Disimpaction seems to have stalled?

[AtoZtoA]

We’re doing a disimpaction for our 3yr old to see if a poo issue is causing her frequent wee accidents (no clear cut constipation case but for various reasons we’re convinced there’s something odd going on poo-wise). We worked up to 8 sachets and have been there for 7 days now, but the weird thing is it doesn’t seem to be having that much of an effect on her poos! We had some watery poo at the start (and loads of gas), but then it thickened up again and today we had poo which was only marginally softer than a perfect sausage poo. And it was fresh poo (we had beetroot for dinner last night and this morning got deep red slightly wet sausage poo!). It does tend to get runnier as the day goes on, but nowhere near rusty water. Volume wise we maybe had a bit more poo than usual at the start, but not drastically and again I’d say it’s returned to fairy normal amounts. Is this to be expected? I can’t work out the mechanics of how we’re not seeing much effect when it’s fresh poo coming out and don’t know whether to keep pushing on or not … she’s due back at preschool on Monday. (We’re mixing it up correctly and she’s been really good at drinking her water as well as the medicine, so plenty fluids going in). Any thoughts / similar experiences appreciated!

[Yaleamanda]

Keep going and request a stimulant laxative to go alongside the regime.

[AtoZtoA in reply to Yaleamanda]

Thanks - I think I knew the answer was keep going really, had just expected the movicol to be more obviously doing something! Re a stimulant, I can see that helping if there was lots of poo still to come out, but the only thing that makes sense to me with the poos we are seeing is that she’s pretty much clear, but there’s one big lump in her rectum which is just too big to come out. Would a stimulant help with that, or do we just need to keep up the 8 sachets and wait for some slow dissolving!

[Yaleamanda in reply to AtoZtoA]

I would definitely add the stimulant to the regime.

[AtoZtoA]

Follow up question on this one! We’ve been prescribed some senna from gp, but he was a bit vague on how to use it as part of disimpaction …his advice was more on using it in order to get a poo, which isn’t really the issue here.

Assuming we use the senna and get to rusty water, do we keep up the same senna dose as we reduce the movicol to maintenance, or do we stop the senna at that point and just use movicol? (We’ve never had an issue with withholding or soiling, though she does often seem to not fully empty her bowel as we’ll see sweet corn or the like first come out the morning after eating it for dinner, but more bits come out in poos she does later that day)

[Le15]

Not sure if this is relevant anymore but we had to get up to 12 movicol for 3 days and senna to get to brown water. We did the poo analysis too and although it looked like the previous meal was coming out the next day, there must have been a shift because the wee accidents stopped quick soon after the clear out. We still have soiling issues but that’s a more complex withholding issue we’re dealing with. best of luck!

[AtoZtoA in reply to Le15]

Thanks - that’s good to know. We’ve gone back to 8 sachets but combined with 10ml senna and are on day 5 of that … poo still a lot thicker than water but think we are getting a bit less poo in the evening now and think it is getting runnier so fingers crossed! We have a follow up appointment with the paediatrician next week so will see what she says and maybe up the dose again if we’re still not there. Glad you’ve got the wetting accidents sorted - hope the poo withholding issues resolve soon too. Good luck!