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4 year old son with chronic constipation, please help!
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4 year old son with chronic constipation, please help!

My 4 year old son has been constipated for over a year now, he has seen 2 different doctors and been to a gastro specialist, they have ruled his stool withholding at 'defiance'. He will hold his poop in for up to 2 weeks at a time, & I have to put pull-ups on him because he 'stains' his panties all day. He was put on mineral oil, Didn't work. They put him on Chocolate Ex-lax, didn't work. Enemas & Supposotories, Didnt work. Miralax, Worked somewhat but they stopped it and put him on Lactulose for the past 5-6 months, and it is not working.I am stopping his lactulose and starting him back up on a cap full of miralax daily. He refuses to eat fruits and vegetables. I've tried to bribe him with stickers, toys, games, places, people, everything and nothing works. I don't know what else to do. Can you please give me some medical advice on where to go from here? Pleassee!
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317787_tn?1373214989
So sorry for your problem, I wonder why the exlax did not work.  I knew a child, same problem and the parents used exlax.  I often wondered if he had  a painful bm and was afraid to go.  Can you get him to drink more water?  Even if you dilute something he likes to drink with water.  It is a very frustrating condition and I am sorry you are going through this.  You could try mixing fruit/vegetable into food he likes, grinding up so he doe not notice it.  I don't have any answers wanted to say how sorry I am
Dee
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973741_tn?1342346373
Hi.  Well, I will say that most kids of 4 are not 'defiant' and purposely withholding poop.  Ugh.  Not sure about that medical opinion.

We've had this issue with one of my kids.  Chronic constipation is a situation in which the above poster hit the nail on the head, it is a bit painful to go, unpredictable when you actually will, and a child becomes fearful of the process.  Many kids are also very picky eaters and come out of the 'fog' not too far from your sons age.  (my kids ate great as babies, hit 2 and got picky and then got better around 5 and 6).  

My son actually would go daily but we ended up in the hospital for impacted stool which was working like a bowel blockage-------  very scary.  So it can also be confusing when they do actually go----  they still may be constipated.

We've had a LOT of luck with grape juice.  Really, all fruit juice is good except apple with grape being the absolute best.  You can get creative and make homemade smoothies-----  use frozen fruit, fruit juice a bit of sugar and cinnamon and a banana----  throw in carrot juice and chopped spinach (seriously, my kids never knew!!  and love my smoothies).  Get things to dip into----  make a yogurt dip and dip cut up fruit in it, get ranch dressing and cut slivers of carrots and cucumber to dip.  Dipping has an allure to kids for some reason. :>)  They make baby food prunes that actually tase pretty good, you can rename them purple pudding!  Put it in a bowl so he doesn't know that it is baby food.  

An old rememdy, a little corn syrup in milk.  By the way, cut back on dairy.  My boy was a huge milk drinker and still is but I cut it back some.  

We also made going potty a routine.  Every night before bed, you get a book and sit on the potty.  Every night.  Period.  And my husband told my son (and this is somewhat true) that water helps you go.  So he also has his glass of water while he goes.  (being hydrated helps the process).  That helped because my son pretty much will always go at that time now.  

Well, good luck.  Hope it all works out for you and your son!
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535822_tn?1389452880
What about Cereal they are many kid friendly cereals out there  does he like beans,I am wondering if backing off a bit may also help, he is getting bribing and attention when he doesnt 'go' try ignoring the issue and see if he takes control himself .. Have you tried the child pro biotics they do work and maybe he will like it, comes in Yoghort and puddings also drinks now .What about OJ that will move anything ..good luck
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973741_tn?1342346373
Oh yes, fiber is supposed to help too----  true about the cereals.  they also are now making these fiber enriched granola bars that mix in a little chocolate---  in the cereal bar/granola bar aisle.  I got some of these but we haven't tried them yet.  I buy the grape juice that is enriched with fiber or calcium too.  
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Avatar_f_tn
Thank you guys so much for your input. Im definitely going to try the smoothies and Such. Im to the point where Im willing to try anything. today has been 9 days since his last bowel movement. Ive even told him to poop in his pants, if thats what it took. Ya know, 'better out than in'. He just doesnt have it. If he doesnt go by this evening i'm giving him a supp. SpecialMom, you know how hurtful it is to watch your child go thru this & not be able to help. My son also has fecal impaction, he had 3 tummy xrays & theyve never taken it serious. Im beyond frustrated with his doctors at this point, poop is natural, it happens, you cant just knowingly hold it in & a doctor tell me its 'normal in boys'. Sorry to ramble, it just seems as if you all understand.
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973741_tn?1342346373
Oh yes, that would greatly frustrate me.  My son was so impacted that he began violently vomiting, was in tremendous pain, and was rushed to the ER.  The stool was blocking his bowel which can create a situation that becomes very serious.  

Yep, I'd do an enema if you have to.  Really not fun but much better than what severe constipation can cause.  

Anyway, stay in touch.  I'd love to know how he progresses.  My son is doing a lot better these days.  Wishing you luck-----   and doctors that will HELP you!
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Avatar_f_tn
Well he could have a medical problem.  Things like chrons, colitis, IBS, cilac disease, or something like that. I would beg his doctor for a GI referral.
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Avatar_f_tn
He has seen a GI doctor at john hopkins, & they said, 'hes being defiant', because other than not pooping, hes fine. Hes a normal 4 yr old, he just cant poop for weeks at a time.. @SpecialMom, I will definitely let you know how it turns out & Im glad your son is much better, this is a long, hard, time consuming process, it seems never ending.
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973741_tn?1342346373
Brit, I do understand!  People kind of scoff at poop pain----  but it is real.  And it really can cause some serious complications.  Try the 'routine' of going before bed too.  That has helped.  Even if he doesn't go each time, have him sit with a book as part of the routine.  

Anyway, I wish you much luck and that this issue resolves.  peace
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1006035_tn?1391310794
Is he lactose intolerant? That can cause constipation. If he doesn't like to eat veggies you could always buy him V8. They have some really yummy flavors. You could also try pasta sauce that veggies in it too. There are ways to trick them into eating it!
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757137_tn?1347200053
I haven't read all the entries so do not know if this subject has been touched on. You say he refuses to eat fruit and vegetables. Don't make the error of catering to his whims. Make fruit and vegetables the only foods available to him until he is ready to accept a sensible diet. No child commits suicide by starvation. When he is hungry enough he will eat. Lack of roughage, as you well know, results in constipation. So give him roughage.
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171768_tn?1324233699
to spin off and combine specialmom and margy's idea, what if you mixed babyfood prunes (or any other fruit puree) with yogurt (for the probiotics) and made purple frozen yogurt pops? I'm pretty sure most kids would eat it.

My kids are fabulous eaters, but both have been getting extraordinarily constipated. They are going daily, but it is becoming so painful for one of them that I am afraid she start to have these problems. The 4 year old screams and cries, and the stool actually gets stuck :( Once it's finally out, she begs us for raisins and peas because she knows that's supposed to help.  So I'm going to be switching to different juices (I was wondering about that) and push more water. I often wonder what she says in school, because at home she'll always comment about which foods will help her poop :)
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973741_tn?1342346373
Oh no tired.  And that is when even more problems surface because that pain upon going causes fear to go!!  You are wise to work on this.  My son has always eaten fruit and lots of it.  I just went gang busters and was like "how about some strawberries. How about some raspberries, blueberries anyone?"  over and over all day.  I make smoothies with frozen mango and pineapple, orange juice a bit of sugar and a banana too.  Kids love that one as well.  

but good idea of the freezer pops.  

So funny on the conversation about what helps you poop!  My kids could probably share all these ideas themselves as wel talk about it so much.  Like I said, my kids have a glass of water on the potty because it "helps".  (Okay, that might be a placebo affect.  LOL  but water throughout the day does for sure!)  Anyway, good luck
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535822_tn?1389452880
probiotics and Orange juice
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Avatar_f_tn
Thank you guys. he hasnt pooped in11days (with the exception of a giant poop yesterday, but I KNOW that poop isnt 11days worth) he still squirms and whines in agony & has knots of poop you can feel thru his belly. His doctor suggested... Half a chocolate ex-lax, 1 childrens fleet liquid glycerin supposotorie, then a half of an adult enema. We are goin to do that today if he dont poop anymore.
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535822_tn?1389452880
exlax can hurt it will give him cramps for sure...try the child probiotics each day , does he get plenty of water, especially when its warm outside, and exercise, move that body how about Dad plays a ball game each evening with him get those intestines wiggling around .
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973741_tn?1342346373
Ugh.  I'd do the fleet.  My son didn't have any cramping and was so relieved afterwards.  And that big 'clean out' makes may help get him back on track.

We used fleet as well, by the way.  good luck to you.  don't make a big deal out of it when you do it and have books and things to do while he sits.  My son sat for about 25 or 30 minutes.  peace
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973741_tn?1342346373
Oh, and all of the above advice from various foods, fiber, and exercise are all good for keeping it on track.  But you are managing a 'situation' right now that you need to get through.  good luck to you dear.
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Avatar_f_tn
Thank you all so much. Unfortunately, im a single mom and his dad isnt involved in his life at all. But im giving him tons of water and prune juice.
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973741_tn?1342346373
You are doing fine sweetie.  some kids just have this problem and you have to work on it as all.  good luck and hope that the 'cleaing out' today helps overall.  Peace
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Avatar_m_tn
My son will be 3 yrs old, same problems ,so frustrating, going to doctor (pediatric) this friday,went to regular doctor yesterday she didn't even ck his stomach or down there and now he can't even go and it's really sore, ,I hate to wait till Friday, sounds like he probably has impacted stool( I think that's what it's called) poor thing , what do U suggest, moms on here know more then doctors or obviously try harder to find the answers
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