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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Comments and Questions

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I am a 19 year old girl, and ive had problems going to the toilet ever since i was a baby. But ever since i can remember .. i really hate going to the toilet, i hate the feeling. Why family and friends dont understand why i cant go every day or every other day. I just cant, i dont like it. But im fed up with getting the " C " word all the time, I take laxactives now and then, but i go before they actually work. My mum said its all up in my head ... I used to be able to not go for about 2-3 weeks, and that was well bad for me, even at school, trying to push it back in. I dont have a fear of using peoples toilets, i just dont have one there lol. I duno how ya can help me?





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After my last visit to my dr im still banging my head against a brick wall. My daughter is now 5 years old and been on movical for 3 years and the only answer or help(joke) i get from her is if you want to take a different route is we can get intouch with mental health,which she also did say that if we do get intouch with them my daughter would be on the mental health register, no thanks!. Why is this not taken more seriously than it is, my daughter is now very reclusive, shy, and concious of herself. Any help please anybody.





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Just found this site and although my daughter is 24 so much of what has been said rings true for us! My daughter is autistic and has learning difficulties so poo and wee has always been an issue for us but over the last 2 years it has become more of a problem - she refuses to use the toilet and goes when asleep or in the bath (when she is relaxed) she takes movical but getting the correct dose is problomatic - we are waiting to hear from our community nurse and be assessed by a psychiatrist - lets hope that they can make some suggestions to help us - all I would say is make sure you keep on top of the problem as just leaving it will not help in the long term Doctors and school nurses can help but need to know how severe he problem is to take you seriously





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does anyone know where I can get this magic Mr Poo book please?





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bless you excactly the same happened to me n my daughter shes nearly 7 now n shes so much better sam





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my daughter is 3 years old and has bean on movicol for 6 weeks i change her underwear every hour its just ullfull a bad loose mess its no better ist getting me down she cant play with anyone long because she smells we both get upset how long will this go on shes missing nursery witch she loved





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hi my daughter was the same 4 2 yrs i then lowered the movical as the same was happening to me i seemed to get it rite at my own pace as she was on to much in the end so i only gave her 1 everyday then 1 every other day if she was to loose. i seemed to get the balance right in the end n i told the specialist n he agreed i was doing the right thing hope this is of sum help Sam

My daughter is 4 years old and for the last three years at least, she has been holding on to her poo, the longest time being 13 days. She would sit upright and jump up and down to stop herself from going. I believe it was because of a painful stool that she passed some time before and now associates poo with pain. She was eventually prescribed Movicol (after lactulose, senna and suppositories did not work) and this helped to make the stools soft. She now goes regularly and we are gradually reducing the medicine. She initially would only go to the toilet in a nappy even though she was dry and it has only been recent that she has mastered the potty.





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