Medical Expert: Constipated toddler
 Toilet time has become a stressful business for a two-year-old who seems permanently in pain. Dr Philippa Kaye looks at what might be the matter.
Raisingkids member's problem
My two-year-old boy has had trouble pooing since he was five months old. He bleeds, he shakes , he sweats, he screams and cries uncontrollably and he sleeps a lot. Now he's lost his appetite and weighs 23lbs. I've been to the doctor time and time again with no luck. I was given Movicol for him which simply made his poo runny, but he was still the same. I'm very worried and would like someone to take this seriously. I really don’t think he is constipated as he has both soft and hard poo.
Medical Expert Dr Philippa's Advice
Although you say he sometimes has runny soft poo, I do think you are describing severe constipation. What happens is that you get a big hard mass of poo in the rectum (part of the intestine just before the anus where the stool is kept before you go to the toilet) and if you can’t poo that out, then you will get a build up of poo behind it. Some stool has to escape so you get an overflow of liquid that can pass round the hard stool in the rectum. So even if your son may have soft poo, he still can be constipated - this is called overflow diarrhoea. If he is bleeding and screaming he may also have an anal fissure. This is a small cut in the anus, so everytime he tries to go, the cut opens causing pain and bleeding. If it hurts children to go to the toilet, they try not to go which can make the constipation even worse.
Take your son back to your GP and describe exactly what is happening - he should be able to help you. If he can’t, you can be referred to a paediatrician. The treatment is to make the poo very soft so that your son can easily empty his bowels without reopening the cut. Movicol is a good laxative, but there are others you could try, as different laxatives work in different ways - some to soften the poo, others to make your gut contract to push the poo out. It may be that he needs a combination of the different types. If this doesn’t work then there are creams you can try to put on the anus to stop it hurting when he poos, such as local anaesthetic creams.
This condition is distressing for both him and you, but it can be treated. You also need to try and take the stress out of toilet time. Try putting your son on the toilet after every meal and keep as calm as possible. It will get better!
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