Rectal Spasms in children

[JOEYGREEN]

My daughter has suffered with constipation for a couple of years - she is 4 now. Her diet is pretty good but it is something she's suffered with and we don't know why. The doctor gave her lactulose which made her visits to the toilet a lot better. However this made her stomach really swollen and she passed a lot of wind and gave her tummy ache. Last year I visited the doctors as she started having 'rectal spasms'. It was always at night time which woke her up and lasted up to 90 minutes on and off. She screamed and pressed her bottom and got very upset and tired. The doctor referred her to a paediatrician who checked her diet - thought that was fine and prescribed Mebeverine (for the spasms) and Movicol instead of the lactulose as she thought this was giving her the wind and uncomfortableness. This medicine has been fine and when we visited the paediatrician 6 months later and I only reported one further episode of spasms but that she goes to the toilet every day now, once a day. She said we could probably think about reducing the amount with a view to coming off. Since then, and I haven't started to reduce this yet, my daughter has passed a clear bubbly fluid on two occasions and had more spasms (five this week). I visited the doctor again and she said she wasn't sure what was causing this and that she would ask the paediatrician to investigate this again (she still goes to the toilet once a day). So we are waiting for them to get in touch but in the meantime my daughter is really suffering and I don't know what I can do. I wondered if anyone else has ever had any dealings with someone who has a similar problem and if so what happened? What was the cause? Are there any doctors on this website that could advise me on anything? We are desperate at the moment. My daughter starts school in September and is going to be shattered at school if she's up during the night with these pains. For an example of what she eats, she'll have a yoghurt for breakfast with a handful of wholegrain cheerios, a wholemeal sandwich with either cheese, ham, tuna, jam or cheese spread. Cucumber with pepper, a piece of fruit usually either grapes, plum, apple or pear, a packet of crisps or fruit flakes. For tea we'll have a mixture of things, I cook dinners from shepherds pie with veg to sausage and mash, jacket potatoes and beans etc - a real variety, we'll have a frozen dinner one day and a takeaway day on the weekend. She does have chocolate but not to the extreme. Although she only attends dancing once a week she is always on the go. Any help or advice will be gratefully received. Thank you.

[boxtops]

If you are not getting any satisifaction via the GP, take her to your nearest walk-in centre when she's in pain - don't wait until the spasm's passed, let the clinical staff see her when it's happening.

[furrypusscat]

No idea on this one, obviously needs an expert's advice. However, could the acid in pears, apples and grapes cause her to have stomach bloating and pain. Just a thought.

[Eve]

Poor little thing :( Have they suggested a reason for the spasms such as pressure/irritation from constipation, changing bowel habits etc? I have very watery diarrhoeah which almost feels like it's burning sometimes and the irritation can set spasms off for me.

Have you reported the fluid and recurrence of the spasm to her doctors - even managed to get a sample seen/tested? Could it be mucus and has she been checked for a fissure up there?

Could a dietician be an idea to help her to get a diet which agrees with her the best and could be adapted as to symptoms and reduces the chance of causing build ups of wind, especially with constipation.

I have no idea as to what you can give such a young child but they may have ideas as to incorporating other digestive aids such as peppermint and even charcoal if they could help with some symptoms. They may be totally unsuitable for a child of that age though so best to seek more informed advice.

[Anngel123]

Try cuttiing out flour from her diet for a bit...I used to be terribly constipated but this is much better when I cut out flour. Insist on being referred to a dietician. GPs are just that GENERAL practitioners. Do not depend on specialist knowledge from them. Poor little mite.

[Eve]

Sorry, that should have said fissure/fistula etc... up there, especially if passing any puss/mucus etc... and with the pain/spasms.

How is she with her fluid intake?

[JOEYGREEN]

Thank you all so much for taking the time to respond. To answer some of your questions, yes we visited the GP yesterday to report the fluid and the recent spasms. She checked her bottom and said she couldn't see any reason why she would be suffering with these pains. This is when she said she'd ask them to investigate further. I think you're right about taking her into a walk-in centre - I think I'll do this or I suppose I could film it on my phone although it would feel a bit cruel, but then they could see exactly what I mean. With regard to seeing a dietician, this I think would also be a good idea. We just cannot see any problem with her diet (e.g. unhealthy etc). I did ask whether she might have some sort of allergy to bread but the paediatrician said she didn't think it was that. In fact she seemed quite certain about that. It MUST be something though. There has got to be something that either doesn't agree with her or just something wrong up there. Thank you for your point about the acids in fruit. I shall keep an eye on that too. Much appreciated guys.

[Eve]

People can be sensitive to things (and sensitivities can change) without being allergic though, allergies and intoleranaces are different things like gluten intolerance and coelliac disease. I assume she has been tested for coelliac?

With a child so long I'd be careful about messing around with diet too much yourself if a dietician could help given her other problems, so you don't unintentionally make things worse, especially if her system is quite delicate at the moment and with her only being young.

Have you kept any kind of diary or food, stresses etc... to try and identify any triggers beyond anything physical?

Can you actually see the spasms then (as opposed to what she says and her reactions)?

[woofgang]

in adults, muscle cramp can be treated with calcium and magnesium. Might be worth asking your doc if giving her extra calcium and magnesium would be okay...it might be worth a try.

[JOEYGREEN]

No Jenna she hasn't been tested for anything yet. I kept a food diary and diary of her pains which I took with me for the first paediatrician appointment. I didn't do this for the second appointment as she'd only had one 'attack' and this was only a week before the appointment. No you can't see the spasms. She starts off by wriggling about in discomfort in her sleep, she will then be woken up by the pain that obviously increases. She arches her back and presses on her bottom. The pain will subside and she'll drift back off only to be awoken again and again - a few minutes in between. She will scream and cries. We can give her calpol but I don't know if that eventually soothes the pain or whether the pain just passes. Thing is we don't know when it will occur so can't just give her calpol every evening.

[Sqad]

I am sorry that this will not be very helpful, but in my opinion, it has nothing to do with diet or constipation. Seen in adults not uncommonly but unusual but recorded in children...Proctalgia fugax.

The cause is unknown, but it will go in time.

No treatment seems to be effective.

[JOEYGREEN]

Thank you so much Sqad - I've googled this and had a read through and this is EXACTLY what happens! I've looked on a few forums and seen posts from other parents with children suffering with the same thing. Apparently it's rare in children so doctors don't tend to diagnose it. I've printed lots of info off and have contacted her paediatrician who is going to ring me back. Thank you all for comments and to Sqad especially! Much appreciated.