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Child diagnosed with encopresis. On miralax. What should be done to improve bowel movement?

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Dr. Uma Rajah Ananth

Pediatrician, Neonatology

Practicing since :1970

Answered : 891 Questions

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Posted on Thu, 20 Dec 2012 in Digestion and Bowels
Question: My three-year old grandchild has been diagnosed with encopresis by a GT in August of this year. She is on Miralax and is now on a maintenance dose. Potty training is difficult because her bowel movements are so pasty. What can we do?
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Answered by Dr. Uma Rajah Ananth 2 hours later
Hi,
I know it is a difficult problem !
It involves perseverance by caretakers.

One aspect is to prevent constipation.
Along with the medicine, you give high fibre diet and sufficient fluids so that there is no constipation at this stage of maintenance.

Secondly the psychological aspect of this problem should be
looked into.
Let the child not loose self confidence .
Use rewards like stars on a chart or small stickers or small toys once a week or so ,whenever she overcomes the problem.
This positive reinforcement will help her to try to gain control and confidence.
Use fixed time for toilet use.
Pease remember that during this course she may have some relapses after periods of normalcy.

She will recover with the perseverance of the parents under doctor's guidance!
Good luck
God bless
Dr Uma


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Uma Rajah Ananth 46 hours later
She is on a maintencance doze of Miralax. This is what her mom said: "I definitely try to do all of those things. It can be tough, but I try. Last night she cried out and kept crying and I asked her what was wrong, and she said ‘I poopied’ and was puling at her pull up. So I went check it out and sure enough there was a pretty hard ball, a little bigger than a golf ball in there. But I celebrated it, and praised her, and said that’s awesome ! And soon after she was also proudly saying what a big poop she had lol .. I want to get across to her that it does feel tough sometimes to get it out, but that it’s a GOOD thing, and that even when and if it feels kinda hard or uncomfortable, I want her to get used to it ya know XXXXXXX Please comment.

Would it be okay to give her Buddy Bear fiber supplements? Or is there another fiber supplement we can try? She is drinking more water and we try to push the fiber bars.
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Answered by Dr. Uma Rajah Ananth 1 hour later
Hi,
I appreciate the way you ,her mom and she( all the more),managed the situation!

This feeling of self confidence on her part and efforts on the part of mother are very essential.

Reg fibres you can give her commercially available supplements and along with that give veg salads, veg like beans ,broccoli,cabbage,greens and high fibre fruits like bananas,dried fruits like prunes and raisins.
She needs fluids also which you seem to be giving.

Good luck
Dr Uma


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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