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2 year old constipation issues
jermanda23 posted:
Does anyone else have experience with toddlers taking Miralax?My son has been having constipation issues for several months now. He started only going every 3 days or so and when he did he would strain a lot to poop and it was very clumpy. That was 6 months ago now. I tried then to change his diet - more fruits (he doesn't eat a lot of veggies although I make him) but that didn't work right away and he ended up having a hemorhoid.
I called our pedi and the nurse said to try Miralax for a week. We did, it helped, then we stopped. Then the constipation came back. So again they said to try it for at least 3 months.
After a month and half of Miralax every day we noticed he was going every day very regularly. So we weaned him off the meds and he continued going well (every day, no straining, not clumpy) for about a month. Then all the symptoms returned all over again.
So we decided to follow what the nurse originally told us and give it to him every day for 3 months. She said his intestines need time to heal after such constipation and he probably had inflamed intestines due to straining that would take that long to heal.
We're giving it to him every day and it's been a month. He usually goes every day but not in the toilet - he's scared to death when we sit him on it to poop since he's had such pain in the past. It's usually a good consistency - not too loose but not clumpy at all - and he doesn't strain to get it out. But he does act nervous before pooping sometimes. I'm not sure if that's due to being afraid since it's hurt in the past or if it's hurting now.
My problem is that I'm not so sure Miralax is the answer to our problems. When I ask the nurse if this is normal she always says yes, they put kids on it for 3 months all the time. But is it really curing the problem or just temporarily relieving symptoms? Does it really take 3 months for their intestines to heal at this age? What if it doesn't work and in 3 months we start this whole constipation issue all over again? It's sad and sounds trivial but it seems some days our entire day revolves around poop! I never know when he's going to start acting like he's hurting, when he's going to actually poop and I never know if it's going to run out the sides of his undies/pull-up or not. It's just been frustrating and I'm worried about him. Any advice/suggestions?
kay_kay75 responded:
Go to a gastroinestinal doctor if you don't think Miralax is the issue. They deal with digestion and bowel issues all the time and there are pediatric specialists as well.
Roy Benaroch, MD responded:
Constipation is very, very common among kids and adults. There is very rarely a specific medical reason-- most commonly, it's just how some guts handle food. I think the big modern culprit is our diet, which is so completely different from what humans were eating for thousands of years. Sometimes constipation makes itself worse-- a constipated child learns that it hurts to poop, so they hold it in, and it hurts more, so they hold it more.... you get the picture.

A chronically constipated child develops a big, distended colon that's less able to squeeze well, and less able to signal the brain that it feels full. That's why it's important to treat constipation for the long haul, to give the gut plenty of time to re-adapt to normal stools. It also allows the child enough time to forget that it hurts to poop.

Non-medical treatment of constipation can include increasing the insoluble fiber (eg bran) in the diet, along with plenty of water. But it's hard to get people to eat enough fiber to accomplish much. More fruits and vegs might help, as can juice (especially juices rich in sorbitol, like prune/pear/mango.) Often, dietary changes don't help much.

One thing you don't want to rely on is suppositories or enemas. Using those more than very rarely is going to lead to misery.

The best treatment for ordinary constipation really is Miralax. It's a simple medicine that stays only in the gut- it doesn't get absorbed into the blood. It draws more water into the stool, keeping the stool soft. That's all it does. Soft stools stay easy to pass.

Along with Miralax, provide plenty ot drink and regular, unhurried time on the potty. With a timer. Kids rush and think they're done when they've passed a tiny bit of stool. Relax, wait, let the magic happen.

I typically suggest using Miralax every day for at least 3 months, giving enough to make the stool soft and pudding-like every day. Stopping the Miralax too soon will invariably lead to a return of misery. Who needs that?

Best of luck!

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