First disimpaction

[Em2006]

Hi,we are trying our first disimpaction with our six year old. We are on day 2 at 12 sachets. He is having mostly liquid poo now, with the odd specks or bits of undigested food and wind when sat on the toilet. He is not feeling the Poo coming yet but is noticing when he h as had an accident. I assumed there would be lots of accidents while disimpacting anyway, is this right? We haven't had any dark sludgy poo or any hard poo. We started with lots of pale skinny sausages. He hasn't been examined, just a telephone consultation with the gp who said it sounds like his two year symptoms suggest he is impacted.

Does it sound like the suspected disimpaction has worked? I'm wondering how long to keep him on this 12 dose. The gp wasn't clear about how to reduce to a maintenance dose.

The whole process is a little unnerving, especially when I read about the really long battles other families experience, and repeated disimpaction regimes. Any reassurance or guidance would be great!

[Yaleamanda]

Essentially you need to stay on the maximum dose until you get poo that looks like rusty water, once you do stay there for 3 consecutive days before you start to reduce the dose very very slowly i.e. 12,12,12,11,11,11,10,10,10 and so on until you reach a suitable maintenance dose to remain on.

[Robinia in reply to Yaleamanda]

This is great advice- love it when you give this response!! It’s helped me 😃

[Yaleamanda in reply to Robinia]

No problem. happy to help

[Em2006 in reply to Yaleamanda]

I thought we were on rusty water yesterday, but there have been more solid stools today so we will continue on 12 for a bit longer.

Once it seems that disimpaction is complete, will he be able to feel the need to poo again, or should we expect this to take time?

I'm just starting to suspect that the issue may actually be very subtle withholding, so will need to keep an eye on this!

[Yaleamanda in reply to Em2006]

It may take time to get the feeling back again. Keep going at the maximum dose until you see rusty water looking poo for at least 3 days consecutively.

[Em2006 in reply to Yaleamanda]

We are now on day 6 at 12 sachets and still seeing lumps in poo; it's not consistently rusty water yet. How many days should we stay at full dose before seeking further guidance from the GP? It seems that the food from the same day is being digested and passed, which I assume is a good sign that it is making its way through the colon. However he is still not feeling any accidents, so I assume that he is still impacted.

[Yaleamanda in reply to Em2006]

Keep going until you reach rusty water looking poo, it will take time. It can take a good couple of weeks to fully clear out. When you get to the rusty water looking poo stay there for 3 consecutive days before you start reducing the dose very slowly ie 12,1212,11,11,11,10,10,10 and so on until you reach a suitable maintenance dose of movicol.

[Em2006]

Hi, we have now been on 12 sachets for 10 days. There is still overflow soiling, although less. Poo is still not liquid but there seems to be less of it now. We're reintroducing toilet time after each meal again as the accidents are less frequent but no other indication that he needs a poo. There is almost always something to come out when he does toilet time. Are we still on the right track? At what point should we speak to the GP again if the poo doesn't turn liquid?