Should we wait till the holidays before starting 2 we... - ERIC

ERIC

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Should we wait till the holidays before starting 2 weeks of Movicol?

Hudson_can
Hudson_can

My 5-year old always poos in his pants. Sometimes just skid marks, usually ‘normal‘ soft sticky poos, 1-3 daily, only a couple of times not for several days. A few times in the toilet but pretty much by accident, coming in his pants already. Literally 2 or 3 times in his life has he said he feels a poo coming; previously that he doesn’t know how to push, doesn’t feel it etc. But he definitely knows when it’s actually coming/has come, he’ll deny it at the time but admit when later (as well as denying it he’ll run away and/or faff about when finally in the bathroom, then refuse to wipe). He’s started school and teacher says sometimes goes and stands in a corner of the classroom and does it standing there - not go to the toilet at the back of the room! But he doesn’t seem embarrassed at all; other children were apparently noticing at nursery and it didn’t seem to affect him. He does have a referral for ASD/ADHD assessment, but no obvious sensory issues. GP has finally prescribed 2 weeks of Movicol, one sachet/day, though pack says 1-4 to produce soft stools. He has them, we just want to rule out constipation! With only 3 weeks/6 days of school left for him, should we leave it until the holidays or get on with it? Pharmacist said that it might not be messy and I really want to get on with it and see if it makes a difference. As he goes in his pants at school anyway it might not make much difference? But I don’t want it to get very watery and them be calling me in/refusing to have him for the last few days. Appreciate any thoughts.

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I should add, he’s definitely not afraid of the toilet - just seemingly can’t be bothered to do anything himself. School got him up to doing 5 wipes himself which we try to do at home too but are often met with defiance. Sometimes he’ll ask for help but when you go into the bathroom after a minute or two he won’t even have taken his bottoms down. I think now it’s maybe physical and behavioural, that perhaps he can’t tell that he needs it until the very last minute but now it’s also a psychological battle or something. Additionally, often he can’t clean himself completely because it’s dried on, having been sat on until someone noticed. He doesn’t like using wet wipes but of course we have to. We try to encourage him to tell someone when he’s ‘had an accident’ but he’s only done this a few times.

Sick of walking into a room and smelling poo, his constant denial and defiance, having to do some wiping because he won’t/can’t, and being called in by school to change him when it’s messy/the 2nd time in one day (I know they shouldn’t call parents in). He’s refused to try blowing bubbles on the toilet, incentives/consequences have no effect, and if we encourage him to put his feet on the stool he just kicks it away. School nurse had no particular suggestions.

Sounds like he is actually backed up and you need to disimpact him.

This is what I’ve been asking for for a while now since reading about it here! No medical professional has really acknowledged the possibility. I’ve mentioned Movicol to Drs since he was 4 but finally got a prescription for lactulose from one GP which had no effect; the school nurse told me afterwards that that wouldn’t have the desired effect anyway. So now got this 2 weeks of Movicol to try, if it has no effect on the problem though I wonder if they’d diagnose impaction? I read that you can’t do disimpaction without a diagnosis? And as he is pooing I think they really don’t see an issue.

You can absolutely disimpact without a diagnosis. Just request enough movicol from your GP to do it. Explain that you are following the Eric disimpaction process. You will need a lot of movicol, it is not a quick process despite what they may say to you. Essentially you need to increase the doses every 2 days and stay on the maximum amount until you reach poo that looks like rusty water, then remain there for 3 consecutive days before you start to reduce very very slowly, 1 x sachet every three days. After a week of disimpacting you can add a stimulant to the regime to help stimulate the bowels.

I feel your frustration. My almost 5 year old has periods like this. I think it’s better and then....

We dismipacted back in the autumn starting over half term and he went back to school while still ongoing. They were brilliant and helped with it.

That said we’ve had some issues again recently and I’ve decided to wait until end of term before doing full disimpaction again.

Good luck. It’s hard and exhausting as a Mum sometimes. X

I agree with Yaleamanda - I have been going through a very similar experience with my daughter and after three disimpactions since Christmas we seem to be seeing the light.

You can definitely go for a disimpaction without the GP telling you to. Without being mean, I’ve very rarely found GPs to completely understand the impaction/constipation situation.

You’ll need at least 2 boxes of medicine and at least two weeks spare. Once you get up for a maximum dose it can get pretty messy so it’s best to stay home. Once you e reached the liquid tea type poo, stay there for about three days and then gradually reduce until you find a maintenance dose that gives him 1-3 soft easy to pass poos and next to no soiling a day.

Once he feels he has more control over it all his behaviour might improve.

It would be worth (if you haven’t already) getting him to do a toilet routine. It’s difficult at first but it’s worth it in the end.

Hudson_can
Hudson_can in reply to Bambie83

Thanks. Would you go back to pull-ups in the daytime for the duration then? Normal poo in pants is bad/messy enough without it being liquid.

And routine-wise, do you mean trying to get him on the toilet for 10 mins every 20 mins after a meal or something like that? Tbh we’ve never tried to put a time limit on it as often he takes that long or more anyway even once on the toilet, though mostly faffing, not actually trying. Today he’s refused to go since I first asked him at about 1030 - it’s now 1330. If I want to get him up there will have to try a countdown which won’t work then potentially carry him etc. In the past we have tried a routine of setting an alarm to go off every hour for him to go and try. School said that was too often but it worked in that he did obey the alarm more than being told/asked to go. Didn’t work in that no real impact on poo, would just do one in his pants 20 min later, etc. Maybe every 90 mins/2 hours would be better. Was there a particular routine that worked for you please?

Bambie83
Bambie83 in reply to Hudson_can

I have used pull ups for maybe the last few days if we can’t get them on the toilet. Though interestingly she actually used to find getting the really watery ones on the toilet easier (maybe it felt more like urine...) but pull ups can help.

Yes that toilet routine - maybe try and see an alarm for 20/30 minutes after eating (I got her to pick her own cool song) and then find something he enjoys - I allow her some screen time but only after she’s blown bubbles for 5 minutes. I put a timer on it so she can see if counting.

It doesn’t have to be bubbles, you could use blowers, balloons or maybe a musical instrument.

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