View Full Version : Possible explanations for BM issue


Becky in NM
02-19-2007, 10:36 PM
Dr. Olson --

My son, 3 1/4, has had "constipation" issues since he got his G tube and started on Nutren Jr with Fiber at around 20 months. I call it "constipation" because, with the help of Miralax, his BM is a good consistency, but he still has a very difficult time going. He's been wearing underwear since last August, but he still needs a diaper to poop, and he always denies that he even needs to go. He has held it in for more than a day (I see him breathing funny and unable to stand up straight) before I finally gave him a suppository or convinced him to do it on his own.

He went tonight (Monday the 19th) on his own, Friday the 16th on his own, Monday the 12th after I gave him a suppository, and Wednesday the 7th after a suppository, so sometimes he waits up to five days and still won't go without my "help." And his BM is always about the size of a softball.

I've been told this is a behaviorial problem. Is there anything else we might possibly be overlooking? And if it's truly a behavior, am I just making things worse by using suppositories so often? How long can I wait before resorting to a suppository? Generally, I wait til I see him trying (or trying not) to go, give him a few hours to do the deed himself, and then step in to assist. But when he's still holding back at the five-day mark, I start to really worry that he might be doing other damage.

Sorry this is so long. I could write a novel about our BM sagas, so please let me know if you need any more details.

Thanks for your time and insight.

Dr. Olson
02-21-2007, 08:37 AM
Hi,

I agree this is behavioral. He needs to be on a consistent program, perhaps with Miralax, to keep all the stools soft and painfree. He needs to be encouraged to sit on the toilet after every meal and when ever he seems to feel the urge. This is a lengthy process that needs to be encouraged. The stools should be made as loose as possible. When he realizes these don't hurt, he will not withhold them and will be going normally. This is a complicated issue and you need to be in close contact with your pediatrician to monitor things and approach changes in the proper way.

Good luck, Dr. Olson