need help for 7 year old daughter - Gastroenterology

by Felix'sMum, Jan 03, 2007 12:00AM

How truly awful for you. My son is 6 and has some long-term health problems - he is so DONE with all the regimes and routines and hospital appointments and blood tests, just like your daughter. Trying to force her to have an enema must be a nightmare.

Apart from diagnosing chronic constipation, has anyone actually said WHY she's constipated? Is it an issue of poor bowel functionality? I doubt the CF test will show up positive so try not to worry about that too much; you would normally have picked up on other symptoms like long-term cough, poor weight gain, foul smelling BMs before constipation became a diagnostic clue.

I am more concerned for you to get to the bottom of the cause rather than just having to accept the long-term treatment of having to live on meds for the rest of her life....constipation is usually a symptom of something so you'd want to treat the root cause long-term, surely?

Are there any emotional/psychological issues surrounding your daughter's attitude to her BM's? You say the constipation has been there for as long as you can remember. but can you pinpoint when/how it began, even roughly? How was she as a baby? Did she have regular BM's then? When she was little did she go better in nappies than she did afterwards when she started potty training? Some kids have real deep seated issues about their BM's - it can be associated with seeing what they poo or even just becoming aware of the weird feeling of passing a BM and it sets up a vicious circle where avoidance of that makes them hold on subconsciously, leading to chronic constipation. It can even be caused after she had one original episode of constipation so the next time she passed a BM it hurt, and she got scared to go again in case it hurt, so got constipated again, so it hurt etc etc round & round.

If the doc genuinely says he can find no root physical cause for her constipation you might want to consider seeing a child behavioural specialist who could talk things through with her and find out whether there are issues in her subconscious which may be at the bottom of all this (no pun intended there!). My heart goes out to you; I hope you get things sorted real soon.

by Felix'sMum, Jan 03, 2007 12:00AM

...and I forgot to ask whether there is sufficient fibre in her diet? That may seem obvious, but if your daughter has an abnormally slow or "lazy" bowel, it may need an extra boost to get going and that has to take the form of increased fibre in her diet.

If there is a particular vegetable she likes and maybe one or two fruits, try her on 7 or 8 portions a day. You're probably giving her the recommended 5 helpings of fruit & vegetables as the norm anyway, but bumping up the fibre considerably might be enough to get things moving. Better to have to eat loads of fruit & veg every day than live on meds, right? Good Luck again!

by jusshell, Jan 03, 2007 12:00AM

It is definitely better to give more fruits and veggies than the meds!! My daughter didn't even have her first bowel movement til she was almost 2 days old. Just before they let us go from the hospital. Even as a baby/toddler she was constipated. As potty training, she was the easiest of my 3 and was more afraid to have an accident in her panties and was alway running to the bathroom to make sure she went before she would have an accident. My oldest daughter would hold it. She would be too bisy playing or whatever and I always had to tell her the playing can wait, the potty can't. So I have an understanding of what holding is like and all and that's not this daughter. I have been over her diet with the dr and she doesn't think that's the problem. The only test that has been done was this am with the CF test and I agree, I think it will be neg. This was the only dr that even tried helping my daughter. Everyone else told me it was all normal and she would eventually grow out of it, but it just gets worse. Even when she's constipated she tries her hardest to go. I see her on the potty and trying and trying and nothing coming out. So I really don't think she's holding it at all. I wish it were that ad could be fixed easily:) Even when they supposively had her cleaned out and weaned off the med. she was cnstipated in a matter of days. So it is frustrating. And she still refuses the enema. So I don't know what else to do. I can't blame her for not wanting it. I wish the dr could say she has done every test and they have all come back neg, but she can't because she hasn't. Where we are, the dr's would have to send her off to a ped GI specialist and I don't think they want to, so I think they are just trying to assure themselves that there is nothing wrong so they don't have to deal with it.

by ozark, Jan 03, 2007 12:00AM

Has anyone mentioned Hirschprungs disease? To diagnose one needs to have biopsies of the colon. Babies can show severe cases where the whole colon is not innervated, having severe constipation and there can also be segmental areas of the colon that can cause constipation that is not as severe. I would look it up and see if this may fit your childs bowel habits. I would also ask your pediatrician to check into this........maybe see a pediatric gi doctor.

good luck

by MLWTR, Jan 03, 2007 12:00AM

Crohn's disease is another possibility. Chronic diarrhea is more common with Crohn's, but a minority of people end up with chronic constipation instead.

by jusshell, Jan 04, 2007 12:00AM

I read about Hirschprungs and I knew a little about it because someone else had said something about it to me. But I never really thought anything about it til you said it too. It does sound like it could be her. My sister had some sort of bowel obstruction when she was first born and had to have part of her bowel removed because it was like spaghetti, but my mom doesn't have much info about it and they had never given her a name for it back then. But she had surgery I guess around 24 hrs old. (she's 29 now) So maybe I can ask my daughters dr about it. Would you know if it could still be hirschprungs and her ever have normal bowel movements? I ask because when the dr first started her on the laxatives and enemas and got her cleaned out, she stayed on the miralax for maybe 6 mths or so and as long as she was having diarrhea, she could go. But as soon as the miralax stopped, the constipation was automatic! But they have no x-rays to prove that she ever really was totally cleaned outbecause they never did another one. So the dr thinks that maybe she never was cleaned out totally.

From what I read about crohns, it sounds like she would have diarrhea instead of being constipated.

She has had 2 small bowel movements finally today. Thank you all so much for all the info. The more informed I am I think the better I will be able to help my daughter.

by Jackolynn, Jan 05, 2007 12:00AM

To: jusshell

I was reading about your issue with your daughter, what a ewwwwy situation having to deal with all that for that long. I feel for you and your daughter. I do have a friend who has a son that went through the same situation. You have to be carefull with your daughter because having that bad of constapation is painful, allot of stomach aches ect...Best solutions is to ask for a stool sample test for your daughter, chances are she may have an infection you are not aware of,including your doctor, that is causing her to have difficulty having a bowl movement. If say for instance your child was in childrens hospital and she was not pooping on schedule they would take her stool sample to make sure she did not have a virus or infection and that is how they test children but the doctor will never tell you to ask for a stool test as wierd as that is.So you ask your doctor for the stool test and he is not suppose to turn you down and if he does... you go to a walk in clinic and a doctor that will.Do not give up.My gf son was told he was lactose intolerent and he was not, always complaining and in pain, poor kid.. I imagine your daughter is like that too. Laxitive stuff did not work for him either and all they wanted to do was enimea and xray, the cheapest thing to do and the only thing they will do for her.They will chop it up to constipation so please ask your doctor for a stool test...I believe it is 2 bottles with presevitive in it and mix her stool in it over a 3 day period you take 2 samples different days... it will be something like ova and parasites and some more tests because she is a child

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