Once dis-impacted how long to i keep the increased sachets up?

[1Luckflower]

We are new to this and my 2.5 year old has dis-impacted, but we weren't really told what to do from there? We started from 1 sachet for the first couple of days and then up to 2 sachets on the 3rd day of no poo and up to 3 sachets on the 5th day. Then everything cleared and her stools became very loose and frequent for a day or so. So I stopped and went down to 1 sachet a day again as maintenance and everything has slowed up again with no sign of a poo in 3 days. My question is should I have dropped down from 2 to 1 over time? Did i jump the gun by dropping off the sachets too quick? I'm a bit confused?

[1Luckflower]

I'm actually going to reply to my own post as I think I've found the answer, looking at the ERIC site. We did not get to the brown water stage, so probably didn't clear out the whole bowel. I will up the sachets again over the next few days, but would still like to hear other peoples advice about how to balance her out once we've achieved a full dis-impact

[Blackberrypie in reply to 1Luckflower]

I think you're probably right about not being quite finished with the disimpaction yet, sorry!

As for finding the maintenance dose, basically you just have to adjust for your particular child and find out by trial and error what keeps them on track (generally a daily stool somewhere about 4 on the bristol scale is seen as ideal). I seem to recall we changed the dose by half a sachet at at time and then watched for 2-3 days on that dose before changing the dose again. Recording stools/medication is helpful. I think it's also a good idea to make sure you keep water intake consistent as it's easy for this to drop when you reduce the movicol. It also helped us to introduce timed sitting for about 5 minutes about 20 minutes after meals - no pressure, just hoping to take advantage of the natural reflex of the bowel to be more active after meals.

Good luck!

[1Luckflower in reply to Blackberrypie]

Thanks for your reply, when we get to where we need to be with a complete clear out I’ll decrease slowly. I was so worried about giving her the runs and a stomach ache, I went from one extreme to the other which took us back to square one with a huge hard stool again this morning.

[Bambie83 in reply to 1Luckflower]

I did the same thing the first time but by the third time I figured to stay on slightly longer than I thought originally.

Once you’ve achieved the watery stage stay there for three days at the highest dose. Then reduce it gradually... I’d say 1/2-1 sachets every 3-4 days until you find a maintenance dose that produces 1-3 soft ‘snake like’ poos per day.

As she’s still so young, you might not be at the stage of getting a toilet routine going but maybe start by getting her to sit on the potty or even in her nappy 20 mins after each meal and blow bubbles or balloons and get her used to regulating herself. It will make it easier when you do start toilet training.

Hope that helps make it all clearer!

[1Luckflower in reply to Bambie83]

Hi funny you should say about potty training! She is happy to sit on the potty and often does when she feels the need to go, but get hysterical if I suggest we take the pull ups off. I hadn’t thought of particular times to sit offer meals though, we’ll give that a try. Thanks

[Bambie83 in reply to 1Luckflower]

Kids! They’ll do it in their time! She’ll get there though - we’ve been at this since Christmas and my four year old is only just starting to tell me when needs to poo (guessing the sensation is finally coming back).

Good luck!

[dharshana in reply to Bambie83]

that's good to hear.all the best

[Grayzie2009]

I've just been where you are at, well we've cleared it out now 🤞 I hope and we are on the maintaining, it's so hard and feel like we've just been left to clear it without really knowing, my daughter is 11 Yr old we ended up in hospital, I've suddenly become obsessed with my daughter bowle movements 🙈

[1Luckflower in reply to Grayzie2009]

Hi I know, the doctor was very sympathetic on the phone, but didn’t explain any of this process. It’s actually quite a long process which obviously needs easing up sachets wise and easing down gently too. I had no idea such a small body could be holding so much, I just assumed that was it 🤦‍♀️ I hope you find the right dose to level everything out, it horrible watching them struggle. My 2 year old is now frightened of going, I think potty training is going to be a nightmare 😩 xx

[Grayzie2009 in reply to 1Luckflower]

Many of times when my daughter was younger we had trips to a & e to get suppository, her diet isn't good she hardly eats, unless I pin her down I don't know how to get the food in her, I thought we were over it after getting up to 10 sachets of movicol a day and weened down to two but last night when she's went made me think it could be back 😢

[1Luckflower in reply to Grayzie2009]

Oh that sounds very stressful for both of you! I realise now my daughter has always been constipated even as a baby her stools were like play doh. She does eat pretty well but slows right down when she has tummy ache which was usually followed by something that would make my eyes water 😳 I i work in a care home, I seem to spend most of my life discussing poo between work and home 😂 xx

[RBsMama]

My GP recently said to me not to stop the sachets... even if it’s only half a packet a day or every other day. Think lots depends on how much water he drinks because thats what the sachets soak up to make the poo softer. I found a food and drink diary helped. Also now i use tv time to encourage him to eat veg. He bow eats the food and drink shows me ‘all gone’ and i turn tv on. Just so i know he has had enough fibre and water for his bowels.

All trial and error to figure what works for your child and their bowels.

I had terrible constipation as a child. Have IBS.... figured my diet, foods to avoid that build gas (like it blocks the poo for me... pass wind and then go toilet) after a dietitian my bowels are managed very well and think my picosulphate solution (for constipation) might even be out of date. Only saying all this because i lost hope and thought i had to live with it.... now different life 😀

[1Luckflower in reply to RBsMama]

To start with fluid intake was good, but she was avoiding food probably because she was so blocked up and asking for milk to fill up instead. I think the milk may be the issue as she has been constipated since very small. I find my daughter ignores veg on her plate, but loves it in a bowl to graze on through out the day. I’ve got her down to two drinks of milk, one first thing and one before bed that I’m now diluting with water and she hasn’t noticed yet. I can see the sachets being a long term thing, thanks for your info it all helps. Xx

[RBsMama in reply to 1Luckflower]

No need to thank me... sometimes its also frustration thats hard when run out of ideas and no medical advise! Just a thought of looking for hidden veg ideas.... iv just bought metal food cutters (plastic didn’t work well) and planning to mash veg with mince, egg and cheese then use bread crumbs and cut into the shapes of vehicles. Anything for an easier life 🙄🤷🏼‍♀️😂 x

[RBsMama]

Milk shake with a bit of milk and water?? Ohh what would she be like making her own smoothies with you for her bowels? Add a little icecream? My son still likes the fruit puree drinks that he had as a baby.... cheap from aldi could add them. As soon as think its sorted the little monkeys suddenly dont like the smoothie or something. Im now saying no its my...... and he wants my fruit..eating veg when its an aeroplane spoon, i know its a matter of time before the novelty wears off x