Where did I go wrong?

[76middleton]

Last month we did our 1st disimpaction with my 8 year old daughter, everything was good for a few weeks, pooing most days and no overflow but now we're back to square one and the overflow is worse than ever!!! I'm distraught, what happened? We reduced the sachets down to 2 a day gradually after disimpaction but I'm guessing we should have kept her on a higher maintenance dose. We are going to disimpact for the 2nd time, I'm even keeping her off school to get this done. Please can you give me any advice/tips as to how I can make sure this disimpaction is a success and we don't end up at square one a month later. Many thanks in advance.

[CJDavies]

I am no expert at all but just wondered whether your daughter is still pooing fully daily? It sounds like you followed the advice to get to a maintenance dose but maybe worth playing around with this. Perhaps two is too high for her? Given she is eight and probably better at communicating, what is she saying about why she is struggling again? By the way- you didn’t go wrong, this is just such a complex problem that is different for every child and we are all just doing our best to try and help them.

[Frustratedmum1]

You haven't gone wrong. It is just a steap learning curve. Each set back you learn a little bit more. Each child is different. For example my son needs to go twice a day and do a tidy amount each time for him to stand a chance of not blocking again.

As a guide what they say what ever they unblock at half the dose and that will give you a guide to what their maintenance dose should be around.

The one thing i do now, is slowly reduce the movicol when I'm getting close to the maintenance dose. Also if I'm in doubt I keep it slightly higher.

With my son quite often we have solid mass in the bottom and alot of dirty water. I'm coming to learn this is probably overflow in his case. Hence I increase his dose especially if his behaviour is changing.

I find my son's behaviour is the best sign of constipation. This shows itself before the appetite starts to go etc

Good luck.

[Nicky555]

Sounds like you are doing s great job. I know that when we did disimpaction last December we were on high doses of movicol as well as suppositories that took months to slowly reduce. Now still on 2 a day 9 months later as needed time for bowel to heal and sensation to return. Maybe ask continence clinic for a medication plan after disimpaction. A month on from disimpaction down to two sachets feels really quick.