Nearly 4 year old still holding poo after disimpaction

[Moonbeam16]

Hi everyone,

I posted last year about our son withholding his poos during potty training, we ended up under Health Visitor support for this who said he was chronically constipated and needed a disimpaction. We did this before Christmas and had a clean slate in the new year for potty training.

He wees on the potty and loo no issues and is in pants and doing really well with this. We've had some poos on the potty which he had been so pleased about but over the past month it has regressed back to holding stools, soiling and only having bowel movements in his nappy or pants.

He is on 1/2 sachet of Movicol a day as per our HV advice, if we kept him in nappies he would easily poo every day but we don't want to keep relying on nappies as it makes him lazy with weeing. He is about to start a new school (nursery level) too and I don't want to be sending him in wearing nappies.

I just don't know what to do. We've tried rewards, bubbles and balloons to get his muscles pushing, book reading, games. We have started setting an hourly timer where we sit him down on the potty too. He just holds it in though. We are now 3 days gone without a bowel movement.

What on earth can we do now?!

[Yaleamanda]

You need to bowels under control before tackling the potty training. When you disimpacted did you reach rusty water looking stools before reducing the doses down very slowly i.e. 1 sachet every three days like this 8,8,8,7,7,7,6,6,6 and so on until you reached a suitable maintenance dose to remain on? His maintenance dose seems too low. As he is witholding you need to add a stimulant to the regime so that he cant resist the urge to keep it in.

[Moonbeam16 in reply to Yaleamanda]

Hiya, thanks for your reply!

Yes we reached rusty water stage and then reduced as you quoted. The 1/2 sachet doseage is what my health visitor and her colleague who specialises in incontinence advised, and they've told us to stay with this.

When you say add a stimulant, do you mean up the doseage of movicol?

[Yaleamanda in reply to Moonbeam16]

The thing is no one can tell you what the maintenance dose should be that's very much dependant on how much is required in order for an individual to produce type 4 stools on the Bristol stool chart, it's not a set dose I'm afraid. A stimulant is something like senna.

[Moonbeam16 in reply to Yaleamanda]

Thanks again for replying.

His stools are nice and soft and resemble type 4 on half a sachet, so no problem there. I didn't realise a stimulant was different though! Are these readily available in pharmacies or is it a prescription only thing?

[Yaleamanda in reply to Moonbeam16]

You will need a prescription.

[Moonbeam16 in reply to Yaleamanda]

Thank you so much for your help!

[Strugglingmumofboy]

I think disimpact again and higher maintenance dose

[Karenmh84]

Hiya my 4 year old was the Same talk to your doctor i did doctor put my son on laxido bout a month ago he goes to nursery they been great about it x