HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Severe Constipation In A Child

default
Posted on Mon, 20 Oct 2014
Question: My son, 11 yrs, diagnosed with a serious impacted colon. Began 9 months ago, began
miralax- 1 capful each week, increase intake of fiberous foods. Continued same problem, seen in May, increased to 1 cap on Sun. and 1/2 on Wed. Seen two weeks ago, began 1 capful every day. Last week began 3 capfuls everyday with a stool softner. Serious pain (7-7/12) above & below belly button and lower abdom. worse on right side. Has had (5-6pain) head ache for almost a week. Bowels moving, (green and loose) but pain is worrisome. What now????
Will pay for information, not go to the ER, already had that one. Saw Dr. on Friday. Said it was more of the same. Can't understand that level of pain and now constant intense headache every day, night and day for a week over constipation. Eating but is nauseous constantly. Had two exrays showing full colon then (2nd xray)some better. Temp @ 99.7
doctor
Answered by Dr. Eric Goldstein (2 hours later)
Brief Answer:
Constipation

Detailed Answer:
Hello. I just read through your question.
Constipation, especially severe constipation, can be difficult and take time to resolve. There are two ways to approach it.
First is from above. Fiber supplements and products like miralax are perfect examples. You mention you are already doing this.
The other is from below. This would be with suppositories or enemas. When there are xray images demonstrating a full colon, enemas or suppositories become necessary treatments.
I'm partial to enemas in cases like this. There are pediatric enemas available over the counter. They are not fun to administer nor are they fun to receive. But they do work.
In cases this severe, it could take several enemas before he is disimpacted. I recommend twice per day for at least three to four days, while continuing the miralax.
Meantime, watch his diet. Stay away from starchy foods and maintain a diet of fiber rich foods.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Eric Goldstein (8 minutes later)
What explains the severity of pain 7.5/10 in the abdomen, and the headache sometimes 5.5 to 7.5 for full week (headache) and abdomen pain started after increasing miralax. Blockage possible? When do I know it might be ER time?
doctor
Answered by Dr. Eric Goldstein (9 minutes later)
Brief Answer:
Follow up

Detailed Answer:
The abdominal pain happens because of the increasing stool volume. The headache occurs often because of mild dehydration that can sometimes accompany severe constipation.
As far as the increasing pain while already on miralax:
Once the stool begins to collect in the abdomen, miralax is not likely to have much of an effect. At this point we must treat from below. The miralax is effective at preventing this from happening in the future and that is why it's important to continue.
If you were to go to the ER now they would either administer an enema or send you home with enema instructions. So now would be too early to go since you can do this at home. If you were to administer enemas for the next two days and not see any response, it would likely be the right time for the ER.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Eric Goldstein (5 hours later)
Gave mineral oil enema 4.5 oz. He held it in for 15 minutes, sat on toilet and pushed some mineral oil out but very little stool. Still has significant pain in lower abdomen, some better in upper. Still has head ache and general malaise. How long before enema should produce stool? If nothing happens, then what?
doctor
Answered by Dr. Eric Goldstein (37 hours later)
Brief Answer:
Follow up

Detailed Answer:
Hello.

It's good that you gave the enema. I know it isn't easy. I recommend administering the enema twice per day for the next 2-3 days. If there is no response after this time, you can take him to the ER. There, they will hopefully have you seen by a GI specialist.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Eric Goldstein

Pediatrician

Practicing since :1999

Answered : 1303 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Severe Constipation In A Child

Brief Answer: Constipation Detailed Answer: Hello. I just read through your question. Constipation, especially severe constipation, can be difficult and take time to resolve. There are two ways to approach it. First is from above. Fiber supplements and products like miralax are perfect examples. You mention you are already doing this. The other is from below. This would be with suppositories or enemas. When there are xray images demonstrating a full colon, enemas or suppositories become necessary treatments. I'm partial to enemas in cases like this. There are pediatric enemas available over the counter. They are not fun to administer nor are they fun to receive. But they do work. In cases this severe, it could take several enemas before he is disimpacted. I recommend twice per day for at least three to four days, while continuing the miralax. Meantime, watch his diet. Stay away from starchy foods and maintain a diet of fiber rich foods.