Grumpy child

‘Can you phone Mrs X, her child can’t poo and she doesn’t know what to do’. This is a fairly common message I get at work. What is worse is that when I phone mum or dad to get the whole story I can usually hear a child screaming in pain in the background. It breaks my heart, it’s agony for them. It can catch all of us out; I’ve been there more than once with more than one of my children! So when it’s been a few days and your little one is sore and crying and can’t poo, what can you do?

  1. Start by reassuring them. It’s very frightening as the pain is intense and if it’s the first time it’s happened then they might quite literally be scared about what is happening.
  2. Don’t force them to sit for ages on the toilet or potty. Even though you know they need to go it’s better to let them hop on and off and feel as if they are in control.
  3. Try a warm bath. This can help them relax and make it easier to pass the stool. Sometimes they’ll poo in the bath but the relief of this outweighs the horror of cleaning it up.
  4. Give them a warm drink. There’s something called the gastro-colic reflex. There’s an automatic stimulation of the bowel when food or drink hit the stomach and a warm drink can again relax them.
  5. Pop on a bit of Vaseline around the anus, it can help the stool pass a bit more easily. The skin here may tear and bleed a little with straining, this is called a fissure and can be really painful.
  6. Give them some paracetamol. They aren’t unwell and don’t have a temperature but it will act as a painkiller.
  7. Nip to the chemist and chat to the pharmacist. If it’s been a few days and the poo is low down and hard then you can buy glycerin suppositories which you dampen with a little water and pop into your child’s bottom. They can be very effective and work quickly when you’ve reached crisis point.
  8. If the situation is building rather than at a crisis then making sure they have lots of fluids to drink is the most important thing. Dehydration is one of the commonest causes of constipation. Fruit smoothies are ideal, make them with tinned fruit such as peaches and pears for a tasty and effective laxative.
  9. Avoid large amounts of fibre. Whilst giving a bit of weetabix may help, large quantities of fibre can make the stool bulky and the more fibre you have the more fluid you need too.
  10. If things still really aren’t moving or your child is vomiting or unwell then it’s time to call your GP. Your Health Visitor can advise you too.
  11. When the bowel is finally clear the most important thing is to stop it building up again. Children get real fear of the pain so hold onto their poo and you can easily end up in the same situation again. Try to keep up the fluids and fruit/veg and encourage them to have a little sit on the toilet or potty everyday around bath time ‘just to see’ if anything happens. Plenty of exercise helps to avoid constipation too.

I hope this list is helpful. I do really feel for you if you’re in this situation. It’s not bad parenting; it happens. Feel free to share any of your top tips too.

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  1. This is so helpful. Poor little pumpkin gave himself a fissure a little while ago poor mite. It is awful. Obviously I should know this stuff but I actually didn’t know you could get glycerin ootc. Great to have everything written in one place too. X

    1. Good to know I’m not the only Dr with constipated kids! There’s lots written about how to prevent it but couldn’t find anything about what to do when they’re screaming in agony! Horrible!

  2. I love the expression on the child in the pictures face – classic constipation face!
    Now that summer is around the corner, don’t forget the benefit that trampolining has on bowels – they will be pooping in no time (you just have to balance the risk of broken limbs).
    Constipation is possibly the number 1 thing seen in paediatric clinics and is actually the most common sense to manage (just like you’ve shown in your tips). #thelist
    Great post by the way, excellent tips.

    1. Thanks. The boy in the pic wishes it to be known this post is NOT about him! Although I did choose the pic for the very reason you suggest. If I recall correctly there was water in his welly!! Trampoline great idea, wish we could prescribe (with safety net of course) 😉 Thanks for reading and commenting x

  3. This is so useful! We still didn’t have that problem, but I guess we will one day. I will definitely remember some of these.. And the picture is awesome, but I will remember that this is not a post about him 🙂 🙂

    1. It’s horrid for them isn’t it? Movicol great and I prescribe it a lot for constipation. Really need to break the association that poo-ing is painful or they just hold on to it and it gets worse. Thanks for hosting #the list and visiting me x

  4. Hellooo – yes this is a useful post. My nearly six year old has had trouble with pooing from age 4. It started off with severe constipation, a lot of pain and then withholding subsequent poos as a result of fissures etc. We were prescribed movicol which does what it ‘says on the tin’ in so far as the child goes to the loo more but it also increases the chances of leakage which in itself is often more distressing. For about a year now my daughter has been weaned off Movicol and has been managing. But she will happily still only poo every 3 days or longer unless I prompt her and then she can almost poo on demand! She eats tons of fruit, porridge, vegetables etc so this is not diet related. She just likes to poo at home (which with her busy lifestyle is hard) and she has said that she doesn’t want to miss out on things by going off to the loo. Our main issue is what holding on to her poo does to her mood – she becomes grumpy, tired and not her usual self. I’m not sure poos are painful anymore but they are sometimes huge and things still just don’t seem right. I also worry about any damage this may do to her bowel/overall well-being long-term? If you have any advice for us, it would be great. I really don’t want to medicate her again. Thank you.

    1. I’m glad you found it useful Charlotte. It’s so difficult isn’t it. It’s great she’s off the movicol and her diet sounds fab. I think it’s all about routine. Lots of kids (including my own!) only like to poo at home which always leads to lots of holding on. As long as when she’s going it isn’t painful then hopefully over time things will settle down. I know with busy lives it’s hard but even now some sort of daily routine like sitting on the toilet after breakfast helps. It helps to almost re-train the bowel if you like. Keep going with the prompting and she’s not too old for a reward chart. She’s still young so try not to worry too much and give her lots of reassurance.

      1. Thank you very much! I’ve started the routine just this week of sitting her on the loo every day. She’s old enough now to understand all this and not resist:-) Great advice and glad to know that we should just be focusing on routine rather than anything else. Thank you again!

  5. Great post! This will be helpful for so many parents. My middle child suffered from constipation. I did all of the tips you said and was very careful with his diet. It is very frustrating for the child and the parents.

    1. I know and can be so upsetting for both too. Parents I see often feel guilty so I’m quick to reassure them I’ve been there too ….. more than once! Thanks for reading.

  6. Any thoughts on weaning off long term Movicol use? All medical input seems to be pro long term movicol but lb (age 7)still regularly soiling, witholding. I’m tempted to wean off & give him some time without?

    1. So sorry to take so long to reply! It’s such a balancing act isn’t it? I would say if your son is still having a lot of problems despite being on the movicol then it’s worth discussing with your doctor again. It can seem like an awfully long time but it can take months to establish a normal pattern. Here is the link for the NICE guidelines on managing constipation in children. It can be helpful to see what docs are aiming for. If you just keep clicking on the ‘Next’ icon it will take you through it and there’s a section on ‘maintenance’. Hope that helps. Best wishes to you and your son. J

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