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Dear Dr. Stoll,
In Reply to: senna help???? question 2 posted by Trish on September 18, 1999 at 23:15:00:
Hi, Trish.
Constipation is just one of the common causes of witholding secondary to painful passing of the constipated stool. Probably the second most common cause is rectal muscle bracing---either voluntary or involuntary (due to stress).
No problem with continuing the Senna while starting the psyllium seed and MO. You will soon see when it is time to reduce the Senna. The problem with Senna is over the long haul because the colon will learn not to move until the Senna stimulates it. THEN, you will have the problem of getting him off the Senna without recreating the problem.
Certainly there is a genetic susceptibility. However, even more powerful is the transfer of attitude to the child. We all have our attitudes and respond to environmental stressors in specific ways. Children are EXTREMELY sensitive and pick up those techniques almost like telepathy.
Since this began with bowel training, the chances are that his problem was one of those attitudinal things and that his resistance was due to his reacting to coersion in a similar way to the way you do. He just tightens up and resents doing it (pretty common in the population and very likely since you had a similar problem without constipation).
Let us know how he does.
Walt
Thank you for your response. I figured the senna was not a long term solution but I was hoping since it has gone so well. He now sais, "I have to go poop" Goes and does it and calls us when he is finished. There is not even a fuss or a whine. I am about to begin the treatment you suggested. I am very fearfull of a regression. Is there any way to overlap the treatments for a few days or start with very high doses and then ease off? Of coarse I mean safely. The other thing I wanted to say is that the first episode began after a bout of very crampy diarreha that I over cured with the brat diet and lactaid when he was 18 mos old. This particular bout began when we attempted bowel training. He is now 3 1/2. He has a very good diet for a toddler
I truly believe that witholding has caused this. But I wonder about a genetic predisposition to it since I suffered from it after 1 urge was ignored. I was irritated from all the topical ointments used for episiotomies but I never felt constipated in my life. I also wondered about what you wrote about it
Thanks again, Trish
Follow Ups:
Re: senna help???? question 2 (Archive under constipation.)
Posted by Walt Stoll on September 19, 1999 at 07:21:39:
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