Weekend wonderings: Constipation's complicated

It has been one crazy weekend.  Wedding anniversary dinner (this was months overdue!) and playdate with a church friend.  The hubby's parents coming down for a visit (they are now staying with us for a week).  Packing for the hubby's overseas trip and settling all those last minute things before the trip.  And to top it all off, the boy's constipation decided to flare up again.

Its been something that has been bothering the boy for the past 2 months or so.  (Warning, gross talk ahead.)  The boy has a habit of pooping once every 2 days, and this has been continuing as the norm and doesn't seem to bother him much, as the poop is pretty soft.  However, recently we've noticed that he's been having some difficulty pooping, and would have many "false alarms" before he actually poops.  On days that the poop is "due", we sometimes have to stay at home the whole day, simply because we'd have to run to the toilet about 10-20 times, and the boy seems to have a phobia of pooping in public toilets.  Most of these trips would see us sitting there hopefully, while he sits there, swings his legs, and tells you "no poo poo", while the "successful" trips see the poop being passed out in bits (hence it takes about 3-4 trips before he can clear his bowels).  It can get rather frustrating, especially if these "false alarms" come when I'm in the midst of cooking (once, it took me ages to get porridge prepared, since I was running to and fro from kitchen and toilet, while trying to peel and chop veggies in 1 minute intervals)... On some rare occasions, the poop never comes and he ends up waking up in the middle of the night, tired, but really uncomfortable and needing to poop.

It got pretty bad on Sunday.  The boy refused to go down for his afternoon nap (I admit I got rather frustrated with him, but in retrospect he might have been really uncomfortable and unable to sleep.), then refused to eat dinner because he was really exhausted.  We had to make numerous trips (at about every 5 minutes!) to the toilet.  No poopoo in sight, just a whole bunch of stained underpants piling up.  This goes on and on for what seems to be forever.  Little boy is tired but can't sleep, starts throwing tantrums and the toilet trips continue.  Finally he manages to poop around 9 pm and all the offending stuff comes out (you can always know when that happens, from the loud cheering in the toilet from us, and a "I will get a sticker!" from the little boy...).

I must admit its been driving us rather nuts.  We suspect that he has the tendency to try to hold in the poop for some strange reason (some days we can see him uncomfortable, but refusing to go to the toilet).  So we've been implementing all the usual remedies: Probiotics, prunes, prune juice, fruits like pear and papaya and other fibre-rich foods, lots of water and even a dose of flax oil every morning.  While he used to love fruits, getting him to eat more fruits now sometimes proves to be a problem as he isn't eating too well in general these days, but usually we manage to get in a decent amount of fibre into his diet (along with veggies and some brown rice).  We've even resorted to lactulose as prescribed by our PD, and have been trying to explain to him the need to push all the stuff out.  He seems to be trying at times (and sometimes it breaks my heart to hear him tell me "I will get stickers when I poopoo", followed by him counting on his fingers how many he will get!)... so hopefully it'll get better!  Meanwhile, any advice, or your experiences battling this would be welcome...