constipation
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Hi Out There, I'm pretty new to the forum so I have mostly been reading. Even just reading problems and responses has been very helpful. My 5 year old son (ASD and ADHD) does not eat very many foods, he will only touch a few things. If not for infant formula, which he will still drink, I think he would be malnourished. Our nutrition problem is that he gets constipated sometimes and has a very tough time. We have actually had to give him enemas when it gets bad (try that with a strong young ASD boy!). For the past year or so he will eat some of the new yoghurt that has fiber added, which keeps him regular. Recently he has not been eating this however and we are worried about him. Does anyone have this problem also? We would like to give him all healthy and wonderful foods but he won't eat them! Also I have a friend with two ASD sons who will eat only McDonald's french fries, that's it, and they survive on protein shakes. I am worried that if he stops drinking formula he will not be getting any vitamins and other nutrients. Are there any ideas regarding regularity that will work with ASD kids? Thanks very much! jonsfca A lot of our kids seem to have problems with constipation. My son has had problems with it since he was about 5, and we also had to resort to regularly using enemas as well. I used to call myself the 'Enema Queen' and got to be pretty good at holding a yelling and fighting 5 year old, and managing to eventually give him the enema. I've tried several different dietary and pharmocological approaches over the years, including dried fruits, apples, fiber bars, mint milk of magnesia, and mineral oil, you name it, I tried it. He either wouldn't eat enough of any of them often enough, or else he would just refuse. The problem with chronic constipation is that the colon eventually enlarges, and the amount of poo it can hold increases, while the colon sucks any remaining water out, which makes it painful to go, which my son would then hold because it hurt. When he would eventually go, I would have to use the plunger just to get the toilet to flush. Sorry to be so descriptive there, but it's a viscious cycle once it gets started. About a year ago, our dev ped suggested using bisacodyl tablets once daily, and it has helped a lot! It took a bit for his colon to shrink back to a normal size, but he hasn't had problems with constipation for many months. The doctor also told us to have him try sitting on the toilet after he takes a bath. The warm water from the bath helps to relax the spincter so it's easier to pass the stool. Place a small foot stool for him in front of the toilet to put his feet on and push against. It's hard to relax enough to go when your feet are dangling. Also, encourage your son to drink water when you can. Wow! What a useful reply!I'm impressed with this forum so far. I will ask about bisacodyl. My ds is very funny about food. He carefully sniffs everything before he will try it. He even sniffs other non-food things to check them out. I guess when it comes to judgement he follows his nose! We can't sneak anything by him, like putting blended veggies in his food. If he smells anything different he refuses it. Of course his NT little sister (3) eats anything you put in front of her. Ds does have giant poops, which have to hurt. I am familiar with the plunger as you say. I feel bad for him, but he's very brave about it. We try to give him Miralax in his formula, which he will drink if we're lucky. A tablet might be easier for him. Thanks again for your helpful advice! 
jonsfca We use Miralex is that the same as above? Sorry not sure. It is oderless and tasteless, you can even add it to his formula if you need to. We had to use if everyday for almost a year to get his colon back to the size it should be and now if he doesn't go for two days we have him take it until he does. This is a very common problem with ASD kids. Good luck. I have a section on constipation on my potty resources link collection: http://www.autism-pdd.net/forum/forum_posts.asp?TID=16098&am p;KW=potty+resources And here's my collection of links on picky eating. Lots of kids under the age of 5 are picky, ASD or not. But if your son rejects entire food categories (for example, eats no fruits), he might be a "resistant eater" and professional guidance would probably be helpful. http://www.autism-pdd.net/forum/forum_posts.asp?TID=18317&am p;KW=pickiness I've dealt with both constipation and picky eating with my youngest son, and it's no fun. Good luck with everything.
My son almost never had constipation issues, thank God even though his main staple is rice & rice milk. But last month he came down with something & his food intake was off for about 2 weeks but he was still drinking the rice milk. But at teh tail end of that illness, he got really constipated for about a week. I panicked & tried to remove rice & rice milk from his diet (well, I tried but he didn't take well to almond milk). That didn't help at all. A friend recommended flaxseed. I had the Trader Joe's roasted flaxseed which are just so nutty & delicious & I sprinkled them in his cereal & he gobbled them up. I also ground them up & put them in this millett pancake he eats & he finished it up. But he still wasn't eating much of anything else & was not having BM everyday like he used to. Then my brother said it was silly to remove the rice milk & rice since that's been a big part of his diet for over a year & he never had constipation before which made sense so I let him eat his rice & drink his rice milk & also continued the flaxseed daily either in cereal or in the pancake & bingo within a couple of days, he was back to his regular BM every day, not too hard, not too soft, just right. It's true that we have to constantly battle our kids eating issues - but for me, I've found that on many things, if I keep pushing a food (e.g. meat which he NEVER used to touch) but now he will eat rice with meat sauce or meatballs or chicken nuggets. So in the case of meat, consistency & perseverence paid off but he still will NOT touch veggies & he literally RUNS AWAY from fruit - it's really hilarious sometimes! Anyway, sorry to be so long-winded. Just sharing my one-time experience with constipation & flaxseed really seemed to work & now it's a regular part of all of our diets. My son has had many problems. He has megacolon, and encopresis. Right now he takes Miralax every day, and we do have some success with getting him to the potty on time. Have you seen a GI to rule out medical issues?Does your son drink a specialized formula (milk-free) or can he tolerate milk? My son's eating and bowels problems are severe. First, for the constipation we use miralax daily. You can buy it over the counter or with a prescription. It's not harmful at all. It just allows the stool to gain more absorption of water to allow for easier passing. If my son is even late on a dose then we are literally having to dig the stool out which is often accompanied by a bloody bum. Gross I know, but so sad as a mom to watch. Our poor babies and the crap they have to go through!!! My son also eats practically nothing. We started our son of the Gluten Free Casein Free diet about 4 months ago and are noticing improvement in both his stool and eating. In the last couple weeks he's started at least touching food and puting it to his lips. Every once in a while he'll stick food to his tongue. He get a daily liquid vitamin and protein shakes. Since we are milk & wheat free we buy a brown rice protein powder you can get at a health food store. Another "cheater" way we get nutrition is through Chocolate Nesquik (another GFCF food). If you're not interested in trying the GFCF diet than any breakfast shake/protein shake will do. Our dietician says as long as he gets a liquid vitamin and some way to supplement protein he technically ok. No pun intended above Also, I wanted to mention it sounds like your kiddo has some serious sensory issues. It might not hurt to get a good OT that understands sensory intergration issues to help. Also, maybe check into seeing if your local childrens hospital has a feeding clinic or dietician that may be able to help. My son goes to a feeding clinic once a month that consists of a speech therapist, OT and a dietician and they work with him to touch/smell/taste foods. The key is to never force them. Praise them for as much as they are capable of and never give up!!! Always offer what you eat on his plate. The first step is to get them to tolerate the sight and smell. Then you work on the actual eating part down the road.
My dd has taken 2 t. of Miralax every morning for a couple years now and goes everyday. If she even misses once she won't go. The only thing is she doesn't empty out. The stool is anywhere from very loose to soft and formed. Because she's not emptying she soils her panties and then I end up putting pullups on her. About a month ago we saw her GI and we gave her 2 t. of Miralax four times a day for one day and that emptied her out. She didn't soil for about a week. Then she started again, but came down with walking pneumonia and was put on amoxacilin. That gave her diahrea which cleaned her out again and we were clean again for about two weeks! The back to soiling again. I just called the GI yesterday. He is scheduling a barium enema at our local hospital and is going to do further tests to see what is going on. I feel so bad for this little gal. I'm so worried for her. She dislikes most meats. She has a history of acid reflux and can't eat acidy foods. so most fruits are out. Some fruits give her constipation, others diahrea. A lot of veggies have a lot of sugar in them but we limit them and some she won't even touch. We limit sugar, NO cocolate, she drinks Rice Dream milk (vanilla). We try to go gluten free as much as we can, I just don't drive myself crazy with trying to do that all the way, I tried it once for three months and thens he was tested and they said she wasn't allergic to wheat. But I did notice a big difference in her behavior so we stay away from it the best we can. DD even helps with that! She doesn't let Sunday School teachers, or PreK teachers give her anything that has wheat, cheese, too much sugar or any chocolate in it. No one said raising these kids was going to be easy but aren't they precious? I wouldn't trade dd for any of my nt kids. She has taught me so much in the short time we've had her. And I know there is more she's going to teach me ! Wow, thanks everyone for such great answers!This forum is very useful. My ds eats some foods some of the time but no foods all the time, and if it is not just so he won't touch it. He is lactose intolerant to some extent (he's allergic to cow's milk but can eat yoghurt and cheese pizza, which are lower in lactose). Periodically he dries up because he won't eat or drink and that's when he has trouble. He carefully examines and smells all foods so it's hard to get anything by him. We had him eating this helpful yoghurt with extra fiber but he stopped liking it. I recommend that yoghurt though, it's available at most big markets. Ds drinks infant formula for 24 month old kids and we spike it with Miralax but sometimes he won't drink it. I agree about sensory issues, he's very physical. At our IEP the special ed person said "There's always football" but that seems a bit over-simplified. He needs some intervention. Next IEP we hope to get some help. Thanks again everyone! Jon SF CA I am not a big fan of alternative doctors, but DAN! doctors have been known to help with the GI issues that many kids on the spectrum have. If you can find a DAN! doctor in your area, it might be worth a try. Also, you should probably investigate "feeding therapy." In our area, some public schools specialize in autism and they do do feeding therapy at these schools. I understand that it can be done as an out-patient in hospitals, too. Malnutrition that occurs in many of the most severely poor eaters CAN be life threatening and more than one child with autism has had to be put on a feeding tube. See if you can investigate feeding therapy because your child's health is at stake if he really eats so few things and also because it's hard to make progress in any way if he is not getting the nourishment his body and brain need. Many kids on the spectrum are quite picky but still get enough nutrition. Some do not. This may sound ignorant/stupid but, what is a DAN doctor? I have tried to look back on this conversation and I don't see an explanation and I've never encountered this before. DAN stands for Defeat Autism Now. They specialize in biomedical treatment, some controversial. You can probably track down a feeding therapist and/or DAN doctor in your area by using the links collected here: http://www.autism-pdd.net/forum/forum_posts.asp?TID=19141&am p;KW=find+an+expert
Update-I did the enema the day of the test. She held it! Can you believe it? She didn't even spill a drop! Then we had to wait at the hospital for 2.5 hours before they took an xray then another 3/4 of an hour before they took us back for the actual test. In the mean time she had dosed off and on and had thrown up twice. I think just from nerves. I had never seen her so lethargic (?) The xrays showed she was empacted way up inside. They didn't use barium in the enema but something to actually make her go. He little tummy was so extended and hard. After they were done they had to wait for her to go so they could tak another xray of her empty bowel. Well, it took her about 20 minutes on the toilet for her to go, and then she only let loose some of the liquid and not all of the hard stuff came out. But I'll tell you later in the day it sure did. It took about three hours later and I had changed her two times. What a complete mess. But I was expecting it and was prepared. Here it is four days later and she hasn't gone yet, again. The doctor called and said she is just fine internally, no physical problems. That is a relief. Like no cancer or anything. But that doesn't explain why she keep getting so "plugged" up. All he told me was to do a cleanse every couple of weeks. Give her an extra dose of Miralax on a Friday night and that should keep her cleaned out. I guess that is better than her having any internal physical problems and I PTL for that! I just thought I'd let you all know how she did. I did find two DAN doctors in the Chicago area and am trying to convince my husband that we should check them out. Thank you all for the information on that. Connie I thought I should share a recipe which is yummy and keeps my daughter regular.1 x Canned pears in syrup (use the equivalent of 1 pear) 1 tablespoon of flaxseed oil 2 tablespoon of prune juice 2 tablespoons of boiled and cooled water 2 tablespoons of psyllium husks 1 teaspoon of honey Mash the pears up and add the other ingredients and stir. The psyllium husks turn the mixture into a jelly like substance. It's delicious, I give it to my daughter once and sometimes twice a day. It has kept her regular whilst she has been on formula and goats milk. I am now trying her on a dairy substitute and hopefully we won't need it. It tastes great though and she loves it. I hope it helps some of your kiddies. Also, I though I should say that we are over the hard poo days now. But before I gave her this jelly she had a couple of bloody bottom poos and poo stuck that i had to dig out with my fingers. Very painful and sore. Just in emergencies to ease the pain, I worked out that if I put her on her tummy over a towel on the side of the bed or couch I could pour Olive Oil on her bottom and on the poo. The oil lubricates the bum and the poo and it will usually go back in coated in oil. I used a dosing syringe full of olive oil to do this. After that it usually softened up a bit and also slid out easier. I know it sounds gross but it's horrible to see them in such agony! *Excuse the simple terminology! Thanks for the recipe, Lori888. I'm adding a link to the recipe from my collection of potty resources here: http://www.autism-pdd.net/forum/forum_posts.asp?TID=16098&am p;PN=1&TPN=1 I had never heard of psyllium husks before, but I looked it up and it seems like it's a powder that's purchased at health food stores and is an ingredient in commercial laxative products like Metamucil. Psyllium husks become gelatenous when fluid is added but it is gluten free.The pears are really high in fibre but also you can use paw paw/plums/or any other fruit which eases constipation. I this recipe helps others too. cheers :o) Shandalyn- I just have to let you know that Nesquik is def not GF/CF. I know that I make tons of "mistakes" with my sons diet and I would want to know if I was giving him something that contained cassein. Connie - your story is exactly the same as my kiddo. Exactly. He also had the barium a few months ago and it came all clear. I almost wished it was something that an operation could "fix" and he would go normally. He's almost 7 and has to wear pullups for leaking, encopresis. This has been going on for years now and I don't see any end in site. Like your daughter, he can take an enema and not go! I don't get it! Anyway, just want you to know you are not alone. Your daughter's colon is probably stretched out like my son's is. Because of this, they don't have the urge to go like regular people. My son's GI drew me pictures of what was going on that explained it well. My kiddo had problems with constipation before we went GFCF. Actually, as soon as we took milk/dairy out of his diet, the constipation dissappeared and has never returned. Food sensitivities can have a huge impact on a child's health, so even if you're not into the idea of the full DAN protocol, it's worth seeing one just to get the food testing done. It's good to know that I'm not going crazy. The doctor said the tests came back normal, that nothing showed up on them. I'm to do a cleansing every other week. WOW that seems kinda drastic but if it makes her more comfortable and makes the pain go away then I guess that is what I'll have to do. I already keep ALL dairy away, including cheese on pizza which she loves pizza! |
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