4 year old - first disimpaction. Please help

[Husky30]

Hello,

I have tried the helpline for 2 days but unable to get through due to the current situation.

My 4 year old has been put on a disimpaction regime using movicol, but we have conflicting advice about when disimpaction has been achieved.

The hospital paediatrician said as soon as he had a bowel movement '7 on the bristol stool chart' we should reduce the dose by half.

He has had 3 days of bowel movements 'chocolate custard' in appearance-The GP who gave a follow up call advised that this evidences the impaction has cleared and we should halve to the maintenance dose now.

Advice on the ERIC website says we should wait for 'brown water' before reducing the dose to ensure disimpaction has been achieved.

We have a very distressed little boy (and therefore distressed parents). He is withholding as much as he's able though is constantly 'leaking' quite large amounts so we have had to put him in pull ups.

He's in a huge amount of discomfort but we're unsure if this is still due to actual pain from impaction or whether the impaction has cleared and it is fear of the process along with bloating from the movicol itself.

As a result we are very confused as to whether disimpaction has been successful, or whether we should be increasing or decreasing the dose?! ... any advice would be much appreciated.

[Yaleamanda]

I would definitely keep going until you reach rusty water looking poo, then stay there for 3 consecutive days before you start reducing the dose very slowly 8,8,87,7,7,6,6,6 and so on until you reach a suitable maintenance dose. Dont rush the disimpaction, you will end up back to square one.

[Bambie83]

Have you reached the largest dose yet? He really only needs to reach the watery stage a few times for you to know it’s disimpacted fully.

Keep going - it sounds like you are really close.

[Littlefair]

Hi Husky30, we're in a similar position now so I'd really appreciate you're advice. Did you keep going and reach rusty tea or reduce at this point? If you reduced was it successful? I keep hearing conflicting advice too. Many thanks.