One of the things that I have seen in my practice with respects to chronic constipation, I’ve spoken about constipation before, but one thing we are starting to recognize is that many kids on the spectrum not only have problems and digestive issues which we’ve known for a while but the regulatory aspect with respects to the nervous system’s input to help with that sensation to have a bowel movement is compromised. So you know the things like magnesium and vitamin C and probiotics and sometimes laxatives can help and they are necessary for chronic states of constipation. What often goes unrecognized in persistent constipation when kids are not responding to dietary intervention, fiber, these other supplements is the potential for an underlying worm infection.
I have actually used a remedy called Vermox, also known as Mebendazole. Mebendazole or Vermox is actually an anti-worm medication, it comes in a chewable tablet that’s specifically used for pin worms. Typically one dose of 100 mg chewable tablet is appropriate for most pin worm infections. But sometimes we need to use it a little bit longer, particularly for things like round worms or other types of worm infections that are more persistent so I’ll commonly, if I am going to dose Vermox we’ll dose it instead of one time, one day, use 100 mg chewable tablet twice daily for 3 days. And this has worked quite well for some kids with chronic constipation and helping to relieve that constipation. If that happens then we know that a worm infection is very likely. And I say likely because it’s difficult actually to find a worm on a stool test so you may have done a comprehensive digestive stool analysis and not found a worm and that is not uncommon.
What I’ve also done for certain cases of constipation where they are not resolved because of other remedies is use the Vermox for 3 days then take a 2 week break and repeat it again for another 3 days at 100 mg chewable tablet twice daily for 3 days. So a common prescription could just be Vermox, 100 mg chewable tablet, 1 twice daily for 3 days and then have an automatic refill that is refilled 2 weeks later and take it again.
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