Advice on Movicol - lg not knowing when she needs to go

[Yippieyay81]

Any advice? My daughter has been on 1 sachet maintenance dose since disimpaction. We have been working to improve her diet/water intake. The last few days she doesn’t seem to have much control so we’ve been having a few accidents. Previously she was aware when she needed to go & mostly made it to the toilet. Doctor has said to try 1 sachet every other day & possibly add Senna to help her recognise the need to go. I’m terrified that I’ll reduce it too quickly and we’ll be back to square one!

[Nanoiu]

How old is you daughter? Can you give a bit more information to understand what have you tried so far? How long ago was the disimpaction?

[Yippieyay81 in reply to Nanoiu]

Hi thanks for your reply! She’s 3.5 years. We did disimpaction for the first two weeks of September. It took a long time & she was distressed by the mess so we put her back in nappies for that time. From when we took her out of nappies up until the last week or so she’s been going most days in potty or toilet at home, recognising when she needs to go most of the time with the odd accident, maybe once a fortnight. At the same time we’ve been really working hard on her diet/fluid intake. The 4 days or so she’s been having accidents & saying she doesn’t know when she needs to go.

[Nanoiu in reply to Yippieyay81]

So before disimpaction she wasn’t soiling nor witholding poo, is that correct? Then why do a disimpaction?

Did you use Movicol during disimpaction or something else?

For how long have you been dealing with constipation?

After disimpaction what kind of poo did she pass (do you know about the Bristol chart?!) did it get to a 4 or do you keep it runny ?

My 6 year old uses 1 sachet of Movicol as maintenance dose and poo would be a 4/5 on Bristol, a fluffy poo barely keeping shape. Gave him 2 Movicol for several days and the poo got runny, then he had accidents.

If your little one does not soil nor withhold, then why not keep the poo at a 4 Bristol shape? Formed, sausage shaped but soft. In which case you reduce the Movicol. By a few grams every 3 days.

[Yippieyay81 in reply to Nanoiu]

Hi! She became constipated in July of this year following potty training...she had a massive fear about going in potty/toilet & began to withhold then. Prior to this we haven’t had any issues. We used Movicol and Senna for disimpaction. 1 sachet of Movicol used to be perfect (soft but formed poo & she was aware of when she needed to go) but I’m wondering if she needs her dose reducing now that her diet/fluid intake has improved...

[Nanoiu in reply to Yippieyay81]

There are a lot of people on this forum wondering if their child has accidents because of Movicol or because of a stretched anal sphincter or overflow. You’ll have to experiment.

But then, in your case, the constipation was caused by withholding due to fear of the potty. But you mention now she’s using the potty. How did you overcome that? Did she stop withholding?

[Yippieyay81 in reply to Nanoiu]

As soon as she realised that it wouldn’t be painful to go she was fine with using the potty. I’m guessing there are going to be weeks where we feel that it’s not going so well but I’m still trying to get to grips with the fact that it feels like it’s starting to take over our lives! We are going to try to reduce it a little this week and see how it goes. Thanks for your reply’s!