Jump to content

4 year old with anal fissure ‘holding on’


  • Please log in to reply
25 replies to this topic

#1 lonestranger

Posted 21 April 2019 - 06:23 PM

4 year old became constipated around 4 weeks ago after an ear infection that required a lot of medication.

An anal fissure is the result, it got a strep infection...so have been on antibiotics for a couple of weeks.
Bowel movements very painful for DS, also with blood (from the fissure).
We’ve adjusted his diet, but it’s not enough to get the soft stools Doctor is asking for. I’m also using 1 movicol sachet a day, also not working.

DS hasn’t managed to poo today, though he’s tried several times. He is very uncomfortable. I believe he is ‘holding on’ through fear of pain (don’t blame him), but it’s making it so much worse.

Please help EB, I’m at my wits end...what can I do to soften his stools more, and how do I convince him to stop holding? Away on ‘holiday’ at the moment (yeah, right), so can’t get to regular doctor for a couple of days...

#2 Ellie bean

Posted 21 April 2019 - 06:29 PM

Oh your poor little boy. My dd has chronic constipation which led to her withholding. Osmolax worked really well for her, but I don’t know if movicol or osmolax is better in your circumstances.
If I was stuck I’d probably go with some pre emotive Panadol before he tries again, heaps of fluid before too, and promise him a one off reward if he can do it or even try BUT I haven’t dealt with a full on fissure, I hope someone more experienced has advice

#3 Not Escapin Xmas

Posted 21 April 2019 - 06:32 PM

Poor kid, and poor you!

As well as the movicol etc, I would also keep him well away from BRAT foods:
  • Banana
  • Rice
  • Apple
  • Toast
Iinstead go for pears (especially the tinned ones in syrup as the sugar helps everything move too) and non BRAT foods.

And then bribery...

I'm sure other EBers will have lots of better ideas too!

#4 Paddlepop

Posted 21 April 2019 - 06:42 PM

More Movicol, or Osmolax. They're pretty much the same medication, just the Osmolax is unflavoured so you might be able to get him to drink more of it.

Lots and lots of water. Heaps of water. The Movicol won't work unless he has lots of water.

Parachoc to help lubricate everything inside and help the poo slide out.

A little bit of haemorrhoid cream or topical anaesthetic on his bottom prior to a poo to help numb the pain? Check with a pharmacist or doctor of course. Even some lanolin or bepanthen or something like that on him bottom to help moisturise and protect the skin from tearing, and some more on afterwards.

Sit with him and hold his hand while he does a poo? Maybe he needs some support to help him deal with the pain, and a parent might help him to be brave. My DD has had constipation issues all of her life and when she was initially TT for poos we'd sometimes have to sit with her and hold her hand or even cuddle her to help her get through any pain and get the poo out.

Poor little guy. My DH has had anal fissures. He said that they really hurt.

#5 ceeshell

Posted 21 April 2019 - 06:52 PM

I’ve had anal fissures and one thing that worked well was putting some lubricant down there to make it easier for things to slide out.

Also: more movical. When my son was constipated he needed more than one sachet a day.

#6 28 Barbary Lane

Posted 21 April 2019 - 06:53 PM

Oh no you poor things. DD and I have same problem. Heaps and heaps of water and pear juice. Will he eat lentil soup? There’s some at the supermarket in the fresh food section you can heat up. If so that can help. There’s stool softener as well coloxol(?) not sure for kids but maybe ask Chemist x

#7 taters

Posted 21 April 2019 - 06:54 PM

Can you increase movicol to twice daily? That could help ensure the stools are soft. Poor little man what an awful thing to be dealing with.

#8 Sincerely

Posted 21 April 2019 - 06:59 PM

I agree with previous suggestions of Parachoc, topical anaesthetics & preemptive panadol, as well as fluids, fruits & fibre.

#9 Paddlepop

Posted 21 April 2019 - 07:09 PM

View PostNo Drama Please, on 21 April 2019 - 06:53 PM, said:

There’s stool softener as well coloxol(?) not sure for kids but maybe ask Chemist x

Yes, there's children's coloxyl. My DD has been on it since she was a baby. Caramel/chocolate flavoured. We just put it in a drink of milk and she's happy to have it.
https://www.chemistw...oxyl-drops-30ml

#10 Caribou

Posted 21 April 2019 - 07:17 PM

Chemist also sell probiotics in tablet and liquid form. They swear by it for regular soft bowel movements.

There’s also cereal such as Ancient Grains museli by freedom foods which is pretty much an instant stool
Softener

And polyskium husk which works well adding to things like weetbix. You would hardly notice the difference. Both listed above are in health food aisle.

Good luck. I feel for you, DD has the same, the food and probiotics worked best for her.

ETA: when things were REALLY blocked up, worse after colds, we had to use lacttulose which is from chemist. It worked pretty much instant. Is safe for kids.

Edited by Caribou, 21 April 2019 - 07:19 PM.


#11 tweedle-dee

Posted 21 April 2019 - 07:20 PM

Lots of good tips. I'd second osmolax (we were using 1 x heaped small scoop twice a day), plus some cream to help numb the anus (haemerroid cream or xylocane [although that would be prescription only, so no good whilst your inable to get into a doctor]. The other thing we had to work hard at (excuse the pun!!), was having regular (as in 3 times per day) 'sitting times'on the toilet. In our case it was ipad time and they had to sit until the buzzer went off. The reward wasn't for actually doing a poo, more so for sitting long enough to give their little body a chance to poo. The other thing we learnt along the way is the value of little one using a step stool to rest feet while sitting on the toilet. Good positioning does help. Good luck, hope all resolves quickly.

#12 suline

Posted 21 April 2019 - 07:21 PM

Is he having adult or children’s movicol- you need the adult strength one with a softener like parachoc as well. The children’s movicol isn’t as effective. Maybe sitting on the toilet and being allowed to watch and iPad for 10mins would help him relax too. (It certainly works for my DH)

#13 tweedle-dee

Posted 21 April 2019 - 07:37 PM

Oh yeah, another tip we found helped, was to have 'sitting on the toilet time' just after finished having night time bath. Seemed to be a bit relaxed / calm at that point of the day.

Edited by tweedle-dee, 21 April 2019 - 07:37 PM.


#14 lonestranger

Posted 21 April 2019 - 07:48 PM

Thanks all...great tips, will try them all!

It’s childrens movicol, will add a second sachet I think immediately. He has no problem drinking it.

We also have parachoc...so we can take movicol and parachoc at the same time?

We also have the bum-numbing cream, but he hates the application of it...will try some more bribery on this front.

Haven’t tried pear in syrup, but will...I think he would love it. He is eating prunes by the handful (loves them), but might try prune juice? Avoiding BRAT, but will be more vigilant (there was toast this morning). He loves lentils, will try the soup.

Thank you all

Thanks all...great tips, will try them all!

It’s childrens movicol, will add a second sachet I think immediately. He has no problem drinking it.

We also have parachoc...so we can take movicol and parachoc at the same time?

We also have the bum-numbing cream, but he hates the application of it...will try some more bribery on this front.

Haven’t tried pear in syrup, but will...I think he would love it. He is eating prunes by the handful (loves them), but might try prune juice? Avoiding BRAT, but will be more vigilant (there was toast this morning). He loves lentils, will try the soup.

Thank you all

#15 Jenflea

Posted 21 April 2019 - 07:49 PM

Baths are GREAT for relaxing the muscles to poo.

Just ask my DD who'd poo in the bath when TT and holding on...

#16 Ozquoll

Posted 21 April 2019 - 07:51 PM

I’d increase the dose of movicol - the poo really can’t be too soft when you have an anal fissure 😢. Haemorrhoid cream also a good idea, per PPs.

#17 TheGreenSheep

Posted 21 April 2019 - 07:53 PM

There’s been great advice given already, so i wanted to add, all the best!

#18 lonestranger

Posted 21 April 2019 - 07:53 PM

Thanks all...great tips, will try them all!

It’s childrens movicol, will add a second sachet I think immediately. He has no problem drinking it.

We also have parachoc...so we can take movicol and parachoc at the same time?

We also have the bum-numbing cream, but he hates the application of it...will try some more bribery on this front.

Haven’t tried pear in syrup, but will...I think he would love it. He is eating prunes by the handful (loves them), but might try prune juice? Avoiding BRAT, but will be more vigilant (there was toast this morning). He loves lentils, will try the soup.

Thank you all

#19 Romeo Void

Posted 21 April 2019 - 08:01 PM

Watch out for Banana, I thought it was the food of the gods and fed both my children liberal amounts of it.  My DD was fine but it used to bind my DS up like crazy...I had no idea it could do this, I though fruit was good.  I had no idea his pooing problems were caused by me :(  At one stage he held on so long he passed a poo shaped like an orange.  He tore himself and bled so much.

Parachoc was the go for us.  Unfortunately he'd developed such a fear of pooing it took us years to get over it.

#20 Romeo Void

Posted 21 April 2019 - 08:04 PM

We also made it a rule that you had to sit for weeing.  Even dad got in on the act, everyone has to sit for wee's!  We found that sitting to wee sometimes would bring on a sneaky poo he wasn't expecting.  And a comfy stool for his feet so he can get a good posture for pooing.

#21 Hands Up

Posted 21 April 2019 - 08:12 PM

Parachoc. It’s been a lifesaver for us.

#22 FuzzyChocolateToes

Posted 21 April 2019 - 08:23 PM

My 8yo actually ended up in hospital last week due to faecal impaction. :( As such I have lived and breathed poo for the last week. :omg:

The RCH have references you can access but the short version is increase the Movicol/Osmolax until it works, then reduce. Continue for a minimum of 6 months. Osmolax has no taste so kids tend to prefer it. They must drink fluid too though,  so ds has been getting lots of diluted juice to ensure he's getting enough. Do what you have to do!

Movicol dosing from RCH ( Kids sachet. BD = x2 per day )

Quote

One sachet BD on day 1, two BD day 2&3, three BD day 4&5, four BD on day 6&7, titrate until desired result is achieved. 

When ds was younger a warm bath would often help him to go.  I actually didn't mind if he pooed in the bath as it was less painful. We also used massive bribery - ipad on the toilet, lollies for poo etc!

Do you have a stool for his feet? Knees higher than bottom is the ideal position.

Probiotics aren't proven to work for constipation according to RCH. Also, fibre supplements are not recommended for kids as they can block them even more.

https://www.rch.org....x/Constipation/
https://www.rch.org....s/constipation/
https://www.rch.org....c_constipation/

Edited by FuzzyChocolateToes, 21 April 2019 - 08:49 PM.


#23 Wonderstruck

Posted 22 April 2019 - 05:24 PM

Second the advice about increasing the movicol.

My toddler requires a fair bit of osmolax as a maintenance dose.

Coloxyl, pears, prunes etc do nothing got her.

#24 hm6

Posted 22 April 2019 - 05:30 PM

All above advice - plus liberal amounts of a lubricant eg Vaseline to help it slip out. Agree with feet position  - apparently squatting encourages best  pooing practise!!

#25 blimkybill

Posted 23 April 2019 - 04:35 PM

View PostWonderstruck, on 22 April 2019 - 05:24 PM, said:

Second the advice about increasing the movicol.

My toddler requires a fair bit of osmolax as a maintenance dose.

Coloxyl, pears, prunes etc do nothing got her.
One of my daughters also had constipation and associated anal fissures. She also received no benefit at all from prunes, pears, Coloxyl. Her doctor put her on Parachoc, she had to have enough to make her poo soft like cow manure for several months to allow both her fissures and her bowel to fully recover.




0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users

 
 
Advertisement
 

Top 5 Viewed Articles

 
Advertisement
 
 
 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.