Moving from movicol to senna

After 7 years of movicol my 10 yr old still leaks and very rarely knows when he needs to go to the loo. He manages this by going regularly after breakfast and evening meal. He's on 1/2 a sachet in am and 1/2 in pm. If we cut down further he gets constipated then has bigger accidents. He is a major fruit and veg refuser. He was at GOSH for 5 or 6 yrs had lots of tests - no real reasons found for issue.

So inspired by threads here and mumsnet I thought we could try switching or adding in senna. I bought senakot tablets and he had 1/2 sachet of movicol in am and the one senna tablet before bed. No affect whatsoever this am - he went to the loo as usual after breakfast. He has had no urges. Do they take a while to develop?

Should I try 2 tablets? It's says for 12 plus but he's a pretty big boy, definitely the size of some 12 year olds.

I was feeling so hopeful but now just feeling so depressed again and feel he will never stop having dirty pants and leaving dry bits of poo everywhere.

17 Replies

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  • Hi, we had very good results with senokot when the consultant prescribed it last year for my 6 year old, after 3 years of just using movicol. Initially we used it alongside movicol, 1 sachet of movicol and 5ml spoon of liquid senokot, both in the evening. I then reduced the movicol little by little but continued with the same 5ml dose of senokot until the messy pants stopped. I think the movicol caused a lot of the soiling issues for my daughter although it did help over the years with her constipation and withholding. Gradually I stopped the movicol and just used senokot in evening and gradually reduced that. She now takes no senokot or movicol and hasn't since February. We have had no pooey pants at all and regular poos! It's as though the senokot taught her how to recognise the need to poo. It has been quite life changing for our family.

    I'm not sure of the dosage in the senokot tablets but if you get it prescribed you can get the big bottle in liquid form. 5ml is the starting dose I believe. If one tablet is the equivalent to 5ml then maybe your son needs more.

    I really hope you have success with the senokot.

  • Have just checked the senokot syrup bottle and it says 5ml contains calcium sennosides equivalent to 7.5mg/5ml.

    thought that may be useful comparison to the tablets for dosage purposes?

  • Thanks. That's really helpful - I'll check the dosage. Did it happen quickly ( recognising the need to go) or take a while to kick in?

  • I think once we got the dosage of movicol right after adding the senokot things improved straight away. I think the pushing effect of senokot helped push out the softened poo (softened by the movicol) rather than the softened poo coming out regularly in the toilet but also leaving bits to leak out into her knickers. The senokot cleared her more effectively if that makes any sense.

    I suppose because of the stimulant effect of the senokot she felt more of an urge to go. We also started regular sitting after dinner to try and regulate her bowel, this was also suggested by consultant. Even if she said she didn't need to go she would still have to sit for 10mins. We read a lot of books in the loo! You are doing the regular sits so that is good.

    I think the key for us was lowering the movicol as much as possible but that was obviously what worked for my daughter, some children seem to do well with movicol.

  • Weirdly he did have an urge to go last night. He had one tablet ( which I checked is 7.5mg) on Friday night at about 9pm and then one on Saturday night at 6.45pm because we were going out and a friend was babysitting. He said this morning he had the urge at about 9.45pm last night just after he had gone to bed, that's odd timing with the tablets but at least he had one!

  • My daughter generally always pooed in the evening and she always took senokot in the evening. It rarely 'had effect' the following morning which I think is what the bottle said. So seemed a 24hr result for her.

  • That's interesting - I shall look out for that in the future - I just don't want it to happen at school as he's hates the toilets there.

  • He had another urge just after lunch. I'll give it later tonight so it will hopefully happen at home!

  • He had an urge at 2.30am and went! It's all a bit random at the moment. Hope it settles down soon!

  • There is a fabulous soiling clinic at Darent Valley Hospital. They do a 3 hour session for parents that explained completely soiling and how to use macrogols and Senna properly. If you are getting dry bits he is still massively constipated and to be honest 1 sachet Movicol for a large 12 year old is nowhere near enough to clear the constipation. If you want to message me the area you live in I will see if you qualify for a referral there as they do take out of area. You will also get follow up support from the bowel nurse.

    Well worth going to.

  • Yes this was a massive help for us, I can't recommend it enough :-)

  • Thanks, but we attended Great Ormond Street for many years and we are not near that area. We have done much more movicol in the past and we were advised to very gradually cut down. He goes for at least one big poo a day so I don't think he's that constipated. He's only 10 as well. I think the leaking is more the action of the Movicol but maybe over the bank holiday I'm try and up the dose for 2-3 days to ensure he is fully cleared out. .

    He had another urge at 12 at school, luckily his teacher let him go to the loo. I've written a note today to advise them of his change of meds. It's odd that there doesn't seem to be any correlation yet between the time we give him the senna and the urge to go. Hopefully that will settle down and luckily next week is half term so we won't have the school issue.

  • Please have a look at the website thepoonurses.uk

    Everything you need to know to manage constipation and soiling!

  • Thanks - that's interesting. IAlthough it states if your child is regularly pooing the leaking will stop. Mine has had followed a disimpaction regime in the past and was also cleared out at the hospital- once for a colonoscopy and once for an anolrectal manometry procedure. He always regularly poos once or twice a day but still leaks.

  • Hi

    I know this is an old thread now, but just wondered Eloise8 how the last couple of months progressed for you? My son (although he's only 4) has just gone on to senokot, and like you, I am struggling to find a pattern as to when he needs to go, and therefore deciding on the right time to give it?

    At the moment he takes 2.5ml of the liquid senokot just before bed, so around 7pm. Over the past few days he has soiled at around 9.30am, again at around 5pm, and then again sometime around 9pm. I am not sure why the senokot is causing him to soil multiple times per day either.

    p.s he is not constipated as been on previous medication, and regular disimpaction.

    Thanks

  • No sorry - there hasn't been much of a pattern and he hasn't really had any urges to go for a few days either. He tries to go regularly after tea and breakfast so maybe we will try to stop that over the holidays to see if he'll just have the urge to go when he needs.

    He still leaks but that could be bad wiping on his part more than actual leaking. Or he may need more senna or less movicol- it's such a balancing act.

    And we can only really experiment in holiday time in case he has bigger accidents at school.

    Does your son have regular times in the toilet? He used to sit with books/ toys but then changes to games - we did lose an old phone when he dropped it in though! That really helped mine when we were in the first stages of it when he was 3/4.

    Good luck - it's such hard work!

  • Yes, I sit him on the toilet, like you, after breakfast and after dinner. We dont sit there as long as I would like as he gets quite upset, even with his ipad, or books, so I dont want to push it and make the experience even worse.

    Over the last few days, on the maintained dose of 2.5ml, on day one he didnt go at all, on day 2 he soiled 3 times as I mentioned in my last comment (9.30,5.30 & 9pm), day 3 he soiled twice (10.30am &6pm), day 4 he didnt pass at all and day 5 he soiled at around 11am.

    Unfortunately every single one of these was in his pants and not the toilet, as he still seems to claim it just 'slips out' and cant 'feel it coming'. Very frustrating!

    I am not so much concerned about when he needs to do (although would prefer it not to be during school hours), but about actually getting them on the toilet.

    Thanks very much for coming back to me though.

    xx

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