Pico, Senna, Movacol daily for months...

[Lozza00]

Hi my daughters 3 and a half, struggled with constipation since 1 so was put on movacol early. Since then she has become a with-holder making potty training difficult... withholding made her compacted so been thru disimpaction over & over. She’s now under a children’s centre incontinence team who have had her on 2/4 movacol a day, 10ml pico sulphate, 10ml Senna... so she’ll sit on loo (reluctantly) & maybe every 7/10 days we get a proper clear out but this surely isn’t enough is it?

My family are now saying because it’s all so upsetting for everyone involved listening to her screaming on loo or crying in pain (tummy pain) I should look into going private! Has any1 else done this? I think it would be a box ticked that we’ve tried but really I can’t see what they’d do that we haven already tried, it’s her thats holding it & there’s no magic wand so all I can do is continue to put her on loo twice a day & hope for best... is upsetting when I think she’ll go then with holds so I get stressed & sometimes shout to try to make her understand she mustn’t hold it & not to be scared but it’s been years so I can’t see anything is actually working.

Any replies are useful thanks in advance.

[Robinia]

I did go and see a private nutritionist with my son, and an osteopath. Next we are trying a chiropractor (next week). I think it’s worth excluding food intolerances. 2/4 sachets sounds a bit odd. I would stick with 4 daily and if necessary try a disimpaction week (under medical supervision) . My son is so miserable when his poo is stuck so I up him from 4 sachets to 6 as soon as it starts to get stuck. He soils constantly but that is better than the pain he experiences when his poo is stuck. I would go massively down the reward route for daily sitting on the loo. Best of luck xxxx

[Frustratedmum1]

We have got to a stage where we are strongly considering it. We are also going to see if a chiropractor can help. Personally I think it is easier to stay on the same amount of movicol each day than going up and down. Also when I did this i found it harder to work our what they should be on.

Perhaps it would be wise to do a discompaction programme. Sometimes the senna and picosulphate will give them more cramping because they are stimulants and it is helping get things moving. My son has screamed the house down in pain and it has broken my heart. Stick in there.

Another suggestion is swimming. Play with them in the pool, tickle there stomach but pressure on it. I find this does help my son get things moving on occasions. Soft play is good for them ie the rollers you can get.

With the with holding that takes alot of time and pateinance. What I found with my son he didn't understand what was going on. Try not to lose your rag. This is harder said than done on some days. They seem to pick up on your anxiety and I also found that was putting more pressure on to my son. Once I relaxed things got slightly better.

I hope things get better but listen to your gut

[Lozza00 in reply to Frustratedmum1]

Hi thanks for the reply. She goes swimming most weeks & I sit there worrying like mad the big ‘release’ will come out in the pool!

She’s been sitting on loo twice a day but only by chance something comes out & every so often we have a ‘clear out’. But we’ve been here before & just go round in cirlcles... was thinking a private paediatrician but part of me thinks it’s all pointless as no1 can force a child... other than suppositories which would take at least 3adults to hold her down to get it in (nurse couldn’t even do it) we really feel everything’s useless yet she’s taking all this medication every day & has been for months! It is so so hard 😫

[Robinia in reply to Lozza00]

You’re not alone. My son just spent a few days at his dads and has come back blocked. He’s been taking all his meds, drinking plenty and sitting on the loo 3 times a day but his dad doesn’t check his poo obsessively like me! He’s now on 12 sachets with just dry teeny soiling coming out....argh 😫 also in horrendous pain. He’s been swimming, cycling and trampolining since getting blocked, going horse riding this morning! One thing that’s helping loads (especially his anger/mood) is he’s now using my tens machine. I’m putting 2 pads on his abdomen and 2 on his lower back. He’s definitely less angry. Hopefully things will move over the next few days. We have GP apptmt Monday with a GP I trust. Some of these kids seem really prone to getting blocked and it’s very hard but at least we know we aren’t the only ones, 🧡

[Lozza00 in reply to Robinia]

A child nurse, mum of older daughters friend just said everything we’re doing is all there really is to continue to try although when her little uns struggled she used lactulose which she said worked better than pico, movacol & Senna... anyone had their kids on this? It’s one of the few we’ve not had yet?

[Robinia in reply to Lozza00]

We used it when he was young before movicol, didn’t help at the time but I’m sure your GP would prescribe it if you talk to them about it. Personally I would try anything I thought might work!

[Frustratedmum1 in reply to Lozza00]

At the end of the day no one is going to know your child like you so please remember that.

If you don't think something is not working say to your doctor and give them your reasons. They will be able to use it in combination with other things.

To give u an idea my son's maintenance dose is 7 sachets of movicol and he is blocking again and i cant get my head around it. I spoke to his doctor and said we are going backwards drastically and explained why. They have now introduced a type of stimulant for a short period of time and he appears to be going again. Fingers crossed. Sometimes they just need a kick start. I found everything takes longer than you want.

Persistence is key,even when it feels like its not working. I am thinking of you.

[FranAdam]

Not to step on anyone's toes but 2/4 is not enough Movicol if you are still bunged up. All that will do is stir things up and give belly ache. I am presuming she is still impacted because she is not opening her bowels enough. You want a minimum of of 3 poos per week which are soft and sausage like ( look at Bristol Stool scale).

Try the recommended disimpaction regime:

Day 1 4 sachets

day 2 6 sachets

day 3 8 sachets

day 4 10 sachets

day 5,6 & 7 -12 sachets

Then maintenance dose of 2 sachets per day, titrating up or down depending on response.

[Lozza00 in reply to FranAdam]

Hi, thanks for this, she’s also in pico sulphate & Senna, she’s been on 6 movacol now for 2 days & has just ‘been’ but obviously like water... few weeks ago we had just over a week where things had calmed down & she was ‘going’ a lot more & stools were getting to the point of being more formed. Unfortunately things then get worse & she started to with-hold again so was massively impacted again. We’re under the childcare nhs incontinence team who tweet the meds whenever things go down hill.

Any input / info always welcome.

She starts school next year so I’m preying with time & her getting older she’ll grow out of it but she’s suffered since she was tiny so I do wonder..

[Lozza00]

Still on all above meds but getting no where!

So finally had enough & managed to get suppository in her at 11am today- she’s still with holding & only had a tiny amount of over flow in potty. She’s massive now & so so uncomfortable. I hope the specialist can come up with something else tomorrow now I’ve tried the suppository ☹️

[Amy1985]

How did it all work out, Lozza?