Q: My 10 year old daughter will get terrible stomach pain and she is so tiny you can see her belly is distended, and it’s because she won’t poop for days. This has gone on for years. Then she goes and it’s traumatic and hurts because its huge, and it becomes a cycle. I literally have to make sure she goes every day. She’s my only introvert, I wish I knew what is in her mind. I’ve asked her why she does this. She says she won’t poop because it will hurt, so she holds it and then it hurts. Vicious cycle. But I so think there is more to it. She’s predisposed to anxiety thanks to me, she definitely has middle child “stuff.” I feel like she’s asking for help and I can’t get her to tell me. She also has chronic neck pain and headaches, and I noticed she grinds her teeth a lot. That probably contributes to the headaches. It’s such a constellation of symptoms. We took her to an osteopath and he said her neck and head were because she insists on sleeping on the couch. But there is so much more going on. She eats like a bird. I always wonder if she’s not hungry because she has to poop, or because she’s afraid to.
She is the typical introvert, very artistic, creative, smart, and you can see her mind is always going, but she doesn’t like to talk about things. The other thing is for 10 she is super hormonal. She was 2 months premature due to placenta previa so I had the steroid injections to mature her lungs, and I’ve read those can lead to early puberty. She also lashes out violently at her siblings and cries at the drop of a hat because they looked at her funny. And as much as it hurts when she poops, she has me to herself sitting on the bathroom floor holding her hand and talking to her, I wonder if that could be part of it? She asks me to come in with her. I can’t sit too close or too far away. I think, unintentionally, we almost overlook her because she is so quiet and the other two are so loud and extroverted. Maybe we aren’t doing enough one on one just in everyday life.
A: Changes in our stools can be upsetting and scary. They are often the first indication that something is not right with the body. The kind of thing you are describing is often linked to anxiety, just like grinding the teeth, tension in the neck and headaches. They are manifestations of stress. There are many ways to reduce stress for kids that involve no meds, no chemicals, etc. Maybe she ought to try some. Poor thing. Just too sensitive for this world. The anxiety involved with holding in a bowel movement is usually about the pain of the bowel movement but can be other things as well.
Holding in bowel movements is actually not uncommon, especially in younger children. It’s called encopresis and results in dry, hard, painful stools. Generally, a dietary change and lots of liquid coupled with a natural stool softener or laxative is very helpful. Given her age and other symptoms though, it is important to make sure there are not other problems. Her headaches along with this could suggest dehydration. Dehydration can make going to the bathroom painful and it can cause headaches as well. The teeth grinding and tension in the neck suggest anxiety to me, though, either directly linked or as a mitigating factor. Certain infections and things such as Crohn’s Disease can also cause painful bowel movements as well. She should be checked for anal fissures, tears, abscess or any obstruction as well, just to be sure. If she is on some kind of meds, they could cause this to happen, too.
Once you have eliminated any physical cause, you can focus on the emotional aspect of this, which sounds like it might be the root cause of it all. You have other children who get more attention. This is not uncommon and it does indeed cause friction and sometimes emotional problems. It sounds like she is sublimating a lot of emotional issues that are coming out in other ways.
If the pooping thing is a daily conversation in your household, that is significant. If she asks you to come into the bathroom with her, that is also significant and so is her telling you where you can sit. That is her asserting control over you and the interaction with you. Since she is also in charge of when she goes to the bathroom, she is asserting control over the entire situation. She is an introverted personality, and because of that she is sensitive. It may that certain things just bother her more. Some people really do just suffer more than others. It’s not something they can help.
Children are generally unable to understand their own behavior and they are generally not able to tell us what is really wrong. They operate off of very simple cause-and-effect rules and behavior: “When does Mommy pay the most attention to me? When I’m sick. Then I will be sick more often because I really want Mommy’s attention.” It’s not a conscious thing and it isn’t really intentional. It’s just how they’ve learned to behave. It has to be corrected though, because this can develop into very serious problems later in life. Children need to be taught the correct way to communicate their needs in order to become well-adjusted adults.
The important thing is not to blame yourself. Needs and priorities change in families all the time. That is normal and natural. You’ve identified the problem now and you are trying to correct it. That is what is important. Nobody’s perfect.
Daily exercise and meditation would help her tremendously. She is tight like a fist and needs to relax very badly. You can do some things one on one that will help repair the relationship and will also help her relax, like aromatherapy, going for a walk (helps relieve stress and move her poop along) and giving her a massage, just to name a few. It should also be very clearly understood that you are in control of your interactions with her, she is not. Suggestions are accepted from her, demands are not.
This pattern must be broken immediately. Acquiescing to demands this way – even if you feel bad for the person – only entrenches and reinforces the behavior. She should be made to feel that she has valid input just like everyone else in the family but she should understand that she is not in control of the situation. Need for control often stems from children not feeling validated or important; they feel they must control the situation or their needs will not be met. This is partly where temper tantrums come from. It is an inability to communicate clearly what they need and a fear that they will not get it. She needs to learn that her needs will be met and that it is not necessary for her to orchestrate situations for that to occur.
This can also be applied to the behavior regarding her siblings. This is a child that is attempting to control the household through tantrums and emotional outbursts. She needs to learn that she will never get what she wants by acting that way. It should absolutely never be rewarded. Temper tantrums should be ignored completely unless the child is being violent. I cannot stress this enough. Ignoring the tantrum takes away it’s power. It forces the child to try something else to have her needs met and I have never seen it fail when it is consistently done. If the child is being violent or destructive, she should be removed from the situation and put into a safe area away from others until she calms down. She should be made to understand that once she calms down, you will listen to how she feels and address the situation but not until then. She may very well be experiencing early onset of puberty; it is not uncommon anymore. However, she still needs to learn the proper way to behave and have her needs met.
So in closing, it sounds like the stool problem is a physical issue but like many, many other things, it has emotional roots. Once physical causes are ruled out and once the dietary issues and possible chronic dehydration have been addressed, you can really kick the emotional work into high gear. Many processed foods contribute to overemotionality and anxiety, so switching her to a more natural diet would certainly be beneficial as well. It’s never too soon to start. Some doctors recommend things like 7-Up to add more liquids to the child’s diet but 7-Up contains – among other things – excess sugar and this is not something I recommend anybody ingest.
This is a classic example of how just treating one symptom is not enough. The body is a whole of interdependent systems, not a collection of independent parts that don’t affect each other. Good luck to you. Please update and let me know how she is doing.
Shaman Sister Sin
*It is important to note that most children who hold their bowel movements are younger and are simply afraid it will hurt to go to the bathroom. A natural stool softener, a diet change, some reassurance and some patience works wonders in these situations. This particular situation is a situation that has many other mitigating factors that were not readily apparent until I asked more questions.