Disimpactation at a teen - please help. : Hi everyone... - ERIC

ERIC
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Disimpactation at a teen - please help.

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Hi everyone,

This may be long so apologies.

I have recently posted on here about me wetting the bed as a teenager (I am 15). I am trying to find out why I do it and what might be causing it as I have been bedwetting for a long time now and nothing has changed. I went back to doctors 2 days ago and they thought that I might be constipated and this is why I am bedwetting - so they felt my stomach and apparently I am very constipated and my stomach felt hard.

They have put me on movical and told me to start the disimpactation process. I started the process that night before I went to bed. I am currently on day three of it and have a couple of questions I wondered if anyone could help?

1) how long does it take of average for the poo to come out?

2) is it worth wearing nappies to help with the messes?

3) how long does it take to be fully clear out?

4) what have your experiences been with disimpactation

5)do you have any advice

51 Replies
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I asked how long it takes as so far nothing has happened

Robinia
Robinia in reply to Hidden

That’s from the Grear Ormond Street website, I phoned a while ago and spoke to the biofeedback nurse. I think they do it at the Evelina hospital too but you need to get a paediatrician to refer you

Hidden
Hidden in reply to Robinia

Oh ok

Hiya, Are you only having support from your GP? I feel like you could do with some more support, like from a continence nurse or a paediatrician or both. Disimpaction can take 7 days (going up to the full 12 sachets). It can also not work fully on your first try. I would say if wearing pull ups or pads in your pants helps you then do it. Whatever you need. It’s very hard to be at school during disimpaction once you get onto 8 sachets Plus. Have you watched the Poo nurses video? That might help. I think in view of your bedwetting you should be seeing a specialist in urology. They could then consider biofeedback training. Let us know how you get on. I’m so pleased you found this forum and it’s great you’re taking these steps to help yourself. We are all here to help.

Hidden
Hidden in reply to Robinia

What is biofeedback training

Robinia
Robinia in reply to Hidden

Biofeedback training

Biofeedback therapy concentrates on the pelvic floor muscles, which are vital for successful bladder function. The pelvic floor muscles are at the base of the pelvis, below the bladder and are shaped like a ‘sling’.

Both males and females have pelvic floor muscles. If the muscles are weak, the bladder may leak urine in between wees. If they are too tight, it may be difficult to wee so the bladder retains some urine after weeing.

Biofeedback therapy has been proven to be effective in the treatment of urinary incontinence in a number of research studies. It can be used to teach children to control and strengthen their pelvic floor muscles and how to relax them properly.

What happens during a training session?

Most children have a two-day stay at Great Ormond Street Hospital (GOSH), with biofeedback therapy in the morning and afternoon. When you arrive at the Urodynamics Unit, our clinic assistant will explain about biofeedback and what it involves. They will then take you to the biofeedback room and show your child the equipment for the test.

Biofeedback works by measuring and displaying body functions on a computer screen, so our clinic assistant will fix two sticky electrode pads either side of your child’s anus, another set on the abdomen and a final set on the bony part of the hip. These are connected to the computer using long wires and measure your child’s pelvic floor muscle function.

Once the electrodes are in place, our clinic assistant will explain how to control an animated character on the computer screen. It can be quite difficult to work out which muscles to squeeze initially – the electrodes on the abdomen will help us see if your child is using these muscles rather than the pelvic floor muscles. Each session lasts up to 90 minutes.

Practice makes perfect

As well as the training sessions, we will give your child pelvic floor exercises to practise at home. Like all muscles, the pelvic floor muscles need regular exercising to stay strong – they quickly weaken if they are not exercised. Your child will find the exercises much easier to complete if you are supportive and encouraging – perhaps do the exercises together every day. Remember that you can do pelvic floor exercises wherever and whenever convenient – no one will know you are doing them.

How many sessions will my child have?

Most children have six sessions of biofeedback therapy, but others have fewer or more. We will discuss how many sessions your child might need at the end of the first session.

More information

If you have any questions about biofeedback therapy, please call the Urodynamics Unit on 020 7405 9200 ext 5916 or 5917.

Hidden
Hidden in reply to Robinia

At the moment yes I am only have support of the GP - I haven’t watched the poo nurses video. Have you had any experiences with disminpaction

Robinia
Robinia in reply to Hidden

Yes years of experience!!! My son is nearly 10 and currently in pull ups all the time because he has no bowel control, you’re not alone xx

Hidden
Hidden in reply to Robinia

Have you ever done disimpactation if so what was your experience and do you have and advice or tips that may help

Robinia
Robinia in reply to Hidden

I have to get ready for work now but I’m sure others will respond, and I will reply this evening, take care and have a good day x

Hidden
Hidden in reply to Robinia

Ok thank you

Hi, my son is 12. We did the dis impaction last year. We waited until the school holiday. Pull-ups might be a good idea. My son made it to the toilet we ended up taking over a week and (sorry for too much info) poo was huge quantity.

In our area the incontince unit would never return my calls and emails, I did self refer to the ‘school nurse’ who basically covers any child of school age. We were already doing all the ‘right things’ but it’s good to check- ask your GP about your area. She came to our house as my son didn’t want her to come to school.

My son still has problems with wetting and the GP refuses to refer us. Would be very interested to see how you get on.

Dis impaction has helped enormously, I should add.

Best wishes.

Hidden
Hidden in reply to Mum0fBoys

I will update in a couple of days - currently still nothing and ok Day 4 of disimpactation. Is this normal

Hello Ofkfnf,

My daughter who is 12 nearly 13 is doing a disimpaction at the moment. Now we are in NZ so it maybe a little different to UK practices. She is on an adult dose of Movicol and takes a maintenance dose of one sachet per day. After some recent issues her specialist has put her on a disimpaction where she did 3 sachets for 3 days and if that didn't achieve liquid bowel motions we had to increase to 5 sachets for two days then drop to 2 sachets for the remainder of the fortnight.

We stuck close to home and she has had very few soiling accidents during this time. She tells me it took 5 days (so she was upto 5 sachets) for it to work but everyone is completely different.

Her appetite was really variable over this time and sometimes I think she just felt 'awash' with all the liquid she had to drink. Choose something to mix it with that you won't mind never drinking again! (She hates Banana milk after last time!)

Watch the poo nurses video - I think it should be compulsory for older kids diagnosed with constipation, for my daughter it really made sense and suddenly she had the ability to tell me what was going on in her body.

I wish you all the very best for your disimpaction- good on you for looking for more information, there is some amazing info on this site.

The Laundrymaid xx

Hidden
Hidden in reply to Laundrymaid

Thank you - I will do an update soon - currently on day 4 of disimpaction and nothing is happening . When I say nothing I mean not a still thing even at night. I am not sure what do next - what would you do in my position

Just carry on, it can take getting up to 8/10 sachets to get things moving x

Hidden
Hidden in reply to Robinia

Is it normal though for by day 4 nothing to happen - not even the tiniest little leak of poo

Robinia
Robinia in reply to Hidden

It means your impaction is stubborn and will need more sachets to get it moving. In my experience with my son he often needs to get up to 10 to get things moving. Maybe it’s a big part of what’s causing your bedwetting

Hidden
Hidden in reply to Robinia

I am on 10 sachets now and nothing is happening - if you don’t mind me asking how long did it take for your son to start clearing out during disimpactation

Laundrymaid
Laundrymaid in reply to Hidden

Hello Ofkfnf,

are you saying that you have had no bowel moments at all in the last 4 days and if so is that your normal pattern? I think that the fact that nothing has happened is a sign of just how blocked up you are. i agree with Robinia, Don't stop now, keep downing the Movicol, make sure you are mixing it with the correct quantities of water then mixing it with another drink/cordial/juice make it palatable to you. Also make sure you are drinking plenty of extra fluids as that will help the process along too. Another thing that you can do, and you may have read about this on other posts is sitting on the loo about 20 minutes after you have breakfast or your evening meal. Eating stimulates the bowels, so if you sit on the loo for about 10 minutes, you are putting your body in the right position to poo. It may not work as you are so bunged up but give it a try. I'm amazed how often it works for my daughter. (She has suffered constipation for manys years and has very little sensation of needing to poo.)

As this it taking a while, it could be a bit explosive when it happens so don't wear your fav knickers and be prepared to maybe throw away some soiled clothing. There is a good reason I call myself 'The Laundrymaid' 😉 Xx

Hidden
Hidden in reply to Laundrymaid

I haven’t had any bowel movement in the past 4 days that is not normal for me - I am on 10 sachets now so do I take 12 because the doctor said I can go up to that amount if need.

I have a question about the loo thing - do I sit on there after both breakfast and dinner for 10 minutes or 20 minutes I don’t understand (sorry if I am being stupid) Or do I stay there until I go for a poo.

You said it may be explosive when it happens would it be worth wearing a nappy or a pull up for when that does happen.

What did you do with you daughter during disimpactation to help her or to help her with her constipation in general - any tips would be appreciated

Laundrymaid
Laundrymaid in reply to Hidden

If it is not usual for you to go this long without some sort of bowel movement I would be inclined to call your GP and perhaps ask to speak to the practice nurse and give them a heads up on what is and isn't happening. There are other things your doctor can prescribe to get things moving. It took five days for my daughter to get a result but everyone is different.

Okay the loo thing, eat your breakfast/evening meal. Wait for 20 minutes and if you can try to be reasonably physically active, don't just sit waiting. Then go and sit on the toilet, knees bent and depending on your height you may want to have you feet supported on something so that your your knees end up being raised slightly higher than you bottom. Legs well apart and sit tall. All these things get your body into the right position for a bowel movement. It's pretty standard to do this for 10 minutes. So my daughter tells me that often when she does this she does not 'need' to do a poo, but when she sits there she starts to feel the sensation and out it comes!

I think the use of a nappy or pull up is a very individual thing, my daughter's nearly 13 and I think the anxiety she would feel at even the thought of using a nappy well and truely outweighs the indignity of cleaning up soiled clothes. If it gives you reassurance and control then use them. 😀

In terms of helping the constipation, water, water, water! Whenever she doesn't drink enough her body suffers. Probiotics can't hurt and lots of fresh fruit and veg. Have you ever tried Kiwifruit - they are amazing for constipation, try 1 per day.

And keep reading around this site, there are some amazing old posts on here.

Best of luck, The Laundrymaid xx

Hidden
Hidden in reply to Laundrymaid

Thank you so much - it is now day 5 and you were right it came and it was explosive -

(sorry if TMI)

You advice on sitting on the loo - I tried it last night but nothing and then I tried it this morning and it just kept on coming. I am starting to feel a bit more positive on this whole situation and I feel as if I am getting somewhere.

That's fantastic news -keep up the good work! Your body will take a few days to clear and you may find that you get some minor soiling for a week or so as things settles down so don't expect things to change over night, this is just the start. Keep up the day time fluids as the Movicol is drawing liquid into your bowel so you will need extra fluid. You have every reason to be feeling positive and the way that you have approached this, seeking out information and answers, should be commended. Well done you!!

The Laundryymaid xx

Hidden
Hidden in reply to Laundrymaid

Thank you - have you got any further with your daughter

Laundrymaid
Laundrymaid in reply to Hidden

Good morning! We are in the tapering off phase which means as at today she is down to 2 sachets and tomorrow back her maintainence dose of one sachet. It will take a few days to settle but she is off back to school tomorrow and I think she will be able to manage. We know the routine and when she follows it we get pretty good results. I think the hardest thing for her is keeping up with her liquid intake. It's the middle of winter here so she doesn't feel like drinking much water during the day and that always has an impact on her body.

I think that you are amazing with the way you have approached this. At this point has the disimpaction been better or worse than you thought it was going to be?

Take care, The Laundryymaid xx

Hidden
Hidden in reply to Laundrymaid

Worse - although I am glad that I am that there is no impacted poo in there any more. It makes me feel like a baby as I have to change constantly as I am not making it to the toilet in time and I have no control over my bowel. The accidents are worst now than they were before

Laundrymaid
Laundrymaid in reply to Hidden

This too shall pass! You still have a lot of Movicol in your system and that is still being processed by your body.

My Mantra is "play the long game" meaning this is really unpleasant now but think about how much better life will be once this is over.

You are doing really well, keep up the good work!

The Laundryymaid xx

Hidden
Hidden in reply to Laundrymaid

I fear that all this hard work will be wasted when I am not on movical any more and then o get impacted - the doctors don’t want to keep me on a maintenance dose after as they want me to trian my bowel but I don’t know how to do that

Laundrymaid
Laundrymaid in reply to Hidden

No, the hard work you are doing now won't be wasted but Movicol is only part of this.

Once things have settled down you will feel and start to recognise how your body feels when is is working efficiently. You will be much more aware of the things that help like making sure you take enough fluids, monitoring your bowel motions, how often they are, whether it is easy to go the toilet and when it's not. You may even start recognise that some foods don't agree with you and really bung you up. There are definetly supplements that you can purchase to help achieve healthy digestion. Eat lots of naturally good food like berries and kiwi fruit.

No two people are the same and require the same treatment. Even on this forum there are hundreds of variations of treatments.

Have a great Sunday!

The Laundryymaid xx

Hidden
Hidden in reply to Laundrymaid

I will try to enjoy my day - when you did disimpactation did you child gain control of her bowel again if so how long did it take you

Laundrymaid
Laundrymaid in reply to Hidden

Hello, she said that the first time we did the disimpaction it was over a three dad period (short and sharp!) and it took just over a week 8-9 days for things to settle down. This time the disimpaction was done over ten days and tapered down back so that today, the first off disimpaction she already feels much more in control of her body - not perfect but give her a few days, I'm hoping she will be better than normal! 🤗

Hidden
Hidden in reply to Laundrymaid

That is the point where I want to get to - where I feel normal but I have a feeling that will take a long time

Laundrymaid
Laundrymaid in reply to Hidden

Hang in there kid! You are doing great xxx

Hidden
Hidden in reply to Laundrymaid

Thank you

Hidden
Hidden in reply to Laundrymaid

I have one quick question - how do you deal with traveling

I'll reply to this. The same as you are doing for the bladder issues, although you might want to keep more protection available, and disposable washcloths as well. Also keep spare clothes with you in case you have an accident that gets into your clothes. Something else I thought of. You say your doctor doesn't want to put you on a maintenance dose of Movicol. There is a possibility that you won't need it, however, there are things that you can do to keep your bowels in good shape. Find good sources of fiber to have in your diet, keep your fluid uptake high, and if that doesn't do it, something like Metamucil may work. Although I would suggest that if you are going to take anything else, that you talk it over with your mom (mum) first.

On the other topic, I suggested that you may want to consider wearing skirts with a top or dresses to make it easier for changing. Those should be at least knee length and loose fitting other than the waist band. Too short, and you may reveal the secret if you have to bend over for some reason.

Hidden
Hidden in reply to Slice

Thank you

Hello, was just wondering how you are getting? I hope things are starting to improve for you!

Xx

Hidden
Hidden in reply to Laundrymaid

Unfortunately not much has changed and I am still disimpactation for and spending most of my day on the toilet to stop accidents. I am going away in a couple of weeks so hopefully I will be ok by then but I don’t know. I am starting to get frustrated with my body now

Hi, firstly I want to mirror what others have said. You are handling this so well with so much maturity. My son is 9 and has never really been dry! He was put on medication for an irritable bladder about 4 years ago as that is what they thought it was but Ive stopped that now as it’s never really solved the issue! About a year ago he started having the occasional poo accident and, a couple of months ago, these became much more frequent. We went through disimpaction at half term and, although it’s not totally solved the problem, it is better. He is also on a sitting routine, where he sits on the loo for 5 minutes at set times throughout the day. After speaking to a friend who has a daughter who is 13 who had similar problems, she recommended fibre gummies!! They aren’t that easy to find in the UK but her husband is a pilot and brings them over from the states. They really work! He takes 2 gummies a day (which are like chewy sweets) and having that extra fibre boost seems to ‘keep things moving’ so to speak. When my son is on a maintenance dose of movicol, we find accidents increase! If he feels he’s not going as often, we will give him some but we are very early on in our journey with a long way to go. Keep positive, remember you’re not alone and this will get better. x

Hidden
Hidden in reply to CatDub

I don’t feel like it is getting any better - I am on day 6 of disimpactation and am basically living on the toilet to stop accidents

Are you still on the Movicol? Did your doctor give you a timeframe you needed to take it and are you to just stop taking it at a certain point or taper down the dose before coming off completely?

Hidden
Hidden in reply to Laundrymaid

I am still on Movicol - the doctor didn’t give a time frame he just said when you are fully disimpacted. I don’t know when I am fully disimpacted- how do you know

The disimpaction is done when you are passing mainly liquid, no hard or firm lumps. Did you watch the video by the poo nurses? They give a pretty good description. Are you still taking multiple sachets? I think you were up to ten at one point. If you are still on large doses this would explain the constant soiling. I would recommend that you call your dr's office and speak to the nurse, or you could try phoning ERIC and get some advice about either tapering off or stopping the Movicol altogether.

Hidden
Hidden in reply to Laundrymaid

I am now on about 8 a day - I never got to that mainly liquid point - what I was passing was still very much firm but they said to stop after day 8 or 9 I think that said so that is what I did but I still think that I am impacted

I think that it's time for you to go back to the doctor and get them to reassess your situation. It may be that Movicol is not the right treatment for you or that it needs to have another medication added to it to stimulate your bowel. Make sure you tell the doctor that you are due to travel in a couple of weeks and that your situation as at today is actually worse for you than the accidents you were having previously. Ensure the doctor is aware of not just the physical effects but also the stress that this situation is causing you. Xx

Hidden
Hidden in reply to Laundrymaid

What should I do if they just prescribe movicol again - my doctor is not very understanding of my situation and think I am making it all up when I am not

Laundrymaid
Laundrymaid in reply to Hidden

Your Doctor has examined you and ascertained that your abdomen was hard indicating constipation, and has prescribed you medication to help treat that problem. I think you should return to your doctor as they will want to reexamine you and see how things are progressing. They may prescribe you more Movicol but they also might reassess the medication you have been prescribed.

The other thing is do you have an adult that you trust (mum or dad?) who can come to the doctors with you to support you and advocate on your behalf? An extra set of ears and someone who will speak up is helpful especially when you are not sure the doctor is listening to you. Be calm and confident and make sure you ask questions!

Are you aware that you can phone ERIC for advice? I think you are charged for the call but they maybe able to give you some advice on how to deal with your Doctor and whether you can seek a second opinion if you are not sure of the treatment you are currently getting? I'm sorry but the system is different here in NZ so I can't advise you what your options are doctor wise.

HI

my son is 15 and suffered since he was around 6years old ,and bedwetting was a part of his constipation too its because of being so blocked you cant feel the signals to go to the toilet .

The process varies a lot for disimpactation just keep increasing it as told day by day the most my son had gone once started is 5 days . The mistake we made was going back down to just one or two sachets once he had the clear out , this doesn't work and it needs to stay high and reduce slowly so you are passing stools regular,

We embarked on a disimpaction again last August and once clear went to 6 sachets a day with a senna in the evening , now currently he is on 5 sachets a day and still taking senna , it seems to take forever to start getting back to normal , the leakage was immense in the first months , we put waterproof sheets on the bed to protect it and he suffered cramping slowly its improved and now he rarely has any accidents or leaks , however he seems to have a 2 week pattern of pain which the consultant seems to think is the bowel shrinking back to how it should be , its not perfect yet but he is seeing the light at the end of the tunnel so to speak.

Its a awkward age to be suffering and school was a big issue he felt embarrassed and ashamed lucky the school have been very supportive .

Keep going even when you think its not working eventually it will , everyone is different and its not gonna be cured over night .

Best advice is to talk about it how you feel, what effects its having on you on a daily basis . My son struggled with daily tasks feeling tired and no energy it made him feel depressed and alone , he knows now he isn't alone and many suffer . while I'm tying I have told him what you have wrote he replied just keep going the medicine is disgusting but worth it .

Good luck

Hidden
Hidden in reply to fedupmum

I find it so hard, not only do I have to stress of this I also have my GCSE’s. However this stress i think is having a damage on my mental health. I already suffer with anxiety and this makes it work. Although my parents are so so so helpful and do everything they can. My head of year at school who I am very close with does really help me and I can always go to her.

I feel like I am taking all the medicine but I feel like I am not getting any where? Do you or your son have any advice or tips on how to deal with this

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