Advice needed please

[Ems86]

Hi all, I am wondering if you can offer any advice. My nearly 5 year old has been soiling for a year now. In the first instance we were prescribed movicol and senna as they said it was overflow. We continued using until he had a big movement and then stopped - the doctor said we could stop if he’s had a large movement. Looking back this was the wrong thing to do but doctors weren’t overly helpful and was almost like they didn’t understand the situation my son was in. Fast forward a frustrating year of soiling and bad behaviour we went back to the doctors. I actually asked for a referral as it was heartbreaking seeing my son go through this on a daily basis not to mention he’s just started school. They have not referred him and have said that we need to give movicol daily. We have done one week of daily sachets combined with a toilet time routine and reward stickers which has helped, my son has passed daily sometimes twice daily, anything from a small nugget or two to a large ‘fluffy’ type poo. The problem is he is still soiling which is making me think he is still impacted?? We decided to give a double dose Friday and Saturday as it was the weekend to try and help but he’s not really passed anything and is refusing to push. I really don’t know what to do, he said he doesn’t care about stickers. He had a leakage this morning we sat him in the toilet and 3 very small drops came out but that was it and he refused to push. We are at breaking point and I’m not sure what to try next. We just want this sorted for his sake as it’s heartbreaking. Sorry for the extremely long post just wanted to give you the whole picture 😢 Thank you x

[redtomato]

Hi there, sounds like constipation and needs a disimpaction, as one large movement isn't clearing any blockages or clearing out the bowel. When constipated, the bowel gets so full, it stretches, you can get blockages and soiling is when there is leakage around the blockage, so it all needs to be unlocked with a disimpaction. My son did it under guidance from bladder and bowel nurses (he was referred to them from school nurse). If you don't see the school nurse already, then they can help, in the first instance. Get school to refer in to them, they should if impacting on his education and when you see the school nurse, if there is still no improvement, they can refer to bladder and bowel nurses. I would push for a disimpaction regime from the nurse.The disimpaction involves an increasing dose of movicol. My son started day 1 with 2 sachets, then 4, then 6, then 8 then 12, had to do two days of 12 as the one planned day wasn't enough, then reduce down again, though he got to the two days of 12 and nurse said that 's enough. The dosage and plan of how many to take and when will vary with age etc . For an effective disimpaction, you need to clear out the bowel completely til you only see brown water coming out.

[SallyandPaul]

Very good advice from red tomato also watch the video by the poo nurses,link on the right on this page. Good luck x

[Ems86]

Thank you for both of your replies. I have booked another doctors appointment for tomorrow, thinking they will say disimpaction which is what he needs. I just feel like an awful mum. I know it’s not my fault but I know I have reacted badly at the beginning as I thought he was doing it on purpose. We have had discussions about accidents and if it happens it’s ok but he must tell someone (teacher or us) because he cannot stay in soiled underwear but he isn’t saying anything. He must be so uncomfortable when this happens. I’ve stressed how important it is to tell someone and that people will not be angry that he’s done it but more so if he’s done it and not said anything. Fingers crossed tomorrow we get some more answers. 🙂

[M-bass]

Hi I would agree to see school nurse. They understand the situation probably better than the doctors for us and then they referee us to the bladder and bowed nurses, who understood but for us it’s been a very long process as my daughter is now 11. I too feel like a bad mum but keep going . You will get there x x