Chronic Constipation - Looking for Solutions That Work

Google high fiber diet and get lots of those foods into his system. A high fiber diet makes everything work better and move along.

I do agree with seeking the help of a dietician. S/he can help tell you just how much fiber to get into his diet and how to sneek some in as well. Perhaps a high fiber cookie every day or smoothies with pears and apples (skin included). Raspberries are super high in fiber, too.

Good luck. Poor little guy.

That sounds like a lot of Miralax. Maybe too much.

My daughter has constipation troubles. I solved it/ manage it by regulating her diet. She eats a banana for breakfast half the week. The other half of the week I make her oatmeal pancakes.

So simple, but it works great.

What kinds of fruits does he eat? And do you give him anything - ANYTHING - with artificial sweeteners or sugar alcohols (splenda, sucralose, aspartame, sorbitol, xylitol, stevia, truvia, agave nectar, etc...literally anything other than sugar)?

The reason I ask, is that some people are extremely sensitive to certain fruits, and it can produce the opposite-than-expected result. My daughter cannot have sorbitol (or the other sweeteners ending in "itol"), or the fruits they naturally occur in (apples, cherries, purple/red grapes, pears).

A rather simple experiment would be to eliminate all apple, red grape, cherry and pear products from his diet for a week or two (maybe a month). Let him have strawberries, green grapes, blueberries, bananas, oranges. Check every juice and drink label (most juices and kid drinks are sweetened with apple juice or pear juice). Give him 100% white grape juice if he needs a fruit drink, or water, and check that it's not "white grape juice with other natural fruits". Remove all sugar-free foods from his diet (most are sweetened with sorbitol or the "itols").

When we removed all sorbitol and apple/pear/cherry/red grape-containing foods from my daughter's diet, her constipation, which was so serious that her intestines were beginning to atrophy and they were considering surgery, became controllable, and improved remarkably. Her GI dr explained that many kids are very intolerant to the sorbitols (used in sugar free foods and naturally derived from apples, red grapes, cherries, pears, some seaweeds, and a few other sources that aren't so common). Some kids react with constipation, others with diarrhea, others with abdominal pain. It's a fairly easy thing to eliminate and try.

Some fruits are constipating.
Peaches, pears, oranges are helpful.
Apples & bananas? Not so much.

Has he ever done the treatment for encopresis? It's a LOT of Miralax over a few days, THEN a maintenance dose and a scheduled bathroom use plan.y friend went through that with her son and I don't think it has recurred. He's certainly not on the Miralax anymore...

I do think it's a good idea to speak (again) to the doc and to a dietician for suggestions. Good luck!

Has the GI doctor done any testing? My daughter who is now 7 suffered the same thing. Except it was from about 3 months old. She had numerous tests done and then we were shipped to a nationwide children's hospital in Columbus Ohio for motility clinics and testing. They determined that she had a motility issue. They surgically put in what's called a cecostomy tube, and we had to "flush" her tube every night to make her poop. Today she still has the tube in her stomach but we have not used it for the last 5 months. We have an appt to see about having it removed. They did tell me its something she could out grow but after 26 surgeries(fecal disempactions and biopsies) they were treating her aggressively. Best of luck to you!

It seems like you're doing everything right.
Try prunes / prune juice every day and add some Benefiber into almost every beverage he drinks (nothing carbonated).
It may be that he just can't take any chocolate.
Find him a different treat for awhile and see if it makes any difference.

Have you had him tested for Hirschsprung's disease?

Hi M. P,

Overuse of Miralax (which is defined by more than occasional) causes dehydration. Even though you are adding fluids, he is probably not absorbing them. Ant-acids do the same thing....they initially help with heartburn but they mess with the chemical makeup of the stomach and cause more heartburn. I agree with the prunes. Juice is okay for emergency use but he needs the fiber in the meat of the fruit.

I personally think he needs to be on an absorbable (that's the key word) multivitamin. Nutrition keeps the digestive tract working. It's completely possible that he is getting what he needs but his body chemistry has changed and he is not absorbing what he needs.

My daughter struggled with constipation until she was about seven. When we detoxed her little body and started her on the right vitamin and made sure she was getting water (not just fluids), everything adjusted and she's been fine since!

Hope this helps!
M.

Give him prunes. Prunes are high in this one particular type of sugar that draws more fluid into the stool. I give my almost 2 year old 1/2 jar of pureed prunes nightly -- the kind made for infants. When her constipation is really bad, I give her a whole jar. She hates it, but works. I've had prune juice for occasional constipation and while it works, I want to warn you that prune juices are high in sugar. Also avoid dairy foods. During my last preganancy and with my current pregnancy, I'm taking Colace, which sort of works for me, but I'm not sure if that's okay to use long term.

yeah, I can't imagine a 4 yo eating prunes...nope.

What fresh fruits is he eating?

Grapes, grapes and more grapes. Frozen, fresh, red, green.
Pineapple
Melon
Apples

Those are the best ones. Rotate but eat daily.

Beans are also great. My kids love bean and cheese burritos.

Sorry about the level of management this must cause for you. Perhaps try and serve the fruit first before every meal, as an appetizer.

My granddaughter has this. When she's having an especially "hard" time going she drinks Miralax several times per day for 4 days. If she doesn't get relief by that point they look at surgery as an option. Almost always she is done and find by day 3. Only once she did this much for 5 days then went.

The doc knows what is going on in your son's body. We don't. The meds your child is taking could be the only thing making his body work this well.

My doc said eat a 1/4-1/2 cup 100% Bran in the morning. It would draw in fluids to combat constipation and would soak up moisture to prevent daily diarrhea. I have bad teeth so it didn't work out for me. The bran gets in my cavities and makes my teeth hurt.

I'd say that his diet has nothing to do with it. It's a physical issue. His body doesn't do the right thing with his body fluids. It doesn't draw in the moisture it needs. That doesn't have anything to do with what he eats.

NOT saying diet doesn't help, just saying that the doc has meds that help the body do this other ways.

He needs fiber, best the insoluble kind.
I use wheat bran personally (it's the cheapest option), but there are plenty of other options (flax seed, chia seeds, other kinds of bran). I add mine to oatmeal, baked goods (like cookies, banana bread) and even thicker sauces (like tomato-meat sauce for spaghetti). We have also switched to whole grain everything (bread, rice, pasta, cereals) - it a bit of taste adjustment, but after a few weeks you get used to the difference in taste and texture.

I am surprised that this has been going on for so long and you have yet to see a dietiacian...

Have you checked his blood for anemia? A lady I worked with years ago said her son had exactly the same symptoms as yours. His grandfather was a doctor and couldn't figure it out either. Then, he tested his blood, and the little boy was anemic. I don't know what it was exactly, but he was also impacted all the way up to the tippy top, and it took Miralax over year to get it all out. (They saw it on X-rays). I hope this helps.....I hope you find some answers soon too. As another idea, have you checked with an allergist? That might have more to do with it than nutrition.

Have you tried eliminating dairy?

I work in food science and we always recommend a patented product with both soluble and insoluble fiber plus digestive enzymes & herbs. A patent designates proven safety, effectiveness and uniqueness. It seems to me that if you're loading him up on miralax and you've done the home nutrition route, you're pushing fluids & activity, and you don't have results, you don't have much more to gain through medical intervention or a dietitian. My baseline is significant results in 3 months, ideally sooner. You've been doing this since 2011? Based on long-standing findings of pediatric nutrition experts as well as the emerging science of epigenetics (to make cells perform the function they are supposed to, and more efficiently), I'd say there's more going on that you're just not addressing through all the paths you've taken. There's a lot that can be done to actually address hereditary tendencies and it sounds to me like your son needs this extra boost. I've never met anyone with IBS issues (constipation, diarrhea, or a combination) who has not benefited from this approach.

Ask your doc about taking a magnesium supliment everyday. Something like a 250mg pill. Works on muscle contraction and works wonders for me.