Disimpaction

[rvc123]

Hi all

I wrote before about my daughter having mucus in her poops, and the possibility of there being a blockage. We’re doing a disimpaction this week while we are off school, and I’m currently upping the movicol daily. My question is, once we get to the watery stage, and want to reduce movicol, do we cut straight back to our maintenance dose or do it slowly?

Thanks in advance 😊

[MrsKS30]

Hi, best of luck. You move into a maintenance dose afterwards. Here’s a good link, the maintenance doses are listed towards the end of the web page.

eric.org.uk/pdf-a-parents-g...

[rvc123 in reply to MrsKS30]

Thanks for that, I was looking at it last night too... but when we go to maintenance; do I go straight from, day 8 sachets daily back down to say2, or do I go back down 8-6-4-2?

Thank you for replying 😊

[MrsKS30 in reply to rvc123]

Sorry I know what you mean. It could be trial and error. This is another good link. I hope you get more replies based on others experiences.

thepoonurses.uk/maintenance...

[rvc123 in reply to MrsKS30]

Thank you so much. It’s a minefield.

[MrsKS30 in reply to rvc123]

Absolutely! I find my daughter aged 3 has a few good days and then we are back to square one. It’s so frustrating. Best of luck with your daughter!

[fedupmum]

Hi , I found reducing it very slowly is working . My son has gone from the 8 to clear him down to 3 sachets over 18 months , reducing it by half a sachet at a time . Good luck.

[Barbiecar]

Hi, I just wrote this post which might help...

I have an old friend who is a consultant paediatric surgeon and I quizzed her tonight about my daughter’s chronic constipation and the best course of action. Here’s what she had to say.

Many many cases arise from an anal fissure (tear) at some point in the child’s past, even as a baby. A fissure is notoriously slow to heal and easily torn again when passing any solid poo. So you can well understand why withholding becomes the preferred option for a child who has experienced it. Looking back, I remember one occasion when my daughter did make herself bleed by pushing too hard. Things are starting to make sense.

My friend went on to say that because of this, Movicol is the preferred treatment; it it is considered to have no side effects and creates the right consistency for healing to take place. 3 months of porridge like poo is required to allow the fissure to heal. In other words you WANT the poo to be falling out of them so that it eases all pressure on the anus.

So I would say from that, even after a disimpaction, keep the poo as loose as porridge with the laxatives, don’t aim for solid poos for 3 months. I guess the child needs to be disimpacted AND healed before he or she can even think about pushing again! Otherwise, as with my daughter, the likelihood is that the whole thing will just keep repeating itself.

It was a useful conversation and I hope it sheds a glimmer of light for some.

[rvc123 in reply to Barbiecar]

Thank you for that... were porridge like at the minute 👍🏻 and surprisingly there have been no accidents, which I’m surprised about as she’s now on 6 sachets a day. I thought by this stage we would be at no. 7 on the scale.