Senna vs Sodium picosulfate

[Helen36]

Hi - my five year old has been on Senna for a while to help manage constipation that is causing day wetting. We recently had an appointment at the Evelina that advised to up the Senna as her bowel is enlarged and pressing on the bladder. Unfortunately this higher dose is causing really bad tummy ache for her. We have tried dropping the dose back down but everything slowed down and the wetting increased. The continence team have said we could try Sodium picosulfate instead. Has anyone switched from one to the other? Any noticeable differences? Are the tummy cramps any better or worse on one or the other?

[Robinia]

My son reacted badly to the picasulphate but I believe that is unusual. It’s definitely stronger than the Senna in terms of reaction. He was a ridiculously high dose as well. Senna never seemed to have an effect on him. It’s probably worth a try on a low dose but just see how she goes, you can always stop it if you’re worried

[Helen36 in reply to Robinia]

Thank you. She seems very sensitive to the Senna which scares me about the effect the picasulphate might have, but probably worth a try as you say x

[Robinia in reply to Helen36]

If you think she’s reacting badly definitely stop it straight away, good luck xx

[SKY01 in reply to Helen36]

Hi Helen. What dose of Senna were you were put on? We haven't had the tummy cramps but when we've increased the Senna dose (to 10ml) my son's poos have got really loose and dodgy. Also considering trying a change to sodium picosolphate as Senna seems a nightmare- too little doesn't work at all and too much causes a dodgy tummy! I hope that you have some success and would be interested to hear how it goes!x

[Helen36 in reply to SKY01]

We were on 5ml but got upped to 7.5ml but that seems too much so are now doing 6.25ml! I agree that too much just makes it explosive when it arrives and she’s had a few soiled accidents which is actually quite unlike her since we got the constipation sorted. I will keep you posted if we do give the SP a go. I am a bit scared of it!

[Louloubelle23]

Hi Robinia

I think Sodium Picosulphate may be slightly stronger than the Senna as when my daughters had it she's been on a smaller dose.

My daughter has been on 30ml of Senna for 18 months. It did give her tummy cramps for the first few months but that did settle down. Any tummy aches she gets these days are due to the anxiety she has because of the problem! She was also on 2 sachets of movical a day but last month we dropped the movical and put her on 5-10ml of sodium picosulphate a day (as well as still being on the 30ml of Senna!).

To be honest I really don't think all these laxatives are helping at all!

Have they not suggested movical for your daughter? That keeps the poo hydrated and stops it getting hard so is easier to pass. The senna and SP stimulate the bowl to push. Maybe a smaller dose of Senna or SP along with movical would be better for your daughter?

Good luck!

[Helen36]

Thank you everyone - I think things have settled a little for us now so I shall stay on the Senna for now... but will probably change my mind next week!

We are on movicol too and think that dose feels about right at the moment there.

[mummykj in reply to Helen36]

Hi, did you have to push for a referral to the Evelina or did your gp advise it and was happy to refer?

[Helen36 in reply to mummykj]

For us, our continence team referred us once they felt that we had exhausted all avenues of managing the condition without real success. I had gone to the appointment planning to push for it and they brought it up first.