4 year old still soiling after a disimpaction and maintenance dose.

[BrAl]

Hi, we finally had a break through with out 4 year old in early December after getting in touch with the Eric helpline. He had been soiling every day and often more than once, and the school were getting pretty frustrated with it (he's in reception). We did a disimpaction and everything seemed to be going great, we were accident free from boxing day and he even started taking himself to the toilet without needing to be told it was 'toilet time', he was feeling it for himself. His maintenance dose of movicol has stayed the same but we dropped out of the toilet time routine as he didn't seem to need it anymore. However, over the last couple of weeks we've noticed him soiling again, just small amounts in his pants, soft and very sticky and smelly. Just like it was before the disimpaction. Any ideas why he may have regressed? Do we need to do another disimpaction and start from square one? Or just start the toilet time routine again? Thanks any ideas would be greatly appreciated.

[Robinia]

I would recommend another disimpaction and then follow up with a higher maintenance dose than last time. At that age a classic issue is them not drinking enough in school. Get him a bottle with the amount on and explain to school how much he has to drink every day. If poss hot drinks at home like hot squash can help. Also go back to toilet routine and include hot bath eg hot drink, hot bath, toilet time every evening. Also use bristol chart to keep a close eye on how often he is going and the consistency

[BrAl in reply to Robinia]

Hi, thanks for the reply. He has been going to school with a bottle of water to drink but it comes home full most days, even though it's on his healthcare plan to drink it. I guess we'll just have to try harder to explain the importance to him and his teachers. I think we got a little too complacent thinking we'd got to the bottom of it. Thanks .

[Robinia in reply to BrAl]

You could always try a bottle that’s not see through and put some squash in it if he doesn’t like water so much. My son drinks lemon squash at school from a metal bottle. He drinks 750mls at school each day (but he’s 11). Also he has his bottle with him at all times, even if the others have it on a tray outside the classroom. Sounds like school need to get on board a bit more, I know how hard it is xx