Impaction in toddlers?

[sherichance]

I have a close friend who has a 3 year old daughther. This child is going through hell. She was down here this weekend visiting with me and I woke up one morning to her screaming in the bathroom trying to have a BM. I talked with her father who was down here with her and from what he tells me, this little girl has been impacted many times.

Her mother is no help of course. This lady lets the daughter eat whatever she wants. I keep telling her, she needs to eat right, more greens and fiber but she wont listen.

The pediatrician has had her on some type of laxatives, colace, and some other medication but the father couldnt remember the name. When he gets the daughter for the weekend, he tells me that he constantly has to give her enimas, or disimpact her himself.

I honestly never heard of such a small child being so severly impacted. The father can only do so much. The mother is here in Connecticut with the child and the father is in the navy up in Maine. Does anyone have any suggestions I can tell my friend to help his daughter? I feel so horrible because this little girl is getting to the point where she will try to hold her BM's because she is so scared that its going to hurt her to try.

Your help is appreciated.

[QuilterLPN]

Tiffy RN has hit the nail on the head. These kids (even if they don't have Aspergers) can often retain the BM, just because they can and little kids want control over something. Then the colon becomes overextended, they get a megacolong thing going on, they know by then it's gonna hurt to go poop. By the time their colon is too large, they really loose they feeling of urgency. It really is a vicious cycle.

Definitely requires LONG-TERM therapy described above. Some pediatritians can help you with this, if not go seek a ped. gastroenterologist. Other complications also mentioned, like spina-bifida or aspergers, can be causing this, so there definitely needs to be a specialist involved.

As far as getting Mom on board with the treatment regime, I would say that she could be setting herself up for problems with custody of the child if she refuses to go along with the prescribed treatment. Have them keep a notebook that goes with the child to Mom's and Dad's, where they document when she's gone poop, when she's taken her meds, possibly even documenting her meals for the day.

If it's not corrected now, it will get worse. And the emotional impact can be huge.

[sharann, BSN, RN]

Tell dad to take the child to a peds GI ASAP. She could also have Crohn's Disease(this can cause extreme constipation. If it gets bad enough when she is w/dad, have him take her to the ER rather than disimpact her. He could accidently tear something and next thing you know child protective is after him.