How Long Did Disimpaction Take for You?

[Jellylorum]

Hi everyone,

My son is nearly four (still in nappies) and has struggled with constipation since he was 6-12 months old. I think his bowel is probably quite stretched as we were prescribed a maintenance dose of Lactulose / Movicol for a long time, though with hindsight he was clearly impacted.

Anyway, we're currently two weeks into a Movicol disimpaction and some parts of his poo occasionally seem quite dry (like a light brown smear, little lumps of plasticine or tiny crumbs). He tends to alternate - a completely liquid poo and then one with a few bits in it. They can be pretty be explosive (down his legs or up his back).

I'm assuming we're not done yet but I'd be interested to know how long disimpaction generally takes as I get the impression from other posts that it's usually faster than this. I have visions of years worth of dried out poo lining the walls of his bowel and gradually breaking off a tiny bit at a time... in which case we could be doing this for weeks! I want to be 100% sure he's clean though. He's never been x-rayed, though I'm considering asking for one if we're still in this position in a couple more weeks.

Thanks in advance to anyone happy to share their stories.

[KR01]

Hi there, my son is 3.5 and we've done it twice - both times took around 6 days. 2 weeks does seem like a very long time - we were told to stop and reduce the dose by half as soon as we had the first pure liquid nappy, which we did. What dose are you currently on? We got to 6 (we were told to go up to 8 if needed) which worked for us so he's now on 2-3 sachets per day. It might be worth reaching back out to your doctor/consultant to check as I'm certainly no expert but I was told it should only take up to a week. Like you, my little guy has been suffering for some time so is quite stretched (I assume) therefore it's hard to know what the right maintenance dose is. We have another appointment next month and I'm also going to push for an x-ray to see if he's clear - given they are so stretched it's very easy to get backed up again

Good luck!

[Jellylorum in reply to KR01]

Thanks, that's really helpful to know! We're currently on 8 sachets per day and my son hasn't done a liquid poo for a few days now (there have been lots of poos but they've always been lumpy). I'll try and check with the consultant at the start of next week. We've been told to give a maintenance dose of half the disimpaction dose to start with, which sounds like the advice you've been given too.

Good luck with the appointment next month. This is our second disimpaction too as my son was found to be impacted again a couple of months after the first, although we're not clear whether the maintenance dose was too low (it was only 2 sachets last time) or whether he was never properly clean. I wish we could have a little window so that we could look inside to see what's going on!

[Yippieyay81]

Hi there! I just thought I’d add that apparently it’s not unknown for disimpaction to take longer than the average 7 days. We were nowhere near finished disimpaction with my 3.5 year old after 10 days (with quite a few days on 8 sachets of Movicol per day). I went to the gp and we were given Senna in addition to Movicol. It took another 4 days of 10mls of Senna in the evening before she was disimpacted so maybe you need something else in addition? Good luck! X

[Jellylorum in reply to Yippieyay81]

Thank you, that's useful to hear. I think we're in the same boat as you were so I'll do the same and ask whether we can give some Senna on top as well. We don't seem to be getting any closer (just more brown mush over the weekend!) so he probably needs something more just to help him get everything out.

[Nicky555]

We had to get to 12 sachets and took 10 days. Nurse told us we needed to get to the brown water stage then half the dose for maintenance and slowly reduce from then. Also we were using pico sulphate along with maintenance dose.

[Jellylorum in reply to Nicky555]

Thank you! Do you mind me asking how old your little one is? I took my son to our GP on Tuesday and asked whether we could increase his Movicol dose above 8 or add some pico sulphate (he's nearly 4). Unfortunately our GP felt it was beyond his remit but he's referred us back to the hospital. Hopefully we'll finally get a scan too. It's interesting to hear that you gave pico sulphate along with the maintenance dose as I think that might be the answer for us too. My son has never had hard poos, he just has difficulty getting them out, so I worry that a maintenance dose of Movicol alone might not be enough.

[Nicky555 in reply to Jellylorum]

He was 13 when we did the last disimpaction not sure how much you can go up to for a little one. All our advice was through continence nurse as the doctor didn’t really have the specialist knowledge about how long to carry on, getting to brown water stage and then slow reduction.

[Em2006]

Have a google search for the poo nurses who explain it really well. They advise to keep going until you have watery poo with no bits in. Other people on these forums recommend staying at watery poo for three days before reducing down very slowly. I suspect this is because it can go watery and then back to lumpy again as more poo is removed, as we experienced.

We are currently on day 15 at 12 sachets with our 6 year old and only now considering reducing, simply because we've not seen any real change the last few days; it's mostly watery with some little flecks. We will be reducing to 11 for a few days and then by one sachet a day until we get type 4/5 poos. I think the poo nurses suggest reducing by 2 sachets at a time, rather than by half. It's tough when you receive conflicting advice but so important to get a full clear-out. We don't want to do subsequent disimpactions either.

Out of curiosity, does anyone know how much the private x-rays cost?