My 3-year-old daughter has constipation even after giving Lactulose and Miralax. Why?

Question

Hello doctor,

My daughter has constipation since she was 2 weeks old. She is now 3 years old, and constipation is still a huge issue in her life. She has been on Lactulose and now Miralax. The Miralax does not seem to be helping much anymore. We have seen four different GI's and none of them have any answers as to why this is happening to her. My baby girl needs help. She screams and cries when she has to use the bathroom and there is nothing I can do to help her. We massage her belly, give her plenty of apple juices, and prune juices. We have even increased the fiber in her diet and nothing is helping her situation. We have done Celiac thyroid and barium enema X-ray. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

From your history I would like to improve on the following facts:

Increase the intake of water being consumed by the child. I would advise consuming at least 0.26 to 0.39 gallons of water daily. Avoid consumption of any bread or bread products like cake, pizza, burgers as much as possible. You can limit their consumption to once a week to maximum twice if all is well.

Reduce the consumption of milk and limit it to 8.33 fl oz daily. The diet that you have explained above is fine. Continue the same with the above modifications as mentioned. You may need to give the child lactulose twice on a daily basis for a week or two with the above modifications to see the change. Above all, I would recommend to get the child examined physically to rule out any fissure that may have developed due to the hard stools and which is now preventing the child from passing stools peacefully. I hope this helps.