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How to get her to poop...

My daughter just went through a horrible ordeal of having feces manually removes from her bum, and then an enema a half hour later because there was still way too much too far in.

Apparently one highly possible reason for the impaction was her holding her bowels in, too afraid to go because it hurt. Well, everything was removed and she has been taking Miralax once a day as well as eating higher fiber foods.

My problem is she is still holding her bowels in.

She woke up last night at 9:30 rocking back and forth trying to hold it in so I picked her up and ran her to the bathroom. Kicking and crying, I finally got her pants off slightly and sat her on the toilet. She wouldn't go but one piece finally came out. She got some on my hand and shirt (before she went.. This was when I was still trying to get her pants off).

I can tell she is holding it in still. How do I get her to finally poop?!

She will be going to her fathers today for the weekend, and I'm afraid he will just ignore the situation and she will end up back in the ER.

I'd like to start her on a daily fiber gummy to help regulate her. Does anyone have any other advice as to what I can do for her, or give her to help her bowels come out much softer and easier? Any good bribes, too? Lol. I'm almost out of birthday presents to give her (she gets a present if she takes her laxative or if she poops.. No pooping yet though).

I'm scared to death that this will happen again. She was in so much pain and she's so tiny, it's so difficult to watch her to through something like that.

Thank you in advance. :)
by on Nov. 30, 2012 at 6:25 AM
Replies (11-15):
by on Nov. 30, 2012 at 9:33 PM

The product that has the least flavor that we've found is Metamucil's Clear-and-Natural in the BLUE bottle (Inulin powder).  My daughter could always still taste the Miralax, no matter what we mixed it in (I could taste it, too).  My daughter can't taste the Inulin powder, even when it's mixed in straight water.  It's a smaller dose, with less flavor. Very easy to use. 

If you want to use more of the Miralax, you can talk to your doctor.  At one point, our GI doctor had my daughter taking 4 doses (17gm each -- plus two other laxatives) daily.  Let your doctor know that your daughter can still withhold her stool with one dose and that she's getting backed up again.  He/she should be willing to reassure you that larger doses of laxatives are okay and necessary.

If your pediatrician isn't as familiar with this kind of problem, you might want to seek a consult with a pediatric gastroenterologist for more direction.  If the problem isn't properly resolved, it can lead to encopresis where the bowels are consistently overful for so long that they lose muscle tone and develop uncontrolled soiling.  You're right to nip this problem in the bud.

I planned to use the fiber gummies and have asked her father to do the same but he never responded. She is on a daily dose of Miralax and I have upped her fiber intake as well as her fluids. She is able to hold her bowels in because she just strayed the Miralax. I was told she can only have one dose a day and she gets 17gm every morning. Same as me. 

I tried putting another laxative (stool softener) into her juice but she can taste it and refuses to drink it. But I will try your suggestions of combinations to get her stools to be soft.

Thanks again so much. Incredibly helpful!

by on Dec. 1, 2012 at 7:56 AM
Add Karo syrup to whatever she's drinking. That should help
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by on Dec. 1, 2012 at 12:48 PM

Awesome advice

Quoting hwifeandmom:

If she can still withhold her bowel movements, then she's not on a high enough dose of laxatives.  With some meds, it's dangerous to take additional doses.  With laxatives, the dosage is very individual.  You don't want to give so much that your daughter gets chronic diarrhea and becomes dehydrated, but otherwise, it is safe to use enough laxatives to get the job done (daily eliminating a sufficient quantity of healthy poop).  Gradually increase your daughter's laxatives every day or two until you find a dose that prevents her from withholding her bowels.

There are two basic types of laxatives:  stimulant and non-stimulant (stool-softening laxatives).  Stimulant laxatives force bowel contractions to semi-quickly eliminate stool.  Stimulant laxatives are for occasional use only since the body can become dependent on them.

Non-stimulant, stool-softening laxatives help hold water in the stool to keep it soft.  They are not habit-forming (the body does not grow dependent on them), so they are safe for long-term daily use.  Some good ones are Miralax, Benefiber, Milk of Magnesia, Fiber Choice with Inulin, Fiber gummies, and Metamucil's new Clear-and-Natural with Inulin powder.  Several of the fiber gummies I've seen are Inulin-based.  Inulin is plant based, from chicory root.  It is fine to use both fiber gummies and Miralax (or any other combination of laxatives).

Because your daughter apparently has really good bowel control (the ability to withhold her poop), then you'll need to give her enough laxatives to make her poop very, very soft, possibly even borderling diarrhea.  Once she's pooped in the toilet enough times to overcome her toileting fears, then you can gradually reduce the amount of laxatives she uses each day.  This may take several weeks or longer.

Eating is supposed to provide the body with a natural laxative effect (like how babies poop right after eating). Many doctors will recommend having your child sit on the toilet about 15-min after mealtime (esp breakfast & dinner), and sit for 10-15 minutes, to try to work with the body's natural rhthyms.  Even if your daughter doesn't poop, having her sit and try is helpful.  Let her blow on blow-out party favors and balloons while sitting on the toilet, since those use the same muscles as those needed to poop.  If she doesn't want to do that, then let her read or play with a special toy, to help relax her while sitting on the toilet.

Good luck.

by on Dec. 2, 2012 at 1:37 PM
Quoting hwifeandmom:

Luckily my daughter can't taste the Miralax. Do you know if I can add Kayro (or however it is spelled) syrup along with the Miralax? Can the Metamucil also be added with Miralax?

Thanks again for all of the advice. :)
by on Dec. 6, 2012 at 2:13 AM

Agree with all before me. My son sort of did the same thing but we didn't end up in er. Keep putting her on the toilet every hour or every other hour and let her sit there. Also when she's on the toilet Put vaseline on her butt hole and possibly with a qtip insert it in. Adult lube works better. I put both on my son so it passed through easier even though it hurt him and seemed hard as a rock. It did help alot. I also massaged his back while he was trying to go. I once had to lay him down on his back in the bathroom on a towel and push his knees up as he tried to push the poop out. Easier to lube that way to.I had his younger sisters diaper under him and he did get it out. I had gloves on and had to help it out :( Not inserting my fingers in him but the poop was visible and "there" and it was hard but not coming out :( so i was trying to break it apart. His poor bum was stretched and him crying but mama was helping him as much as I could. Lube allowed it to come out. My poor son. I think it traumatized me more than him. He was 4 also.

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