Lactulose and Senokot HELP

[Pamelasuzanne]

My son has been on Lactulose and senokot for 2 weeks.

Originally he was on 10mls 2 times a day of the lactulose and then 5ml of the senokot once in the evenings.

This made no change so I rang the pedestrian and she told me to start increasing the senokot until we get to 20ml and ring back.

We’ve got to 15ml and on Tuesday my son was pretty much on the sofa most of the day in discomfort followed by lots of poos.

The colour did change but the pain he was in worried me and I also have no idea when I need to start decreasing the amount (pedestrian just kept saying that we need to loosen up the hard poo but nothing about dis-impaction).

She’s currently on annual leave and my gp literally fobbed me off so I feel I’m left to it with.

Also reading NICE there is nothing about following the medication I’m following.

I’m just wondering now if I need to lower the dose now as the “maintenance dose”..

Anyone else using these two forms of laxatives?

[Pamelasuzanne]

I realise my phone had auto corrected pediatrician to pedestrian 😅😂

[Robinia in reply to Pamelasuzanne]

I would reduce the Senna by 5mls and monitor carefully how he gets on. Then in a few days if all is well you can reduce Senna by another 5mls. Keep fluids as high as possible and keep dairy to a minimum. You can always increase Senna back up again if needed

[Pamelasuzanne in reply to Robinia]

What am I waiting for? Should he get to a point where the soiling stops so much and then poos a certain amount a week (paediatrician said to aim for 3 times a week minimum).

I’m not sure if disimpaction fully occurred. Xxx

[Robinia in reply to Pamelasuzanne]

If there is still loads of soiling there may well still be impaction. Senna is a stimulant so can cause cramping and pain. The usual way to do disimpaction is with movicol rather than lactulose and Senna.

You could go to another GP and ask for them to prescribe movicol and watch the poo nurses video about how to disimpact with movicol.

Or you could persevere with current dosage of Senna and see if pain decreases.

Or you could reduce Senna slightly and see if it decreases pain while maintaining regular bowel movements.

Getting the meds right is sadly trial and error usually 🙄

[Hidden in reply to Pamelasuzanne]

Hi I have same situation as have son 13 been on 20 mls Lactulose twice a day and ten mls senna, he has been off school two weeks tomorrow. He has been in agony with stomach cramps his bowel is distanced although he was still going it was still storing up old poo.

He has been backed up for four days, dr yesterday said stop the Senna and keep the lactulose going and he prescribed Fybogel to take two sachets twice a day well he had one last night and this morning within two hours he had been to the loo, no straining either ! Seems to be much gentler !

He has been on Senna for a few months with extreme stomach cramps. He has had lots of vomiting and unable to go. It was also getting stuck ! Even antacids and anti sickness not working. He has spent last four nights up until early hours with the cramping which escalates through the day. It gets worse after each meal !

This is the first day in six months that I feel positive. I know its only two sachets but keeping fingers crossed. Box says its sugar free and gluten free never heard of it before.

It does contain aspartame which I would usually avoid but if it gets him going then see what happens.

I have noticed if I fill up a sports bottle he drinks more.

We have only had this for six months and still trying to get to the cause at the moment. I know its frustrating especially when your used to having an active child like mine. Hope this helps.

[Pinkpen]

From what I understand Senokot causes the tummy to contract in order to push the poo out. When we started we did 5ml for a week, then 10 for another week then 15ml building it up gradually. My son was in moderate pain but it definitely helped retrain his body to go to the loo. He stayed on 15ml for a few months and he no longer had the pain but I believe it got his body used to going and into the habit. I personally wouldn’t reduce the dose yet unless the pain is unbearable.

[Pamelasuzanne in reply to Pinkpen]

How long until you got to a regular stage? We are just pooing all the time here.

I did panic and went down to 10ml and then 5ml yesterday and today nothing for the morning but this afternoon it was just the usual bitty stuff that they get from overflow. Only difference is the colour isn’t dark anymore.

My son is still in nappies, didn’t even get the chance to start potty training.

[Pinkpen in reply to Pamelasuzanne]

I think the sennokot was pretty instant with my son (once we got to 15ml) he would take it in the morning and empty his bowel in the morning. Although we had to keep the movicol up also to keep it soft enough. I think it might be worth trying to get hold of the paediatricians office and ask to speak to whoever is covering her annual leave as it’s hard to guess and stressful for both of you.