Bowel Management Problem-Solving Tips for Home

Your child may be constipated if they have:

• A swollen belly
• Cramping and belly (abdominal) pain
• Not as hungry as usual
• A hard time pooping or straining to have a bowel movement
• Little or no results from laxative, within 12 to 24 hours of giving laxative dose
• Little or no results from the enema even though they are doing normal activities and eating their regular diet
• Hard pieces of poop (stool)
• A smear of stool in the underwear

• Give your child an extra enema for 1 to 2 days, to remove the hard stool that is trapped in the colon. It never hurts to give an extra enema, but only give your child 1 phosphate-containing enema every 24 hours. Check the enema ingredients for phosphorous, sodium phosphate or phosphate.
• If your child passes a good amount of stool from the second enema, or a hard stool, this will improve their symptoms of constipation.
• Please call us before making any changes to the enema recipe.
• Your child may need an X-ray to make sure that the colon is empty and a follow-up appointment to discuss any changes to the enema program.

• The goal with a laxative program is for your child to have at least 1 large, soft bowel movement every day.
• We will give you instructions about how to increase the dose of laxative at home to accomplish this goal. If your child consistently has little or no bowel movement within 24 hours of giving a laxative, they may need an enema before increasing the laxative dose.
• Call us with any questions about adjustments to your child’s laxative dose.

These might be reasons your child is having soiling or diarrhea:

• Your child is taking antibiotics
• The enema may be too strong
• The laxative dose may be too high
• Your child may be impacted which can cause soiling
• Your child may have a virus which can cause them to have more severe symptoms. The symptoms may last longer than with other children.

• If your child has severe diarrhea, do not give the enema or laxative until the diarrhea goes away.
• If the diarrhea is due to a viral illness, you may start by giving plain saline enemas without the soap. Once the diarrhea has eased, then you may slowly add the soap (stimulant) back into the enema.
• Call your child’s primary care provider if your child shows signs of dehydration such as less urine (pee), being very thirsty, headaches, being irritable, crying with few or no tears and dry, warm skin.

Call the Reconstructive Pelvic Medicine Clinic at 206-987-1240 (option 4) if you need help with your child’s bowel management plan.