Embarrassing Bodies, 12:15am Tuesday 4th November 2014 on More 4. Catch up for free »

Video

oice over:
Let’s face it poo is a fact of life, and for some children it’s far from funny. 1 in 12 kids under ten have a problem with wetting, soiling or constipation. In fact 43% of children will suffer from diarrhoea at some point and 1 in 3 parents report their children suffer from occasional constipation.

And it’s poo that’s brought five year old Kelsey and mum Claire to the Embarrassing Bodies clinic.

Claire:
She gets very distressed about going to the toilet, we worry for her that she can’t go to the toilet and we’re trying to help her but she gets herself into such a state that she screams and cries.

Dr Christian:
I hear you’ve got a little problem your mum says. What is your problem?

Kelsey:
I can’t go poopee.

Dr Christian:
You can’t go poo poo, why not? Why can’t you go?

Kelsey:
I cross my legs.

Dr Christian:
Do you stop it coming out?
(Kelsey nods)
Why do you stop it coming out? Does it hurt?
(Kelsey nods)
Mum what happens?

Claire:
She holds herself for 7 to 10 days before she’ll go to the toilet.

Dr Christian:
7 to 10 days? That’s a very long time.

Claire:
And when she does go it’s very, very painful for her and that’s why she’s stopping herself from going to the toilet.

Dr Christian:
And she eats well?

Claire:
Yes she eats very well, she’s got a very healthy appetite.

Dr Christian:
And eats anything and doesn’t vomit?

Claire:
No.

Dr Christian:
It sounds like a problem that we see quite a lot in children, that don’t like pooing full stop, it’s not a very nice feeling for them particularly if they have, once upon a time been constipated and it’s caused pain for them. Then going to the loo is always associated with pain.

What we’re going to do is have a bit of a feel around, check for lumps and bumps, make sure her organs feel normal. Sometimes in very, very constipated, true constipated children, you can feel bowel loops that are very hard, and they’re just full of solid poo basically and there’s absolutely nothing like that at all, which says to me it’s not a true constipation, it’s her not letting it out. There’s probably hard poo right near the opening, but that’s it, everything else is fine.

There are a few things that we can do to treat it, laxatives can help, and also possibly looking at a child behavioural specialist to get her over this fear of going to the loo. Alright Kelsey? You are going to see a specialist who is going to sort you out, ok? Jump down, big jump!

Voice over:
Dr Christian has sent Kelsey to meet Dr Andrew Cohn, a consultant paediatrician who specialises with constipation.

Dr Cohn:
So who do you think that is? Is that Mr Poo?

Voice over:
Mr Poo, is a specially created cartoon character created to help Kelsey’s fear of pooing through play.

Dr Cohn:
Mr Poo said, “Hello Kelsey, can I come out now please?” and Kelsey said “No you can’t Mr Poo.” And Mr Poo got cross with Kelsey and started hurting her tummy. And what happened then? Mr Poo said “Can I come out now please?” “Yes of course you can” and she went off to the toilet and said “Out you come Mr Poo” and Mr Poo jumped out and said “Have a nice day Kelsey” and Kelsey said “Have a nice day Mr Poo.”

That’s what we want to happen because Mr Poo wants to be your friend.

Voice over:
Dr Poo also describes a high fibre diet and laxatives to get the bowels moving.

Dr Christian:
So I remember that your problem was that you were not going to the loo for a very long time, weren’t you? We sent you off to see a specialist in that didn’t we and tell me what happened then?

Kelsey:
Now I can go for poopoos now.

Dr Christian:
So mum, what was the secret in the end?

Claire:
Well when we went to see the specialist he went through the fear of why she wasn’t going to the toilet and put her on some medicine which she’s, which has helped, she’s been extremely good now. She’s managing to go to the toilet every couple of days, which means she hasn’t got the build up and it isn’t hurting her as much and she’s able to go to the toilet.

Dr Christian:
So did you think this was going to work, just giving more laxatives, or were you “eurgh, tried that, been there done that, not going to work”?

Claire:
Well, the medicine I thought would make it too soft, which it did initially, which then makes it quite messy, uncomfortable and embarrassing. But after that seemed to get in her system, we continued with the medicine every day, and after that was in her system it seemed to not be as messy, it would just come out as a normal toilet.

Dr Christian:
All praise to you to actually persevering, because a lot of parents decide “No I’m not putting up with all this loose poo and it’s messy, no, no, no it’s not going to work” and they’ll stop and you have to be persistent and you have to believe in it and you have to keep going as you can see it does work given time and things do settle down and she’s happy now isn’t she?

Claire:
Yes, a lot better.

Dr Christian:
And your happy too?

Claire:
Yes, very happy, yeah.

Dr Christian:
Excellent, that’s job done I’d say.

Read the video transcript

Five year old Kelsey, like 1 in 12 children under ten, is suffering from a poo problem. Kelsey holds in her poo, as she finds it painful to go to the toilet, it can be as long as 7-10 days between poos. Dr Christian wants to determine whether Kelsey is suffering from constipation or toilet phobia, and has a feel of her stomach to check that her organs and bowels are ok and that there isn’t a build up of hard poo. He confirms that it is a psychological problem, rather than physical, and refers Kelsey to child constipation specialist Dr Anthony Cohn. Dr Antony tries to change Kelsey’s perception of poo through a friendly cartoon character Mr Poo and by prescribing a high fibre diet and laxatives. After trying out the treatment, mum Claire reports positive results to Dr Christian, Kelsey is going to the toilet regularly now, thanks to mums persistent use of the laxative.

The EB team would like to thank:
Dr Anthony Cohn, Consultant Paediatrician

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my sons been costipated since he was a baby n been on movical since he was 2 hes now 8 n on 4 sachets a day hes lost sensation down there he as loads of accidents n he goes hospital every few months for checkups but hes not getting no better hes getting embarassrd now at school n sometimes theteahers tell me to keep keep him of school cos there not willing to help him is thete anything else that can hekp him





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My son is 6yrs old,can anything be done to help him.please HELP thanks you





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I am so tired of not getting any conclusive answers or results from the doctor. We have a consultants appointment tomorow after waiting 3 months! Meanwhile my daughters condition has worsened: Been on medicine since she was 3 and now nearly 6 years old. We are nearly finished primary 1 and she is now incontinent- she was not this bad at the beginning of the school term She soils her pants every couple of hours On max dosage medicine a day- 4 sachets of movicol and 30 mls of lactilose She is naturally small for her age but really not growing much- I see a difference in height of her friends since the start of the school year and my daughter in comparison is just not really growing Enjoys her food and eats a varied diet but very small portions She always has a distended and solid feeling stomach Her belly button looks like an outy even though it is not! What is the usual procedure tests that can be carried out to ensure a thorough review and to rule out possible conditions? I want to ensure a thorough investigation is carried out by the consultant.





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I here you loud and clear. My son suffered exactly the same as your daughter, going to see the consultant every few months and nothing seem to change, the last straw was when I witnessed my son being bullied at school about the smell emanating from him, it was heart breaking, i took him out of school immediately , he was 8 then. I noticed the difference more or less straight away when he started his new school. Now he is 14 and although the constipation and the leaking has stopped he does have very large stools sometimes almost a foot long, the doctor isn't worried about it nor his consultant. He is still a skinny bean pole but eats like a horse. For my son it seems that it was a problem that he has simply grown out of, this may hopefully be the case for your daughter.

my daughter has cronic constipation been movicol for 3yr & still nt helping she soils herself alot & shes getting embarrassed as she is nearly 8yr.. the doc at the hosi says av 2 carry the movicol on as shes needs 2 b on it as it needs time 2 work but av said am taking her of it & she is now on syrup of figs & it has works wonders no more soiling so try that





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Wow it's strange to see others with the same problem! I'm 20 now, but up until I was probably 16, I had this problem. When I was very young I began retaining, probably due to one or a few painful movements. I struggled for years until my mom realized how bad it was and took me to a doctor. He put me on a special diet an I had to do a few enemas (yuck) but it started the process of getting me back on track. There was definitely a psychological factor too, because I would often plug up the toilet and my older sister would make fun of me for it, making it harder to go! I slowly got over it by telling myself that "holding it in" was only going to make it worse. So, my advice to parents - make sure your kids aren't ashamed of this, and try to make using the bathroom as pleasant as possible (even presenting a small reward after they wash their hands and exit the bathroom could help!)





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my daughter is now 5 and has suffered with chronic constipation since 4 months old. she has 2-4 sachets of movicol aday but still soils herself she is now getting very concious about this as it happens when shes in school as well as at home. the consultant has explained to me that her bowels have streched causing her to loose sensation. can anything be done about thi s to help her stop soiling herself? xxx





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my daughter is 6yrs old been attending the hosi for 3yrs they tld me shes gt cronic constipation & pt her on movicol which has nt helped then they pt her on octifibre nw on senacot & still nt wrking she can go 5 days without a poo & the poor thing goes on the toilet herself 2 try way no luck..dnt knw what else 2 do..shes supposed 2 get an incontinence nurse out 4 support bt shes seen her since christmas (as shes 2 busy) bt its nt good enough a need help gud u give me advice....thnks





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My son is five years old and has attended paediatrician for over two years now with no success whatsoever. He has had movicol,senna and lactulose,lentil soup,prune muffins,you name it he has had it! At the moment we are waiting for a referral for a child psychologist(been waiting since Dec 2011). He will sit on the toilet but as the poo just runs out of him, nothing goes into the toilet so he doesn't seem to connect with why he is sitting on the loo!! Also we were told that children are not prescribed suppositories even though when the problem first occurred our son got one,which worked,so it was a yea for one professional and a nae for another. Help please.

my daughter is 6, been to the incontinence clinc for over a year, been on fibre diets, movicol, senna, had a bladder scan and we have had no positive results so far, its lowered her self confidence, ashamed, makes every day life for us as a family harder etc. i know how frustrated you are as a mum

My daughter is nearly 4 and refused to poo! She is still in nappies and i cannot see her getting out of them anytime soon. She has leakage but doesnt have big poos. She is due to start school in september and i need to get her out of this... We have been prescribed Movicol but this hasnt worked.... Please help





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I have a 13 yr old son whos has trouble going to the toilt for poo. He is a special needs child with with speech , language ,learning and understanding diabilites, A psycologist tried the story of Mr Poo and this didn't help him at all. I too have been given lactulose, senna and suppositories but he refuses to take his medication and ive tried all ways to sneak it into drinks etc but he wouldn't have any of it, when he finally releases his bowls he finds it very painful and screams and cries, i use to have tantrum upon trying to get him to go to the toilet but now occasionally he will go and sit but 8/10 he does nothing, there is lots of soiling in his pants throughout the day, he's still seeing his psycologist but i feel its not enough and have asked for my son to be medically checked just for peace of mind as its very frustrating and very embarrassing especiall now he's 13yrs, but no steps have been taken forward to medically asses him, not really sure what to do next x





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thank you for your help i will take my daughter as she three and half and get this sorted .i am not the other one thank you





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