Encopresis and constipation in kid

[Anonymous]

My 6YO DD has been dealing with dirty underwear for 6 months. The pediatrician said to give Miralax until it stops and if it doesn't stop to go to a GI Dr. So the miralax worked after a month but then early summer it came back. Called a pediatric gastro who couldn't see her until September. Still doing the daily Miralax but it's been a month or two and while it's improved a lot, it's not great. We increased fiber and emphasize the importance of fruits/veggies - she's generally a healthy eater. Some days there are no issues and some days there are multiple accidents. What can we do to help her in the meantime while we wait for this appointment? I found someone mentioned the MOP theory but that seems tough (a daily enema?? I've never done one and don't know if she'd let me. I'm also nervous about doing that without a doctor's supervision/permission). I feel really bad that she is still experiencing this, especially because she doesn't tell us about it and is walking around with soiled underwear. TIA.

[Anonymous]

Do a search under the infant toddler and preschooler forum. There are several threads on this and I’ve commented on them a lot about my then 4yo.

Stick with the miralax for now and push liquids. I wouldn’t recommend enemas. Watch the poo in you video if you haven’t already with your 6yo. Miralax didn’t work that well for my kid but ex lax squares under advisement of pediatric GI worked really well. It can take several months or a year or more to get things under control. See if the GI office has cancellations and can get you in sooner. Consider having her wear a pull up for now so you’re not dealing with dirty underwear. Remind yourself that it’s out of her control as she’s likely lost the sensation related to bowel movements.

[Anonymous]

When you see the pediatric GI they will most likely recommend a two day in a row clean out of four caps of miralax followed by 3 ex lax squares in the evening. After that they will either recommend a daily dose of miralax and cleanouts one a month or every other week or a daily dose of exlax for a period of time. Having experienced regular clean outs and miralax I can tell you that if it doesn’t resolve the constipation in a year stop and switch to the exlax regime. It’s more effective and resolves the problem.

As for now, the reason that your DD still is soiling is because the miralax is not enough to clean her out. Instead all it’s doing is making the new poop seep around the still hard old poop. You could do a clean out if you wanted now or just wait until you see the GI. Which GI are you seeing?

[Anonymous]

We’re in the same boat waiting for the GI appointment. It sucks. I spend so much time and energy worrying about it and our pediatrician really didn’t help at all.

In our case it’s behavioral (younger kid withholding). I also found MOP but I can’t follow one quack doctor selling stuff online. Maybe he’s right I don’t know.

We do have the liquid glycerin suppositories. They are torture for the whole family but they work and work quickly. They are my last resort option for now while I wait for the GI appointment. We’re going to the Hopkins clinic. Fingers crossed they can help us.

[Anonymous]

Anonymous wrote:Do a search under the infant toddler and preschooler forum. There are several threads on this and I’ve commented on them a lot about my then 4yo.

Stick with the miralax for now and push liquids. I wouldn’t recommend enemas. Watch the poo in you video if you haven’t already with your 6yo. Miralax didn’t work that well for my kid but ex lax squares under advisement of pediatric GI worked really well. It can take several months or a year or more to get things under control. See if the GI office has cancellations and can get you in sooner. Consider having her wear a pull up for now so you’re not dealing with dirty underwear. Remind yourself that it’s out of her control as she’s likely lost the sensation related to bowel movements.

I just posted above. My 7 year old had been on miralax for years and now we are switching to daily exlax. How long has your four year old been on exlax? My worry is that my DD will have daily pain from the exlax and that we will not be able to wean her off the exlax. GI basically recommended a two day clean out and then 3 squares of exlax a day for a period of a year.

[Anonymous]

Anonymous wrote:When you see the pediatric GI they will most likely recommend a two day in a row clean out of four caps of miralax followed by 3 ex lax squares in the evening. After that they will either recommend a daily dose of miralax and cleanouts one a month or every other week or a daily dose of exlax for a period of time. Having experienced regular clean outs and miralax I can tell you that if it doesn’t resolve the constipation in a year stop and switch to the exlax regime. It’s more effective and resolves the problem.

As for now, the reason that your DD still is soiling is because the miralax is not enough to clean her out. Instead all it’s doing is making the new poop seep around the still hard old poop. You could do a clean out if you wanted now or just wait until you see the GI. Which GI are you seeing?

I just want to say that I know the leaking around a mass thing can be true, but in my younger kid we get little accidents that don’t seem to be related to a stuck mass, they’re from trying and failing to hold it in. Not saying that’s your problem just saying it’s very tough to figure out what’s happening.

[Anonymous]

Anonymous wrote:Do a search under the infant toddler and preschooler forum. There are several threads on this and I’ve commented on them a lot about my then 4yo.

Stick with the miralax for now and push liquids. I wouldn’t recommend enemas. Watch the poo in you video if you haven’t already with your 6yo. Miralax didn’t work that well for my kid but ex lax squares under advisement of pediatric GI worked really well. It can take several months or a year or more to get things under control. See if the GI office has cancellations and can get you in sooner. Consider having her wear a pull up for now so you’re not dealing with dirty underwear. Remind yourself that it’s out of her control as she’s likely lost the sensation related to bowel movements.

I just called them and no openings. I asked them to call me if there is anything. She said it's a 3 month wait period. I posted here before and Dr. Serrano at medstar was close and took our insurance. She isn't embarrassed when she tells me but we need to be better about checking her underwear throughout the day since she must not know it's happening.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Do a search under the infant toddler and preschooler forum. There are several threads on this and I’ve commented on them a lot about my then 4yo.

Stick with the miralax for now and push liquids. I wouldn’t recommend enemas. Watch the poo in you video if you haven’t already with your 6yo. Miralax didn’t work that well for my kid but ex lax squares under advisement of pediatric GI worked really well. It can take several months or a year or more to get things under control. See if the GI office has cancellations and can get you in sooner. Consider having her wear a pull up for now so you’re not dealing with dirty underwear. Remind yourself that it’s out of her control as she’s likely lost the sensation related to bowel movements.

I just posted above. My 7 year old had been on miralax for years and now we are switching to daily exlax. How long has your four year old been on exlax? My worry is that my DD will have daily pain from the exlax and that we will not be able to wean her off the exlax. GI basically recommended a two day clean out and then 3 squares of exlax a day for a period of a year.

Is the Exlax something you need to be home to do? She won't have a full day at home for two weeks and I don't want her having diarrhea at camp. - op

[Anonymous]

DP but for our 4 yo DD the ex-lax tabs never work right away and don't cause diarrhea. Our ped told us half a tab if she hasn't pooped for a couple days.

[Anonymous]

Anonymous wrote:DP but for our 4 yo DD the ex-lax tabs never work right away and don't cause diarrhea. Our ped told us half a tab if she hasn't pooped for a couple days.

So did you need to be home for a few days?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Do a search under the infant toddler and preschooler forum. There are several threads on this and I’ve commented on them a lot about my then 4yo.

Stick with the miralax for now and push liquids. I wouldn’t recommend enemas. Watch the poo in you video if you haven’t already with your 6yo. Miralax didn’t work that well for my kid but ex lax squares under advisement of pediatric GI worked really well. It can take several months or a year or more to get things under control. See if the GI office has cancellations and can get you in sooner. Consider having her wear a pull up for now so you’re not dealing with dirty underwear. Remind yourself that it’s out of her control as she’s likely lost the sensation related to bowel movements.

I just posted above. My 7 year old had been on miralax for years and now we are switching to daily exlax. How long has your four year old been on exlax? My worry is that my DD will have daily pain from the exlax and that we will not be able to wean her off the exlax. GI basically recommended a two day clean out and then 3 squares of exlax a day for a period of a year.

Is the Exlax something you need to be home to do? She won't have a full day at home for two weeks and I don't want her having diarrhea at camp. - op

Not for the daily exlax. But you need to be home for the clean out.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Do a search under the infant toddler and preschooler forum. There are several threads on this and I’ve commented on them a lot about my then 4yo.

Stick with the miralax for now and push liquids. I wouldn’t recommend enemas. Watch the poo in you video if you haven’t already with your 6yo. Miralax didn’t work that well for my kid but ex lax squares under advisement of pediatric GI worked really well. It can take several months or a year or more to get things under control. See if the GI office has cancellations and can get you in sooner. Consider having her wear a pull up for now so you’re not dealing with dirty underwear. Remind yourself that it’s out of her control as she’s likely lost the sensation related to bowel movements.

I just posted above. My 7 year old had been on miralax for years and now we are switching to daily exlax. How long has your four year old been on exlax? My worry is that my DD will have daily pain from the exlax and that we will not be able to wean her off the exlax. GI basically recommended a two day clean out and then 3 squares of exlax a day for a period of a year.

Is the Exlax something you need to be home to do? She won't have a full day at home for two weeks and I don't want her having diarrhea at camp. - op

Not for the daily exlax. But you need to be home for the clean out.

What's the diff between daily exlax and the clean out? Less exlax?

[Anonymous]

Ducolax works really well and there’s a fast acting chewable variety.

[Anonymous]

How does she not know it's happening? I don't understand.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Do a search under the infant toddler and preschooler forum. There are several threads on this and I’ve commented on them a lot about my then 4yo.

Stick with the miralax for now and push liquids. I wouldn’t recommend enemas. Watch the poo in you video if you haven’t already with your 6yo. Miralax didn’t work that well for my kid but ex lax squares under advisement of pediatric GI worked really well. It can take several months or a year or more to get things under control. See if the GI office has cancellations and can get you in sooner. Consider having her wear a pull up for now so you’re not dealing with dirty underwear. Remind yourself that it’s out of her control as she’s likely lost the sensation related to bowel movements.

I just posted above. My 7 year old had been on miralax for years and now we are switching to daily exlax. How long has your four year old been on exlax? My worry is that my DD will have daily pain from the exlax and that we will not be able to wean her off the exlax. GI basically recommended a two day clean out and then 3 squares of exlax a day for a period of a year.

Is the Exlax something you need to be home to do? She won't have a full day at home for two weeks and I don't want her having diarrhea at camp. - op

Not for the daily exlax. But you need to be home for the clean out.

What's the diff between daily exlax and the clean out? Less exlax?

Cleanout is 4 caps of miralax during the day and then 3 squares of exlax in the evening per our pediatric GI. Our GI will sometimes recommend to do the clean out two days in a row.

After the clean out is either a miralax maintenance regime or an exlax maintenance regime. Miralax maintenance regime is usually one cap of miralax a day (or more - whatever makes your child poop daily). Exlax maintence regime is around three squares of every evening (or more or less - whatever makes your child poop every morning). Both the miralax or exlax maintenance regimes usually will involve monthly or biweekly clean outs.