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Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 7313
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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There, My daughter is coming up and half years

Resolved Question:

Hello there,
My daughter is coming up for 4 and half years old and has suffered with chronic constipation since she was about 2. We tried all manner of dietary changes (upped her fibre intake with loads of fresh veg, fresh fruit and wholemeal/wholegrains, and boosted her water intake...she also gets loads of exercise) before realising that nothing seemed to worked and that she was still chronically constipated - once going for 2 weeks without passing a stool! We sought medical advice at that point and our GP prescribed Movicol Paediatric. This worked really well and she's currently on 1 sachet a day (sometimes 1 every 2 days) and experiencing loose (but not too loose) stools.
Our difficulty now is that she seems to be unable to control her stools and is experiencing a kind of constant fecal incontinence - her pants are almost always stained and she regularly smells (an embarrassing plight for her). Could this be due to the Movicol? I really don't think she's still constipated as her fecal leakage is not very runny but of a good consistency. Could she be suffering from a distended bowel (is that the right term?) or stretched rectal muscles meaning she has little or no control? Part of me also thinks this may be a potty-training issue as it was delayed with her owing to her constipation issues. She starts school in September and I can't send the poor child to school like this, please help!!! Your advice would be much appreciated. Many thanks
Submitted: 1 year ago.
Category: Medical
Expert:  Dr Uzair replied 1 year ago.
Hi and thanks for the query.If she can hold her wind or pass it willingly then this is not a rectal muscle issue. This is incontinence due to fecal thinning. And is often seen in children her age with or without laxatives. This is in part due to poor potty training and in part due to being on Movicol. I would suggest that you give her the Movicol on alternate days now, limit her intake of formula milk and put her on a low fiber diet to give her gut some rest.A stool routine examination should also be done to rule out any parasites and other causes of diarrhea.Ideally, a course of Movicol should not exceed 2 weeks, since it tends to stay in the gut rather than being absorbed out of it in to the blood stream, while it stays there it keeps on going and retains water in the gut to help relieve constipation.Try to decrease her Movicol as advised and mean while try to contact her Paediatrician for an early appointment. Long term diarrhea can cause electrolyte imbalance and dehydration in children.
Expert:  Dr Uzair replied 1 year ago.
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