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Had Ladd Procedure performed due to lower intestine malrotation. Appendix removed. Suffering from constipation. Continue Miralax?

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My son is almost 5 years old with mild hypotonic CP and is only partially toilet trained.. Was born at 23 weeks 3 days. Had a Ladd Procedure performed when he was 4 months old due to a lower intestine malrotation. Appendix was removed. He is chronically constipated. We have tried all the typical interventions (including seeing a pediatric chiropractor) to help with regularity and motility. None work. Daily Miralax is the only thing that consistently helps. Are there other things we can try? Will he become dependent on the Miralax? If so, what are side effects of long term Miralax use? He has sensory issues as well and refuses to eat certain foods.
Posted Wed, 12 Jun 2013 in Child Health
Answered by Dr. Sumitra Kumar Mukherjee 2 hours later

I think your son got this problem with constipation due to Hypotonic cerebral Palsy with poor toilet training along with surgical intervention (Abdominal)which also plays a part.

I think using Miralax daily is quite okay. As it is helping your son. You can carry on using Miralax for indefinite period it has got no side effect.It only makes the stool soft. I think when it is working it is the best to use.

As regards his food you can omit those food he refuses.

Kindest regards,

Above answer was peer-reviewed by
Follow-up: Had Ladd Procedure performed due to lower intestine malrotation. Appendix removed. Suffering from constipation. Continue Miralax? 21 hours later
Are there any other interventions that can be used so he can be more regular? Is there ever any type of follow-up to a Ladd procedure or another surgery to deal with adhesions or "kinks" in the bowels that impact how quickly food moves through it?
Answered by Dr. Sumitra Kumar Mukherjee 1 hour later

Thank you for your query.

As you know Ladd procedure is done when there is intestinal and bowel malrotation which go twisted and prevent passage of food. Majority of this surgery is successful but bowel obstruction may happen
due to adhesion after any type of bowel surgery.

As he is doing well with medications I do not think it is justified to go ahead with surgical interventions until and unless he develops intestinal obstruction.

I think you should consult Pediatric Surgeon for his opinion.

Kindest regards,
Above answer was peer-reviewed by
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