Is disimpaction needed

[EggandSpud]

Hello, my 5 year old has suffered from with holding poo for years , we finally got on top of it, but since COVID and now going back to school we are having poo accidents again.

My question is whether she needs a disimpaction routine or just to continue with maintenance dose:

For the past few weeks she is passing very large stools every 3-4 days, for the past few days we have up the lactolose and she has now passed two very big stools, one today the other two days ago! Surely that should have cleared her out, or does she need more?

Thanks for the advice. I’m clueless

[Yaleamanda]

What do her stools look like on the Bristol Stool Chart? Do the accidents appear sticky and smell very bad? If so then yes disimpact.

[EggandSpud in reply to Yaleamanda]

Hello

Thanks for replying, I would say the stools are a 4 on the chart, the accidents aren’t sticky but do smell, they tend to be squished where she has tried to withhold.

[Yaleamanda in reply to EggandSpud]

I would switch from lactulose, it's pretty ineffective, i would ask for movicol and consider disimpaction.

[EggandSpud in reply to Yaleamanda]

Thanks, can I ask what makes you think disimpaction is needed? I’m just not sure. Would the passing of the big stools not have cleared her out?

We seem to get more results with lactulose , maybe we need to use more movicol? X

[SCPK in reply to EggandSpud]

We tend to get results with lactulose too, despite it being described as a more gentle laxative. We really struggle to get the movicol into our toddler as she doesn't drink much, so we find lactulose a good top ip option.