Tuesday, August 19, 2014

Number two

One of the most common problems during childhood is constipation.   I honestly have been wanting to write about this for the longest time, but it was just recently that I was truly enlightened, more of alarmed that we really had to seek the expert's help on R's BM (bowel movement) issue.  Some might find that this is TMI (too much information), but I feel that I should share my experience and thoughts on this.  I did my research on the internet on what to do if your child is constipated.  Believe me I have tried everything and was already out of my wits trying to figure out what to do.  I am well aware that lack of fiber in R's diet is a culprit.  However, R is also in the picky eating stage right now, bummer!  I honestly do not want to stress about it, but sometimes I could not help it.

Photo courtesy of howshealth.com

R was having BM problems ever since he was a baby especially when I switched to pure formula when he was around 4 months old (that's why please choose to breastfeed!).  We sought the help of a Pedia-Gastro and it somehow improved. I resorted to giving him either diluted prune juice and it has always worked.  But as he got older, there were a lot of times wherein he would strain for hours trying to get it out.  Making him drink prune juice also became a struggle because I think he is sick and tired of its taste.  The final straw was when he was straining for almost half a day to no avail and he was already in tears. We were so stressed and felt so bad for him.  I quickly booked an appointment with Dra Jean Guno of TMC (The Medical City) because I do not know what to do anymore!

Anyways, I am thankful for the very thorough and very detailed explanation of Dra. Guno.  R has been classified to have functional constipation.  This type of constipation means that the child does not require surgery due to another condition, it's just because the child has a hard poop.  In R's case, other than having a low fiber diet, he used to drink very little water (as in pahirapan). What could have also  triggered longer days to pass on poop could be due to a painful past incident wherein poop was too big to pass and it hurt him a lot.  And as the poop stays in there longer, the bigger and dryer it becomes, thus making it difficult to release. He usually poops every four days which is so not good.  The explanation here is that the passage way has been stretched so it takes more time for it to trigger the brain to do #2.  I did not know that!

Below is the Bristol Stool chart that was shown to me.  What we are aiming for is Type 4.  The first three types are signs of constipation.

For now, R will need to undergo a Bowel Retraining program which includes Disimpaction,
Maintenance Medication, Behavioral Intervention, Fluid Intake and Diet.  He was also asked to have an X-ray of his abdomen to validate fecal impaction.

We are on our second week in the program.  Apart from R maintenance medicine (Lactulose), I have also been training him to sit on the potty every after lunch and dinner. A helpful tip is to make sure that his feet rest on a stool because it is hard to poop when your legs are hanging from the toilet.  Blowing exercises also help.

It is still way too early to see major improvements.  Though poop consistency has greatly improved, we are still struggling with long days.  I cannot wait for the day that everything will be ok, I tell you.

In the meantime, I will do whatever it takes to make him eat more fiber and increase his water intake and of course be supportive of what he is going through.

As a last note, it is always best to consult the experts immediately.  Please do not offer laxatives or suppositories without the Doctor's advice.

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