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4 year old dd and poo, not sure I agree with Dr. What do you think?

(32 Posts)
Indith Sat 11-May-13 09:06:42

I don't seem to make children with very good bowels. Don't know what it is. They all have good diets (typical day would be wholegrain cereal or porridge plus fruit, fruit snack, lunch is school or nursery or CM in week or at home soup or eggs then fruit snack plus biscuit and dinner of stew/bolognase with brown rice or pasta, lots of lentils or beans in stew pudding fruit and yoghurt)

my ds1 has had constipation issues. No longer medicated but still on a strict routine for post dinner poo and still wets a bit, especially if he hasn't done a poo one day. So we know a fair bit about constipation.

dd is 4. She has always seemed to have a sensitive bowel. Eg whenever she is the slightest bit ill she reverts back to soiling. Sometimes she seems to be triggered by something else, maybe something she has eaten (the only thing we have pinned down for certain as setting her off is sweetcorn) and she will poo seemingly uncontrollably for a few days then it tails off but still not great. It can take weeks to settle. Then you have to prod and sticker chart her into good habits again so it can be 3 months or more before she is ok. Then she gets a cold. Or eats sweetcorn. Or something.

Latest bout we decided to take her to the Dr as it was pretty sudden and bad. 4-5 big, loose stools a day at least. Some just a bit loose, some very runny. Mostly in her pants, running down legs etc. Each time it would be a large amount of poo. The loose, squishy ones were like weaning poo with bits of undigested food clearly visible. This went on for around 2 weeks. She seems to be settling down again.

She too has a decent routine as we tend to send her to the loo after dinner like her brother and she usually does a poo then even if she has done others in the day. She poos a lot. Always has done.

So dh took her to the Dr. Dr suggests it is constipation and has prescribed movicol.

I'm not sure it is? It seems a hell of a lot of poo for a constipated child! It doesn't seem like overflow, it is full poos not uncontrolled seepage.

I'm confused.

nextphase Sun 12-May-13 11:42:39

Yep, less soluble fibre in veg than in fruit.
Had a rapid and benifical effect. We've now let the fruit levels creep back up, and do occasionally get problems if I get something in they adore (like melon!)

Lamazeroo Sun 12-May-13 10:43:19

I would also recommend going gluten free. In my (professional) opinion gluten sensitivity - not necessarily coeliac - is the leading cause of bowel problems in children.

Indith Sun 12-May-13 10:34:01

Spiggy that would be helpful thank you.

I shall definitely look into the soluble/insoluble fibre balance.

Maybe she does have too much fruit.

So if you cut fruit you increase veg? Are they different kinds of fibre? So I could replace fruit snacks for veg sticks or something?

I just struggle to believe that 4 or 5 LARGE stools a day is overflow you know? She seems to know when it is coming too (whether she bothers to tell us is a different matter!) and one of the things about overflow is it is smaller amount of seeping poo that they don't know about. Anyhoo there is plenty to think on.

Hey Indith, I have a friend who has had extensive testing for digestive problems and was given a lot of information on food families which links foods (not always ones that you would think were linked) I can ask her what goes with sweetcorn, might help you narrow down some other potential triggers?

BiscuitMillionaire Sun 12-May-13 07:48:28

'She has fruit for breakfast, snack, lunch, afternoon snack and pudding at dinner.'

Maybe that's the issue. That's a lot of fruit.

nextphase Sun 12-May-13 07:41:43

We too have had to reduce the soluble fibre (ie fruit) to get a decent consistency stools. Sounds counter intuitive, but worked for us. Hope things improve soon, must be horrible for her and you.

stargirl1701 Sun 12-May-13 07:23:18

Could it be IBS? As an adult, I suffer from swinging from very loose stools to very constipated. Looking back, I have had this as long as I can remember - it just got worse over time.

PJM18 Sun 12-May-13 07:19:11

Hi. I agree it's very confusing. My 6 yr old has just been prescribed movicol for occasional soiling but more like the overflow you describe. I would phone GP and say you have decided that this has been going on too long and you would like a referral to a paediatric gastroenterologist. Do your homework first and find out who this is in your area. My older son went to paediatrics due to cyclical vomitting and they were useless. I then asked for referral to gastro and couldn't believe the difference. She did test for coeliac and a whole host of things I had never heard of. They were very thorough and knew what they were talking about.

cestlavielife Sun 12-May-13 00:01:51

Sounds exactly like constipation my son was the same and had a severe impact ion ..this was overflow.

Don't give too much fibre.

Do give
Plenty fluid.

Take probiotics eg yogurt drinks like actimel or buy probiotic powder for kids like bio care .

You should ask for a coeliac blood screen before going gf .

Indith Sat 11-May-13 21:25:53

thanks vag. shall see how the diary goes. I know you've questioned how much she poos before when having one of her phases.

Vagolajahooli Sat 11-May-13 21:13:47

Hoi Indith. I agree it def doesn't sound like constipation. It may be in the future you may need to look into GF or low fibre, but I think you are right to start with a food diary now before eliminating anything. As someone else mentioned if she does have a coeliac test she will need to have been on a diet which includes gluten. Anyway with the food diary you might be surprised to find that there are types of foods you hadn't even realised are effecting her bowels.

You say sweetcorn effects her, have you noticed anything similar with tomatoes?

lotsofcheese Sat 11-May-13 19:07:26

We had issues with DS & the solution was to decrease insoluble fibre eg reducing weetabix to every 2nd day instead of daily, changing from granary to whole meal bread etc.

We did not need to reduce soluble fibre eg fruit.

His bowel movements were a lot more solid & he got sensation back that he was needing to go to the toilet. So his toilet training improved.

For DS he sort of grew out of it between 2 and 3 mainly, his gastric transit time was super fast. Eg give him peas with lunch, see them in poo at tea time. Cons suggested reducing fruit but we didn't because he loved it and he already didn't have squash which can aggravate it. His poos are still quite soft occasionally verging on runny but now he eats more carbs as well as fruit so it seems to have settled quite a bit.

He's 4 now. When I saw the cons he asked me if I was worried about coeliac and I said not really, as he was thriving and I felt he would have more symptoms if he was. We had blood tests and poo tests and all was clear.

Jins Sat 11-May-13 11:09:42

Definitely keep a diary as it will help with diagnosis. Make sure you list every ingredient, not just the main ones. My mother fails to understand that flour can't be used for thickening nowadays but everything else in her stew is fine.

Two to three weeks of a food diary and poo diary will tell a specialist a lot. They rolled their eyes at three portions of fruit for us and your dd is on five grin

Indith Sat 11-May-13 11:06:59

Dh has returned with the prescription from the Chemist, he jsut said that the Dr agreed that if anything it would be too much fibre and that it could be the combination of too much fibre and not enough to drink (and she doesn't drink much) although I was under teh impression that would result in dry, difficult ot pass stools rather than gallons of soft ones. Still, she is to have one sachet of movicol a day and we will try to increase her drinks and see where we are. We'll keep a log until next appointment, if nothing else that could help to pinpoint triggers.

Indith Sat 11-May-13 11:04:27

Lol at not buying fruit, I think ds1 would have something to say about that!

Indith Sat 11-May-13 11:04:00

Ds1 used to struggle with dairy but has grown out of it. Ds2 seems to struggle with dairy and is dairy free. Dd has never shown signs of it. That is something we can limit easily as a trial though, the childminder's daughter is dairy free so they don't have any dairy there anyway. As for other triggers I just don't know. The latest episode started after a stew that was particularly heavy on the beans and lentils but we eat loads of beans and lentils all the time. I think that is what makes it difficult to pin down. She has phases of being ok then something triggers but our diet is much the same day in day out. We spotted sweetcorn because of corn on the cob being so seasonal. Dairy and ds2 was so much more obvious as it was things like screaming in pain all night after eating a bowl of yoghurt.

Jins Sat 11-May-13 10:50:53

Fruit free is easy. grin. I just don't buy it

Need to make sure there's plenty of veg though. If she's eating a lot of fruit it may well be part of the problem. It definitely was for us.

insancerre Sat 11-May-13 10:49:15

it does sound diet related and as you have already indicated that sweetcorn is a trigger, then it is posible that other foods are too.
I agree that too much fruit or too much fibre can be a trigger for some children.
I think you need to consider food intolerances or sensitivities.
Major culprits could be
gluten
dairy
eggs
Any of these run in the family?

Indith Sat 11-May-13 10:49:01

MoaningMinge when you say "just" toddler diarrhea what was it like? And how old was he? Others have said it seems like that except that she is too old for it.

Indith Sat 11-May-13 10:47:10

I'm not resistant as such, what I am reluctant to do is to try something on a whim, jsut because someone on the internet said it might help. I am however making note of all suggestions and I will discuss them with dh and with the GP at the follow up appointment. What I cannot do is expect the GP to be willing to work with me if I do not try his suggestion first. Does that make sense? Going gluten free will not just be me having to change things, it will affect the way we cook as a family (and with dh working in another city with a long commute and me as student midwife and the crazy hours that brings cooking is a juggling act at the best of times), it will affect things for nursery and it will affect things for the childminder. Yes, nursery and the childminder will be willing to work with us, of course they will, but I can't expect other people to jump when I say so based purely on a whim.

I might try to look at my timetable and see if I can't be there for the next appointment, but I have something to present in uni that day so not sure. I think I'll be giving dh and big list!

SwishSwoshSwoosh Sat 11-May-13 10:39:53

Why so resistant to trying GF? Wouldn't it be easy to go GF for a month see if any improvement?

I would try the most obvious things first.

Indith Sat 11-May-13 10:37:53

Jins how do you manage fruit free? Dd would eat her body weight in fruit if I let her. She has fruit for breakfast, snack, lunch, afternoon snack and pudding at dinner.

Indith Sat 11-May-13 10:36:02

Yeah I will def speak to GP again before trying GF. It is worth keeping in mind though meg.

Bodies really are bloody complicated! Speaking of which I am supposed to be trying to get some anatomy studying done while the dcs are out rather than being on here!

Interesting about fibre and possibly too much being an issue. We actually did the wholegrain challenge on here a bit ago so increased fibre quite a lot then and from memory I think she was ok then. As always though, worth a thought. When ds1 was medicated he took fybogel to bulk him up and we still have some knocking around which could be used to bulk dd up. I'm guessing if I started her on that we would soon know if it was a case of too much fibre or too little! But from normal diet alone she gets plenty.

I think I'm going to keep a food log from now until her next appointment. I suppose the only thing we can do really is keep a log so that diet can be discussed and give her the movicol. I'll keep a record of poo with the food log too. Sure the CM will be fine to help with that.Then we can talk about it.

I know it can often take a long time to get things right, there is so much trial and error. Dr kept giving us more and more lactulose and stuff with ds1 until the poor boy was just trying to withold liquid. When we finally got prescribed fybogel it was amazing.

Wish I knew what I did to make dcs with poo issues though.

Doesn't sound like constipation to me. I would ask for referral to a paed with interest in gastroenterology. DS was similar when younger and it turned out to be just toddler diarrhoea, but I was relieved to get other stuff ruled out. I would only try GF if coeliac diagnosed, not least because coeliac tests need the person to be consuming gluten for an accurate result

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