# toddler - no bowel movement for a week



## cassn1 (Mar 16, 2005)

Hi 

Sorry me again but could do with some advice re: DD

She has not had a bm for a week now. This isn't the first time, athough not been quite this long before. A few months ago she was having trouble and the dr prescribed various things as she was so bunged up. I ended up having to give her enemas over a week (awful) senna and movical. The senna and movical did seem to work and she has been fine for the last couple of months, going regularly without any meds. Now we are back to square one. Her tummy is bloated again, she is not eating much but she seems ok in herself. I have had her on senna for 3 days and movical for about 4/5 but nothing is happening. 
NHS Direct nurse said as long as she seems ok in herself and not complaining of tummy ache to persevere with the senna and movical. Perhaps try glycerine suppositries if they don't help - not keen on that option and DD is now terrified of anything going up there bless her. 
I just worry as last time we took her to dr who said if we'd left it another day, she would have started vomiting as so backed up. I don't want to get to that stage again. I can't believe she is not being angsty about it. She's not even showing signs of needing to go. 
Is there something i can buy over the counter, maybe a stronger senna or something that would shift it pretty quickly (orally prefereably) I hate giving her all these meds.
Have tried tummy massage, warm baths, orange juice, baked beans - woin't touch prunes or juice. Trying to get fruit into her but as not eating much it's hard.
Nurse said to go to out of hours if she complains of tummy ache.I just want to go down the least distressing route for DD so any advice gratefully received. 

Many thanks as ever

Nic x


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## cassn1 (Mar 16, 2005)

Sorry - should add that she is 2.5 years. Thanks


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## mazv (Jul 31, 2006)

Hi Nic,

Any movement yet? Quite a common problem in toddlers I'm afraid   Am surprised that the senna and Movicol haven't done the trick by now, considering how many days DD has been taking it for. To be honest there isn't anything else I'd recommend to get over the counter on top of this as in theory these should be more than enough to get things shifted   Keep pushing fluids into her as much as possible; plenty of water and if she won't touch prune juice then try apple or pear instead. Don't know how many sachets you're using but you can givce up to 4 sachets a day of Moviol peadiatric to prevent impaction and if impaction has occured you often have to give more (there is a set dosing regime for each day). If things haven't moved by today I'd get back in touch with NHS Direct and see if you can get advice from the Doc's there about upping dose of drugs.

Hope DD gets better soon
Maz x


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## cassn1 (Mar 16, 2005)

Hi Maz

Thanks again. I didn't realise I could give her lots more movicol as currently on one sachet a day (Dr instructions when first happened) 

She had a tiny movement on Saturday which was pretty mucusy but nothing since. She's now in discomfort so am hoping things might happen soon. Will try maybe 2 doses of movicol a day although have nearly run out so need to see if i can get it over the counter....?? 

Anyway, will keep pushing drinks - she loves apple juice - and hope things improve  

Many thanks again

Nic x


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## mazv (Jul 31, 2006)

Hi Nic,

I'd get her to the Dr's now if still no significant movement, especially if tummy getting sore. At least that way you can get prescription for what you need and can discuss dosing regime for next few days

Maz x


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## cassn1 (Mar 16, 2005)

Hi Maz

Thanks, sorry just looked at this. 

Will probably try the Dr in the morning (might as well have our own private room there at the mo!!) if no movement. Still nothing, tum very distended now and feels bloated. She is complaining of tum ache still and not really eaten anything apart from fruitflakes and melon today. Poor little thing.

Thanks for the advice, I really need something to shift this lot then work out a plan of action. If it's an enema, they can do it as I hate it and promised i wouldn't again  

Hope you had a nice BH

Nic x


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## cassn1 (Mar 16, 2005)

Hi Maz

Saw a really nice Dr today. He prescribed more movical and sodium picosulfate (think i said that right). He was a bit unsure about the latter at first but checked his book and said ok to give her 3.5ml. Said it should be pretty potent. Well after about half hour DD started to complain of tummy ache. She woke up sobbing about 2 hours ago, swetaing buckets and complaining of tummy ache. On the plus side she did two small poos so looks like moving in right direction. I read that stomach cramps are a side effect so guess we have to take the rough with the smooth. Not sure how long we are meant to carry it on for but said to check back in in two weeks.

This all sound ok and is there anything i can do to ease the cramps at all apart from big mummy hugs ? 

THanks again for all your help

Nic x


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## mazv (Jul 31, 2006)

Hi Nic,

Poor DD (& Mummy)     Picosulfate is pretty much like a stronger version of Senna and does get things to shift. Can cause cramps and can be quite painful if there is a lot to shift (could give paracetamol to help with any pain) Ideally you want the cramping as that will ultimately be stimulating the bowel to move. It is a good sign that she has passed something today but she really does need to be moving on a frequent basis to ensure the backlog clears! Keep an eye on it and make sure she keeps passing poos if she has a day or two without then I'd contact GP again. I know you'd rather not use enemas but sometimes we do have to resort to them   Hopefully won't come to that   Lots and lots of water/apple juice too to try and keep everything as soft as possible.

Maz x


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## cassn1 (Mar 16, 2005)

Thanks Maz

Will be giving her another dose tonight and will just have to deal with the discomfort best we can. 

Thanks as ever for your advice and support - you've no idea how invaluable you all are on here  

Nic x


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## mazv (Jul 31, 2006)

Just wondering how things are going Nic? Any improvements today with the poo passing? Hope so . If not please get back to GP asap
Maz x


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## cassn1 (Mar 16, 2005)

Hi Maz

Thanks so much for thinking of us. 

I was going to msg you as the picosulfate did nothing last night. No movement since tuesday (which wasn't massive but something at least). Had great hopes for this new stuff. Have been giving movicol but dr said only one sachet a day. DD is sooo uncomfortable and has been very clingy and lying about and fidgety. Desperately want to help her but feel so helpless. She says she needs to go but i think she is holding. Her knickers were slightly soiled just now. 
Thought i'd try the picosulfate again tonight and if nothing, guess i will have to give an enema tomorrow (Dr gavem e some). Don't know how as DD is terrified after last time but i'll have to. 
Darent go back to GP as he will prob just tell to give enema. Her tummy is so bloated now 

Will let you know how we get on tonight...

Thanks again  

Nic x


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## cassn1 (Mar 16, 2005)

Hi Maz

Just to let you know, have had a very busy afternoon! DD was in sooo much pain bless her but eventually has done a few movements so seem to be going in the right direction. Actually left out the picosulfate tonight to give her a break from the stomach cramps as she has suffered with them all afternoon 
Will get back on it tomorrow though, hope that's ok 

Thanks as ever, you've been a great support  

Nic x


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## cassn1 (Mar 16, 2005)

Hi Maz

Just a quickie. 

No poo today so have given her another dose of picosulfate and the usual movicol. Just wondered, do you know how long I need to keep this up? Dr just said to make another appt in a couple of weeks, do i keep going with it till then do you think? Is it ok to give picosulfate daily for a prolonged period? Sure the cramps it causes can't be good for her? Sorry, he didn't clarify (took a call on his mobile so was obviously then keen for us to leave!) 
Just want some plan this time rather than left to work it out, so will see my GP next week, just want to make sure ok to continue over the weekend as we are with both meds. 

Many thanks Maz 

Nic x


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## mazv (Jul 31, 2006)

Hi Nic,

It is fine to give picosulfate for a period of time; it isn't recommended for prophylaxisis but can be used to treat constipation until a regular pattern is re-established. How is DD today? Has pain and distention gone down any? I'd persevere with new treatment for a week but if there still isn't significant improvement then personally I'd go back to GP again.

Maz x


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## cassn1 (Mar 16, 2005)

Hi Maz

Thanks for that. No poo yesterday or today so far although lots of tummy ache and one very upset little one  

I will persevere, we are seeing GP tuesday so will ask her for some plan of action going forward as i stopped the meds as soon as things improved last time and from reading around the subject, that may have been wrong 

The only thing i hate is the thought of Lottie staying on the picosulfate indefinitely and having to put up with these cramps every day. She is really suffering and upset and just wanting constant cuddles and to be near me permanently (which is bad enough for her but she has pre-school etc starting next week and don't want to upset it all...) Maybe the cramps won't persist? 

Her tum is still pretty bloated and hard but not sure how much is stool/wind. Not really eating much but guess there is still stuff to come out. Keeping the fluids going so that's good. I just feel hopeless and helpless 

Thanks again Maz for your help, it's a real comfort knowing you are there  

Nic x


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## cassn1 (Mar 16, 2005)

HI Maz

DD had a stool movement (on Daddy's watch this time   ) so that's good. It's just the cramps and discomfort bothering me (not as much as DD though). If I don't give the picosulfate we go a day without BM. But giving it to her at night means from the morning and most of the day, she is very uncomfortable on and off. I had to get out the bath to massage her tum tonight as she in pain. She's still eating very little and her tum to me seems swollen still. I guess I just want it all to go away and it won't just like that. Just hate putting her through this every day but know I have to. 

Anyway, seeing our proper GP tuesday so hope she will give us a long term management plan.

Thanks again for your help and hope you enjoying the sunshine 

Nic x


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## mazv (Jul 31, 2006)

Sorry to hear DD still not back to normal; it is a horrible thing when you can't really do anything to help, hugs to you both   Keep trying the massage, as that might help   I know the picosulfate isn't particluarly nice but hopefully it won't be for too long and she'll establish a regular pattern again and you can stop it. She will probably need to remain on laxatives prophylactically for a while. Hope that GP is able to help on Tuesday.

Maz x


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## cassn1 (Mar 16, 2005)

Hi Maz

Thought I'd update you as you have been so helpful. 

Saw my lovely GP. SHe told me to stop the picolax straight away as far too harsh for her age. I am only to use it in emergencies. Like you, she said to increase the movicol (i was going to after you told me to but the other dr told me not to!) and see how she goes. Well not pooed since (grrrrr) and def needs to although at least not complaining of awful cramps now. Dr also said the only other way was increasing veg....erm, easier said than done although I am trying very hard and trying to introduce new things. 

So anyway, we carry on and we wait i guess and hope she poos! If not I'll have to resort to picolax. 

I was wondering about just buying some lactulose for her to go with the movicol or do they do the same thing? Can't remember! 

Thanks hun

Nic x


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## mazv (Jul 31, 2006)

Hi Nic,

Sorry things still not fully resolved   Hopefully increasing Movicol will help eventually, as you have seen the picolax does work but side effects not great   The odd dose or two occasionally won't be a problem if you need it to try and shift things. Lactulose does exactly the same as Movicol so no need to add that in, just increase Movicol dose as advised by GP.

Plenty veg, fruit/fruit juice and exercise help to keep you regular but getting a toddler to do all that is another matter   Just do what you can hun and keep going to see GP if you think DD still not back to normal. It will resolve with time  

Maz x


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## cassn1 (Mar 16, 2005)

Thanks Maz

As ever your advice is appreciated. I will just stick to movicol (2/3 sachets a day) and picolax when desperate. Will just have to persevere, another 'fun' afternoon. DD went and...well let's say my newly reborn ms made it very tough to handle!!   DD did say that she didn't want to sit on toilet to do it as her bottom hurt and felt scratchy. Neighbour wondered if she has piles inside..?? Never know. Anyway, will plough on and hope for good news soon.   She is on loads of fruit juice, fruit and more veg (am managing to hide some of it!!) 

Hope all good with you.

Nic x


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## cassn1 (Mar 16, 2005)

Hi Maz

Sorry, me again

Just wanted to know, would Movicol cause stomach cramps? That;s all i'm giving DD now (x2 a day) and it is shifting things (have gone the other waY!) but she seems to be suffering with non stop tummy ache. It's tricky though as when i try and wipe her she screams if i go near her foo foo and gets really upset. Says that hurts and her tummy hurts so now wondering if somehow caused a UTI or something. 
She woke several times in the night for water and is drinking loads.Just we go away tomorrow and this seems to be never ending. Perhaps it is just the movicol causing everything to shift and therefore tummy ache? 
Sorry - i know it's a tricky one

If it sounds like side effect of movicol doing it's job i'll go with that and make sure we pack the calpol!!

Thanks again

Hope you and your ok

Nic x


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## mazv (Jul 31, 2006)

Hi Nic,

Movicol can cause distention and pain so it might be because things have gone the other way now. Is she now very loose? If so I'd cut down to 1 sachet or stop altogether. Is her tummy less swollen now, or is it still swollen? Does it feel hard to touch or soft (so you can push in with your hand?). Constipation is a funny thing as you can get diarrhoea even if you are still bunged up   Her bottom is possibly sore from straining and it will take a time to heal once this episode has passed. Avoid toilet paper and use baby wipes again (if you aren't already doing this). The non stop ache makes me think that she may still be suffering constipatrion  

To be honest I'd get her back to the GP although realise you're off tomorrow. If you can call first thing to at least get a phone consultation for further advice.

Maz x


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## cassn1 (Mar 16, 2005)

Hi Maz

Thanks for your advice. 

Her bm's are very soft but she still strains to get them out (mind you,not had one today). Her tummy still feels more bloated than solid if that makes sense. Will check it again though.
Her foo foo does look a little sore i think but she just goes beserk if i try and wipe/look at it. Her actual bottom doesn;t seem to be painful. I always use toilet wipes during the day (except when we are out when we use loo roll) and baby wipes after her nappy at night. 

Just didn't set a date with Dr to check in and see how things are going or how long to take movicol. Just seems like an indefinite thing.

Only gave one sachet or movicol today as wanted to try and ease off the stomach ache for her. She is just so irritable at the moment and am sure it's to do with this as all seems to tie in. 

We are off fairly early tomorrow I think but may try to ring the GP (although ours isn't there mondays). 

May have to see how we get on on hols and if still a problem, see GP when back. 

Thanks for your support during this trying time !! 

Nic x


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