Disimpaction - afterwards

[Redxmas]

My daughter has been off 1.5 weeks doing disimpaction. She got to the brown water stage for a few days then we slowly reduced down and on 3 doses. For past 6 days she has been having slight stains followed by her asking for toilet and always passing watery stools on the toilet if her on accord. Today was her second day back at school And arrived to be told soiled and didn’t say anything. Does this mean disimpaction hasn’t worked?

[Msarg666]

Not necessarily, it could be that the dose is too high after disimpaction. I would probably lower to 2 doses and ensure she sits on the toilet at the same time daily.

[Nicky555]

I wonder what advice people get for dosage following disimpaction. I know when we did it the continence nurse was clear that after brown water we had to half the dose then stayed like that for months alongside pico sulphate. The pico sulphate was reduded and stopped before any movicol was changed then movicol was reduced over the following 6 months very very gradually. The whole process following disimpaction took 10 months. It was to allow the nerve endings in the bowel and rectum to heal and start working. I would go back to continence clinic and ask for a plan following disimpaction.

[Redxmas in reply to Nicky555]

Thanks. My daughter is under a consultant and he advised the disimpaction but there wasn’t anything about after care. I made contact with my health Visitor and advised it needs to drop to between 1-3 daily movicol for her age. She is also on 5ml if pico but haven’t been told what go do with it.

[Nicky555 in reply to Redxmas]

Our pico was a suppository daily and was reduced slowly before starting any reduction in movicol. Our lad was 13 at the time. The doctor had given different advice previously about movicol dosage and the disimpaction failed, the continence nurses are fantastic and really know their stuff. We had completely different plan under them and it worked. He had been soiling since age 5 before he came to us at 12. We started fresh with looking at potential problems and discovered he was impacted and this was because his bowel muscles and nerve endings no longer worked. hence the disimpactions and then more importantly the long term plan for his bowel to heal. It’s so hard for the children and the adults trying to get the right support. Maybe ask consultant for more support around after care following disimpaction otherwise as we discovered the reason they become impacted is still there and starts again.

[Redxmas in reply to Nicky555]

Thanks x