course of a morning. Doctors don't always tell you that this won't work! The dose must be consumed within 30 minutes.

If your child can't drink 8 oz. liquid straight (mine can do this now at age 7 but couldn't as a 3 year old), your next best bet is to cut the dose in half and give it twice a day in half as much liquid. If you are supposed to be giving a whole 17 g. cap, give 8 1/2 g. in 4 oz. water or juice in the morning and at dinner time.

Also, it's not typically recommended to dissolve it in milk. Maybe not work as well that way either. Water or juice is best. Hope that helps. Good luck!

[Twoboos]

Miralax ... does not work unless it is taken with a lot of fluid.

DD1 is on Miralax too, and I have also heard this. And that you can't put it into food/oatmeal/pudding/etc.

Since your DS is now refusing all fluids, that is going to slow things down too! Pushing fluids is a major part of my day. I say some variation of, "Have a drink of your drink" at least 10,000 times.

When she is really backed up and acting sick because of it, we have had success with the Fleet Pedi-lax (I think?)- the liquid glycerin form, which is inserted recally. With the orange bulb. She will have a BM within about 1min of having one of these.

Good luck, consitpation issues are HORRIBLE.

[LarsMal]

Thanks everyone!

I read all your tips and advice and I'm going to try to push the Miralax again. I've been doing the half dose 2x/day, but he still won't drink it all down. I also used the Pedia-lax chewables and the strips (not on the same day, but I'll do one or the other for several days in a row) and they haven't done a thing. I even did two days in a row of the glycerin (rectal) and that didn't do anything either! I don't know how he can have all those laxatives in his body and nothing is coming out. I'm starting to worry there's something else going on, but hopefully it's just me being a worry-wart! Every now and then he'll double over and moan in pain and I'll think- ooh, here it comes- then he straightens up and off he goes. Poor kid!

I'm going to have to give him another enema tomorrow I guess (he hasn't had a BM since Monday). I hate to do it, but it's the only thing that will work.

Thanks again, I'll let you know what the ped says after we see her on Monday.

[StantonHyde]

We have used Miralax for 5 years with DS. I started with 1 tsp in 6 oz of milk and now we do 2 tsp. Makes him very regular. You can also but mineral oil in milk--use chocolate milk, it tastes better. The other idea is to try a drink he usually doesn't get--they usually love that.

Sprinkle it on icecream!

[lmintzer]

Does the enema really clean him out? I only ask in that we got to a bad place where the enema failed to work--we had that bad of an impaction. Don't be scared by our story--we were extremely unusual.

The problem is that the colon is like a uterus. The more you put in it, the more it grows, and the harder it can be to clean things out. Also, it takes lots of time for it to start working normally again. So the Miralax may be a long-term (or at least semi long-term thing).

Mineral oil in addition is a good idea--and totally safe. My son would drink it out of one of those baby sippy teaspons. You just want to make sure that your kiddo doesn't fight it (don't force it), as it is not stuff you want to inhale and get in the lungs due to its viscosity. Mineral oil is a good one to pour in yogurt or pudding. I would stick with liquids with the Miralax.

We could write a book on the subject, I think. We did some behavioral mod. stuff to address the stool withholding behavior. It's worth asking about, but you want to make sure he's medically on the right track first. Don't be surprised if the Peds GI asks for an abdominal x-ray. We did these to see just how much backed up stool there was.

If you ever get to a point where the enema doesn't work--where you are just getting brown water and not anything of substance--you should seek more immediate medical attention. Also, if he starts to vomit or has severe pain. You probably know all this already but just thought I'd mention it just in case.

Best of luck. Feel free to e-mail me if you'd like: [email protected] or I'll keep checking here.