Movicol, Sodium Picosulfate & now Senokot!! HEELLPP

[JodieS28]

Hi

Like a lot of messages on here, my son is 4 years old and starting school in September. I am getting beyond desperate for help as spend most days in tears, and most days too anxious to leave the house as we know an accident will happen.

Brief back story, about a year ago, after finally deciding it was not a behaviourly thing with the constant pooing in pants, I contacted ERIC who were amazing. For a few months I thought we had hit the gold. After a disimpaction, we went on to 2 sachets of movicol a day. After a while, my son reverted back to soiling his pants. I tried to reduce the dose of movicol but any less than 2 sachets a day resulted in constipation again.

I should say, that whilst on the movicol his poo was very loose and he was definitely no longer constipated.

We continued with this for around 6-7 months when I concluded that actually the majority of his accidents were caused by the fact his stool was so loose, and therefore had no control over it, or if he did, would often not make it to the toilet in time.

Finally a GP took me seriously and refered me to a Peadatrician, who very quickly and confidentantly swapped me from the movicol to the sodium Picosulfate. He was absolutely certain this would work as 'in his 20 years, if you are over sensistive to movicol, then sodium picolsulfate will definitely work'. Well, to say that heightened the problem was an understatement. My poor little lad was then passing what can only be described as water 6 or 7 times every day and that was with only 1ml of the S.P.

I stopped this after 5 days, certain this was not right for us. Another trip to the Peadatrician and now on Senokot. We are currently on day 5.

I know I havent given it much time yet, but if anyone has any experience of senokot, please please let me know. He is currently having 2.5ml as he goes to bed (around 7pm)

I have to say, on the positive side, it does seem to have returned his actual stool back to 'normal' i.e it is no longer too loOse, and he is passing daily, so in the main seems much better.....

However....... My son is still soiling his pants every time, insisting he just couldnt feel it coming, i.e he has no urge to go, and doesnt even need to 'push' it out. He is also soiling 2- 3 times per day.

Does anyone have any idea why he now soiling multiple times per day, and what we can do to try and now get these poo's on the toilet?

Any feeback much apprecaited. Thank you very much.

p.s sorry for all the typos.

[HEfamily]

Hi there. My daughter has been on Movicol since she was was 2 1/2. She will be 9 in November! She was put on Senekot and Movicol 8 months ago and it has transformed our lives basically! I look back on all these years now and wish I had pushed for it sooner. It got so bad with up to 8 accidents daily we decided to home educate because she was missing so much school anyway. She then ended up having a manual evacuation done under general to remove a grapefruit size mass. In my opinion, Movicol just made her more inclined to withhold because it was so soft and made her anxious. Up to 8 months ago she was still trying to withhold despite being on up to 5 sachets a day. Now she is on 1 tablet of Senna and 1/2 sachet a day of Movicol. She goes to the toilet every day happily and is back in school. whenever we reduced Movicol before though she would just get impacted again. I think it was the Senna that helped her feel she needed to go because it contracts the muscles. I know Movicol works for some people but looking back I feel it caused a lot of anxiety for my daughter.

[squizita in reply to HEfamily]

Sorry to hi-jack but just out of interest when she re-impacted, if she was passing poo how did you know?

I'm a bit paranoid haha. My daughter passes a soft 'log' of poo daily in the potty but also sometimes has accidents (although we think this is due to her stretched guts and re-learning non-painful-poo-signals and the fact she is easily distracted - as she will poo on the potty at least once a day happily). She is only coming up for 3 though and still potty training.

I am paranoid about telling the difference between a normal accident for a 3 year old with a numb bum and something more serious basically! I think I Dr Googled too much haha.

[HEfamily in reply to squizita]

Hi. She just kept having accidents and because her muscles had stretched so much she could hold a lot more before feeling the need to go. Even when we did disimpaction we were not giving her enough to empty her properly. At one point she had 30 sachets over 4 days and it still didn't melt the mass.

[squizita in reply to HEfamily]

Wow! My daughter keeps having accidents but as she's a toddler, thankfully I think it's down to being a toddler and her muscles needing to recover. I will keep an eye out for it returning and am thinking of getting the Dr to palpate her tummy every month or two to check nothing is lurking.

Although she produces 1 to 2 adult size logs a day so hopefully that indicates its coming out regularly!

[Luella19 in reply to HEfamily]

I so agree with you about senokot. It also was what worked for my daughter after years on movicol. The gps always prescribed movicol.

When my daughter was initially diagnosed with constipation after constant soiling of knickers aged 3 she was given sodium picosulphate for a few days 'explosive' clear out. My brother (a doctor) said it was often used to clear people's bowels prior to surgery as it's quite potent!

We then went into the maintenance dose of movicol which for us was one a day. I tried taking her off it at various times over a couple of years, we did a 3 month dairy elimination and we had good times and bad times on the soiling front. She was doing normal poos every 1-2 days but still would soul her pants regularly. The stress leading up to the start of reception was immense. I gave up my job so that she didn't have to ever go to an after school club or holiday club. I was obsessed with it all and very down. I so relate to all the parents feelings on here.

Anyway last summer aged 6 she was referred by a lovely young locum Gp to a lovely paediatric doctor. He prescribed senokot to use alongside movicol explaining that the senokot helps with the pushing sensation as it's a stimulant laxative (movicol softens) he put her on 5ml a day and said to play around with movicol dose until things improved and it really did improve.

We ended up on 3/4 movicol per day with the 5ml of senokot and no soiling for months. Earlier this year I started to slowly wean her off both and she was discharged by paediatrician in march.

She is 7 now and doesn't take any laxatives however she is definitely prone to constipation and I have to really watch her diet and fluid.

In hindsight I think a lot of her problems were caused by withholding which at the time I didn't really understand. I think the movicol making the poo softer didn't really help the soiling as she was still trying to hold it in and the end bit of poo was coming out in pants. The other important part of the treatment the paediatrician set us was regular quite strict toilet sittings, after breakfast and dinner to try and train the bowels to be more regular. Sitting for at least 5 mins each time even if it results in nothing keep at it. I still get anxious about her pooing and we had a couple of soiled pant incidents at school this term (never at home anymore) but the improvement is amazing.

For all of you parents getting stressed and dying about the start of school I was the same state as you and now life is pretty normal. She now attends after school club and I have a job again after 3 years! It can get better.

X

[HEfamily in reply to Luella19]

This was us exactly! Her paediatrician wanted me to stop the Senna and just resume Movicol but I am determined to just reduce the Movicol first then wean off Senna last. I actually feel quite passionate that the extensive prescribing of Movicol is causing more issues long term. When My daughter was at school I was back at college and working as a TA. I had to just quit and dedicate everything to getting her ok again. It was worth it obviously but it really did take over our lives.

[squizita]

My daughter is much younger but I was advised if they have gone from very hard to very loose rapidly, their sensations/nerves will be all mixed up and possibly battered/damaged and will need time to recover. Luckily for me my daughter is only coming up to 3 so accidents are considered 'part of life' at that age anyway. However it might be worth asking your Peadatrician to check for any damage (I have been assured any damage will recover on its own over time) which might be interfering with the sensations.

[bluecow]

Hi, just wanted to say I totally feel for you, I could have written your post myself its so similar to my sons situation.

He too is 4 and is due to start school in September, He was constipated for 3 weeks and now is producing thick like melted chocolate! Like your son he says he cant feel it coming, has no urge and is quite happy wearing a pull up as I cant sent him to preschool in pants as he is constantly soiling!

I'm sure he has got so streached inside he has no feeling or urges! Hes been struggling with chronic constipation since birth.

I hope things improve for you x

[JodieS28]

Thanks all.

The peadatrician send my son was just overly sensative to movicol. The senna does seem to be working now in that it is producing daily and normal looking poo's. I just wish they would come on the toilet instead of pant and that there was a bit more of a routine or predictability about it. When I wrote the orginal post, he had poo'd 3 times the previous 2 days. The next day after that he didnt poo at all, and today he's poo'd once.

Today he said he needed a poo, so off to the toilet we went. We sat there for only 5 minutes or so (as we were out and about) and he said it wouldnt come out. Half an hour later he soiled his pants.

I dont thnink its because his bowel is stretched or his nerve endings killed off as he's now been constipation free for almost a year with the aid of the movicol, so would like to think that has recovered by now?

We go abroad in a couple of weeks and have literally no idea how I am going to cope.

xx