Saturday 8 November 2008

constipated 2-year-old

> Hello,
> I have a 2 year old daughter who suffers very badly from
> constipation
> and has done since she was eight months old.I am at my wits end we
> have been to gp and tried several medication with no luck. She is
> currently on lactulose and senna. It seems to work then just doesn't
> work for while. I was advised to increase dose from 2 5ml of
> lactulose twice day to up to ten a day. This just seems such a lot
> to
> give her but did it sometimes works and other times doesnt. She has
> also had suppository aswell which didn't work well. When she tries to
> go she is in so much pain screaming which can last hours and has
> even
> hurt her back trying to do it. She can go several days trying with
> no
> luck. I dont know what to do have tried obvious diet changes etc
> with
> no luck. What would you suggest? Could she have any other medical
> problems that cause this? Could being on these medications cause
> problems later in life?
>
> please get back to me my email is danagray19@hotmail.com i would
> really appreciate it.
>
> Many thanks
>
>


                   I am sorry your daughter is having so much pain on using her bowels. From your description, she has a fissure-in-ano.
This is a small crack in the anus where the bowel meets the skin. When she uses her bowels the crack is torn open and causes pain. This tends to stop her using her bowels making her more constipated.
She needs a local anaesthetic ointment applied to her anus as a thin smear at night after her bath and again in the morning on waking. You can buy the ointment over the counter at the pharmacy. You can also apply the ointment during the time she is using her bowels if it is hurting.
Lactulose and senna are fine. I recommend giving the senna at night. If she fails to use her bowels in the next 24 hours then double the dose. If this does not produce a result in the next 24 hours give her half glycerin suppository and continue with the higher dose of senna. Failure to use her bowels means redoubling the dose of senna and if this does not work another half suppository. After a week of success of using her bowels the dose of senna can be halved. So 1 day of failure means doubling the dose, a week of success means halving. She may get up to quite a high dose of senna but it will do no harm. Throughout all this you continue with the twice daily local anaesthetic ointment.
These instructions are quite complex, so don't have any hesitation in asking me a question. I will be happy to hear from you.
David

2 comments:

Anonymous said...

my 31 month old son ,has also got this very bad.He screems for most off the day on and off holding his cheaks and still dont go hes very upset this is now upsetting me his mum and his sisters.took him to g.p and g.p put him on lactoluce its not working he hasnt been for 8days,the build up for him to go isscreeming holding his bum bt this can be three days befor the movment happens then anthore 10 day 4 the next im stressed.his bottom also bleed lastime and not being rude the size of movement was HUGE this scared me it was masive please PLEASE HELP!!!he was 8 wk and 4 days early i worry there is something wrong with his bowles ? thank kathy

John Roy said...

It is very important to relieve from constipation for good health. Constipation is a really big problem for babies. For this reason, we give Fissure Medicine for Infant Constipation.