Decreasing the movicol dose over time - poos becoming small and sticky even on a tiny dose - help!!

[Gemc93x]

My 3 year old has been on Movicol for about a year now but we only really got the situation under control during lockdown. We followed the disimpaction regime and whilst she was off nursery we were able to play around with the dose enough to find the right maintenance dose. This was fine for a while, but every few weeks we found that this dose suddenly became too much and her poo became too soft and 'claggy' as we all call them! Bristol stool chart 5. I would reduce the dose by half a teaspoon at a time and she would go back to normal poos. This has continued but the rate at which we need to reduce the movicol seems to be increasing, and now her poos are becoming too soft on a weekly basis. We are now down to two teaspoons of movicol from an initial maintenance dose of 2 sachets when we first started. The last couple of weeks she has been doing very small, soft, sticky/claggy poos and hasn't passed what I would class as a decent sized poo for a couple of weeks. She gets really distressed when its like this and tries to hold it in. She says she doesn't like going because its too sticky and not easy to do. She will try to push but only a small amount of sticky poo comes out. What I am wondering is is this a normal part of reducing the movicol dose over time - is it her bowel returning to normal size and not needing as much now? She is over the psychological issue of withholding now and will happily go to the toilet when her poos are of a normal consistency. Just wondering if anybody else has had this where a once fine dose of movicol becomes way too much all of a sudden? I'm just so frightened she is constipated again and this is overflow, since starting back at nursery 4 weeks ago she has been drinking a lot less as she won't drink her water when she is there for half a day and it worries me that she hasn't passed a decent sized poo lately. Her tummy isn't bloated like it was during the initial impaction so I'm hoping its just a case that she doesn't need to be on it anymore and will be fine without it. I've reduced it down to 1 teaspoon today so hoping things might be a bit firmer by the end of the weekend - any advice is appreciated

[Robinia]

I’m wondering if she is constipated again. My son has a dark drink bottle for school with lime squash in it. He has a litre bottle and has it with him all the time (special permission) and drinks the whole litre every day. It’s a fancy one that keeps the squash cold all day with an easy spout to drink from. I’ve always found the drinking absolutely crucial. My son is on mega doses of meds but still gets a bit blocked up while at school and then we up the dose fri/sat/sun to make sure he’s clear by Monday.

I could be wrong obvs and she’s not constipated. That’s just based on what my experience has been.

[Kmm21]

Hi! We’re having exactly the same with my daughter - after being on lactulose she was going everyday but her poos were really big and hard.

So we started 2 sachets of movicol a day. This was ok for two weeks and she did lots of soft big sausage type poos.

But gradually the poos became smaller and smaller and now exactly like you described. Did you manage to get to the bottom of it? I’m sure it’s not overflow as she was doing a poo everyday and they were really soft. We reduced to 1.5, to 1 sachet, then half now for the past 2 days none because she is constantly doing tiny soft sticky poos. I though giving her body a break from it to hopefully let her poos firm up a bit before starting back on a v low dose like a teaspoon. How are you getting on now?

Thanks

Kirsty