Impacted or not? 4yr old

[CheshireMama]

My almost 4yo is on a v v low maintenance Movicol & things have been good for months. She has sausage shape, perfect consistency poos on the toilet potty anything from daily to every other day to every few.

We know that being out of routine ie Xmas etc can impact things.

She passed a proper sausage poo, then a couple of days of nothing, then another sausage (good size, not too hard, no pain). Then had 2 days of nothing except small smushes. Not sure if soiling as she knows it’s happening and she goes to try etc.

Senna has been given & increased Movicol. Imaging she will poo tomorrow.

But is she impacted if she has had proper shape, size poos just days ago? Or is she just constipated and doing parts of a softer poo?

[Yaleamanda]

I would monitor for a few days and increase the doses if necessary. If they start soiling, or the stools are particularly foul smelling then it would be helpful to disimpact.

[CheshireMama in reply to Yaleamanda]

What dosages have you given for senna before? She always had a low 2.5 ml recommendation. Today is end of day 4 of constipation, up to 2 sachets of Movicol - sounds low but was a gradual increase, will give her 4 tomorrow I think 😞

[Yaleamanda in reply to CheshireMama]

You will need to up the senna as per the Nice Guidelines which can be found if you do a Google search. I would be upping the movicol and disimpacting.

[Hidden]

So we had a similar sounding “uh oh” moment during the last week of term. The GP listened and said on the account of how long the new constipated poos had been for (less than a week) she thought we could still aim for achieving regularity without a clear out by slowly upping movicol and using dried fruit as a sort of Senna substitute. And we did manage it! She’s had perfect poos all Christmas holidays.

So in a way I’d agree with wait and see with minor interventions, but maybe book your GP appointment now so by the time it comes up in a week or two, you’ll know if you’ve got it back or if she’s still struggling?

[CheshireMama in reply to Hidden]

What did you use a the dried fruit? X

[Hidden in reply to CheshireMama]

Prunes have been good, she still has one large one or two small ones for breakfast as maintenance but at times we’ve given them to her in the evening too. Naked bars are well received and work quite well too! Dried apricot works well but can make you windy. She also has a YoYo every day at school too, not sure if that helps or not.

I don’t think dried fruit is anywhere near enough when there’s chronic constipation or impaction, but it can be really helpful in the early stages or in keeping regularity. We found that it was much harder to get the consistency and regularity right when just using movicol.

[CheshireMama in reply to Hidden]

Thank you. It’s exhausting. I agree, the medication is needed when chronic and problematic. Will try the naked bars too xx

[Hidden in reply to CheshireMama]

It’s very obvious on the bars, but just to let you Naked bars contain nuts. Either not visible or really tiny pieces but given serious nut allergies are a thing, thought I should mention it.