Bowel impactation-10 year old

[Nsin]

Hi. I have a 10 year old daughter. I noticed things weren’t quite right when she was about 3 I think. Her breath stunk and she never seemed to do solid poos. GP ignored my worries and said it was all in my ‘first time mum’ mind. After 2 years of keep coming back to the GP finally referred me to a paediatrician who could see something was wrong but was a bit ... hit and miss, so he referred me to the gastroenterologist paediatrician who, after an x ray had no doubt it was impacted bowels. She’s gone through 2 Movicol des-impactations and one 1 clean prep at hospital. She used to have full on accidents (full wee and full poo load) when she was 5 and 6 but it’s been slowly improving. Now she doesn’t have heavy accidents (she was always dry in bed but she gets up once or twice a night) and she can mostly manage with using pads but suffers from urine infections quite often and urgency when needing a wee or a poo. My biggest question is that no one has been able to successfully explain me why is this happening to her and when will it stop. How can they successfully fix it if they don’t know why is it happening?? She is 10, this really affects her social/school life and mental health, and the whole family too... it’s heartbreaking and because it’s such a taboo concept (poo) she has to hide it from all her friends which makes her feel different and isolated at times.

[Yaleamanda]

Unfortunately functional constipation can just happen. Have blood tests been taken? What is she taking to help her go daily, how much water does she drink during the day?

[Nsin in reply to Yaleamanda]

Water drinking is a constant battle, she doesn’t drink enough. She’s taking Movicol and Senna daily as prescribed by the gastroenterologist

[Yaleamanda in reply to Nsin]

How much movicol and senna is she taking? When you have disimpacted in the past have ou reached rusty water looking stools before reducing the doses down extremely slowly until you have found a suitable maintenance dose to remain on? Increase her water intake, it's key and unfortunately she is not going to help herself long term. Unfortunately, fixing the issue isnt always possible, managing it correctly and effectively is key. Do you encourage regular toilet sits after every meal, that will help.

[Nsin in reply to Yaleamanda]

She’s done desimpactation with Movicol before. Twice. But the latest des impactation was done with klean prep at the hospital (fed through a nose tube). She’s currently on 2 sachets of Movicol a day and 12ml of Senna. Since the kleanprep

[Yaleamanda in reply to Nsin]

Did you get to rusty water looking stools when disimpacting? Often you have to disimpact regularly. It doesn't hurt and helps to adjust the maintenance dose accordingly.

[Nsin in reply to Yaleamanda]

Yes we did. Mainly with the kleanprep at the hospital.

[Yaleamanda in reply to Nsin]

I would be inclined to disimpact again

[14crosstitch14 in reply to Nsin]

I agree with yaleamanda she needs to be drinking more water, if you explain to her that if she drinks more she'll improve her own health she won't need to hide away from people. Plenty fluids will do help, she's old enough now to know when she's thirsty and that could be part of it all.

[Robinia]

Is she soiling?

[Nsin in reply to Robinia]

Very little. She wears panty liners to help and she doesn’t fully soul herself but she does dirty the panty liners every day. Is almost as if she was leaking but she doesn’t have full accidents if you know what I mean?

[Robinia in reply to Nsin]

She sounds impacted. I would do a full disimpaction every school holidays and increase the maintenance dose. My son is on 12 sachets movicol, 1 bisocodyl tablet and 3 Senna tablets daily. He also irrigates using balloon irrigation system with 800mls of water a day. He still gets blocked up!!!!!!! Not often these days thank goodness because his meds regime is so high. We’ve also worked loads on toileting - he blows a harmonica to help him relax the right muscles and push. It’s basically a complete battle to stay on top of it. My son can’t eat popcorn or nuts because they block him up. When he’s blocked he struggles to drink and eat.

Also he’s violent.

The thing is with disimpacting regularly you have nothing to lose. It does no harm and then you can be sure the bowel is clear. I find every school holiday works well. With my sons meds we don’t really have anywhere to go coz they are so high but hopefully we can get him back down to 8 sachets again very gradually and then that gives a bit of wiggle room.

Good luck!

My son was impacted for 3 years despite hundreds of hospital visits. Loads of doctors don’t have the first clue about chronic constipation in my experience.