Still soiling a lot two weeks after disimpacting

[JarethP]

I've just finished disimpacting my 5 year old, and after rusty water poos we went to 2 and a half sachets of laxido a day (he was on 10 when we got to rusty water for two days). Since then he's had a few poos a day, which have still been very runny. The last three days he's not had any big poos, but lots of little ones in his pants. It feels like before we disimpacted, only even more often. It's been two weeks since we had rusty water. I'm not sure if I should be upping the laxido dose, or reducing it to try to get more solid poos. I'm panicking somewhat, as it's only a few weeks until he's back at school, and I've no idea how we can cope with things as they are at the moment. I've had to clean him up six or seven times today, and it's too much for him to sort out himself. Any help or advice gratefully received!

[Yaleamanda]

You reduced the doses down too quickly and should have worked upto the maximum dose of 12 sachets and stayed there for a few days before you reduced down. It sounds like there is still poo in there. You need to reduce down extremely slowly, one sachet every three days. Encourage regular toilet sits after meal too, this will help.

[Nordica]

Hi. As long as there are small poos that are leaking out and no proper motions in the loo, it definitely seems as though he is still impacted. Once you reach the rusty water stage & stay on that dose for a couple of days, it’s best to reduce the dose very gradually. It’s confusing because some health care professionals say go straight onto a maintenance dose, others say reduce very gradually, but in my experience - gradual is the only way, especially as you need to gauge what the maintenance will be. You don’t need to go up to 12 sachets - if he got rusty water for 2 days on ten sachets, then that is sufficient (12 is just the maximum if you don’t get rusty water at lower doses). So in your case, once he has reached rusty water for two days - it would be good to drop to 8 sachets for 4 days, then 6 sachets for 4 days, then 4 sachets for 4 days, carefully monitoring all the time. Remember there is a time delay - so whenever you reduce the dose, it will take maybe 3 days before you see the results of the altered dose. Also from experience, the fact that he need to disimpact in the first place suggests that the constipation is fairly severe, so 2 doses wouldn’t be sufficient as a maintenance dose, so he probably got constipated quickly again. Once you get to 4 sachets a day, maybe keep on it for a while to really see the effect then seek advice from nurse / Eric website as to whether or not to reduce to 3 etc. Even if the stools are on the loose side / frequent - it’s better that way than risking too low a dose and he gets constipated again. If say his stools are too loose on 4 and you think you need to go down - do it really gradually again, like half a sachet lower till you find the perfect balance, but obviously check in with the medics / Eric advice line.

[JarethP in reply to Nordica]

Thanks for the advice. We'll go back up. It's so confusing as I was following the advice from speaking to someone on the Eric helpline, who said to go down to that once rusty water was achieved for a few days. Something is clearly not right though, so we'll go with a more gradual decrease this time. Thanks!