Maintenance dose issues

[lyns08]

Hello

My 3 year old son has been suffering with constipation since last August and we have done 2 disimpaction treatments (last one in January) which appears to have worked. We are now doing a maintenance dose of Movicol but I have not yet been able to get the right balance so that he just does 1-2 bowel movements a day. He just seems to poo all day, no matter what dosage I give him. I know it is not the same type of impaction soiling though. The poo is soft and it is like he doesn't even realise he is doing it. He is either doing too much poo or within a day of lowering the amount even by just a teaspoon he suddenly starts to get blocked up slightly and I have to increase the dose again, but then resulting in too much poo.

I have 2 older children and it just seems to be having an effect on all of us as I don't feel able to go on days out etc as I just have to be changing his nappy all the time and he is at an age where he hates to go on a changing table when we are out.

I have been delaying potty training him as I just don't know how I can put pants on him when he poos all day but I have just started today to work on it with him by using toilet training pants, although I know this will probably make the process longer!

I have read before that using Senokot can help alongside the Movicol but I am confused as on all the websites it says you should not use it for more than a week?

If anyone has ever been in this situation or has any advise about the maintenance dosage I will be so grateful!

[CN4321]

Not sure about the movicol dosage I’m afraid but we were prescribed senna alongside movicol and my son has been on it for about 8 months and the doctors are happy for him to stay on it. I would speak to the gp rather than buying it yourself though to check.

[lyns08 in reply to CN4321]

Thanks, did you see an improvement after starting with the senna?

[CN4321 in reply to lyns08]

Yes a huge improvement, he will do a really big poo instead of little bits and it’s really helps with the soiling.

[lyns08 in reply to CN4321]

Ok that's good to know, thanks for your reply

[Nanoiu]

Hi, we have been using n Sennokot, alongside Movicol, for about a year now. Paediatrician seems to think that's not a problem.

Sennokot would make my son have a big bowel movement on average 4/7 days a week. Without it, he would soil many times a day and have a proper poo only once in a blue moon. Movicol on its own didn't help him poo unless given in large dose, like in a disimpaction.

Having said that, Sennokot did not give results every day so if my son would not have a bowel movement in the morning he would then soil for the remaining of the day. On days when Sennokot/Movicol doesn't make him go, we use enemas.

It is my understanding, that the large intestine (colon) 's job is to take water out of the food waste. If constipated, waste sits in the colon a long time, so water keeps being drawn out. The longer that waste sits inside, the drier it gets. Movicol adds water back into the colon, to keep waste soft. Senokot's job is to move the waste along in the colon through contractions. With chronic constipation the colon is stretched and it doesn't push the waste as well as a healthy colon would.

[lyns08 in reply to Nanoiu]

Thanks, that's helpful to know.

[Frustratedmum1]

I would took to your doctor. What I understand you can use senna or senokot for long periods of time. Perhaps it depends on the dose. I think there are more restrictions on sodium picolate. My son has just gone back on senna and I would say he is getting more contractions of the bowel. My son tends to have more accidents when he is blocking up. It is a mine field. Thinking of you.

[lyns08]

Thank you! I have been giving him Senna for a few days although not seen much improvement yet although not sure how long it takes to see any. He is still averaging around 8 poos a day which in the Easter holidays with 2 other children is not great to deal with! Thank you for replying and hope everything goes ok with your son too.