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Advice on withholding stool and urnine - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Child Health
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3393 Questions
User :   My almost 3 year old (24lb) daughter (who has been potty trained for almost a year now) has been withholding stool after she passed a hard large stool about 2 weeks ago. Five days on a prescription MiraLax finaly forced her to go (after 7 days of not going), but now she keeps withholding stool again while still taking the same stool softener and eating high fiber diet including lots of prunes. She can barely hold things in when she gets the urge to go, she jumps up and down, cries, rubs her bottom, complains of a stomach ache, but just the site of toilet makes her hysterical. We have asked her to go into pull-ups, bags, grass and other but nothing worked. We have tried suppositories twice, both times without results. They actually made things a lot worse. She started withholding urine and would jump off the toilet before emptying her bladder when she would finally go. She screams and shakes if either me or my husband try to help her pull her pants or underwear up or down and she also makes sure she aways faces us so nobody would stick anything in her bottom. Tonight I've tried reasoning with her (she is quite smart) explaining that I would have to use an enema if she doesn't go on her own to help her XXXXXXXX feel better. That got her to try sitting on the toilet a few times sobbing and without results (she would jump down every time she can't stand the urge to go), but now she is totally horrified of me and screams "no mommy, please" just at the sight of me and tries to run away. It all breaks my heart. We can't go on like this anymore. PLEASE, HELP US!
We have seen 2 doctors from local clinic about this problem (the ones available on a short notice). None of them specialize in pediatrics. The first one prescribed MiraLax and suppository, the second one (the resident we saw today) told us to continue MiraLax and to drop the suppository. He told
User :   nothing else could be done. Now are we to wait 7 days before she poops again (and to watch her suffer)? Won't things progressively get worse? Is there anything else we can do?
Doctor :   hi
Doctor : here
User :   Hallo.
Doctor :   Let me read what you have typed. please give me a few moments
User :   Could you read my note.
User :   Do you have any suggestions?
Doctor :   what explanation did she give when you asked her about her behavior?
Doctor :   have you tried asking her if she still has pain and discomfort when passing stools or urine?
User :   She keeps saying pooping hurts even though it didn't last time
Doctor :   when the last time she passed a 'huge stool' did she have a lot of pain and was bleeding associated?
User :   She told it didn't hurt the day she finally pooped (5 times).
Doctor :   ok.
User :   There was bo blood, just pain.
Doctor :   is her stomach distended? does she have pain in abdomen when you press?
User :   No
Doctor :   ok. I would recommend a check with a pediatrician first and
Doctor :   to try using anethetic gel for her 5-10 minutes before asking for trying to pass stools
Doctor :   by taking a small amount on finger and inserting inside anal opening
User :   We have tried vaselin, but we can barely get to touch her bottom
Doctor :   sometimes there could be other causes related if pain is present when trying to pass stools
Doctor :   an ultrasound scan done would help to rule out any other serious cause
Doctor :   like intusseption and bowel related problem
Doctor :   a barium study might also be needed.
Doctor :   so consult with her pediatritian to see if further imaging would be necessary
Doctor :   did you follow what I have said?
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