Days following disimpaction

[ANormand]

Hi,

I'm new to this forum so please bear with me! My son was recently diagnosed with severe constipation through x ray. We followed the disimpaction regime prescribed until he went several occasions where it was basically poo-ey water with lumps in. We then reduced to two movicol a day as maintenance and we had a great couple of days-large bowel movement when put on the loo in the morning and then clean the rest of the day. Following that, we have returned to have several episodes of soiling a day (despite still doinga bowel movement when put on the loo in the morning). Did I stop the heavy doses of movicol too soon? Do I need to do another week of disimpaction? Or is two movicol too many? It's a minefield so any advice or anecdotes from personal experience gratefully received!

[saramoll]

My daughter is nearly 8 now and we had years on and off Movicol, but never had to do the the disimpaction. But the constipation can over stretch the bowel and it can take quite some time for it get back to a normal size and function so don't despair. You may need to experiment a bit to get the maintenance dose right. Too much and you will get poo accidents because the poo is too soft andd slips out literally without the child noticing, too little and the constipation comes back with leakage so hard to know what is causing the dirty pants! Have you got a helpful nurse or gp who will feel the child's tummy just to see if stool is building up in the bowel (needs more Movicol) or not (may need less Movicol).

[Georgina1475]

Hi you don't say how old your son is. I found that the dosage can be effected by their weight too. My son is small for his age and has been on movical for years as he's now 8 and this problem started when he was 2-3 years old. We take one a day and he has one big movement a day and now is clean no leaks or accidents unless he's being completely lazy which he was at the beginning of the summer 😡. I would suggest asking to see the GP and get them to feel if he's cleared out. Also if he let you, you get to feel his tummy so we are aware of what his tummy feels like and looks like when he's clear. My son is good he still let me feel around to check now and then. Make sure he's not rushing to get off the loo before he's really finished too. Also if he's cleared out when he wipes it should be easy to remove excess, if he's loose then cleaning up will be more difficult if you know what I mean.

[ANormand]

Thank you for your replies! My son is 5 and his height and weight are satisfactory although probably on the smaller side. I've managed to get an appointment with the GP this morning for a bit of advice/guidance. Towards the end of disimpaction, he was just passing watery poo with lumps in, which according to the ERIC website means the disimpaction has worked so we reduced the Movicol to a couple of sachets a day. However, we never saw hard, blackened stools being passed. Over the last couple of days, the soiling has been very soft but not watery making me think we're back to the 'leaky poo.' According to a link posted on this forum, if disimpaction has worked, then the soiling shouldn't continue (not to these lengths anyway!) Also, he passed sausage shaped soft stools earlier on in the day which also makes me think it's not too much Movicol as surely if it was then everything he passed would be a type 6 or 7 stool?! Not sure if this made any sense and how I'm going to explain all this in a 10 minute appointment with the GP!

[Luella19]

Movicol is tricky stuff to judge. My daughter took movicol on and off for a few years and although doing regular normal looking poos she would still occasionally soil her pants. Our consultant explained that it was bits coming off the end of an awaiting poo. She was sometimes withholding too which I think is common for constipated children. The withholding behaviour can cause leaky poo too. I used to reduce dose by the teaspoon to try and find optimal dose. Stick with it...