Help! What to do after faecal disimpaction

[Mumuk]

Hello, I'm new to this chat. I have a 3 year old who is currently going through faecal disimpaction. We are on about day 3, seems to be going according to plan.

My question is, once all the blocked up poo has been removed and he poo is watery/bitty, can I just encourage lots of fluids and give him prune juice or smoothies with chia seeds ect...?

Or do I have to give him lactulose for a few days gradually reducing it until hes passing consistant stools regularly?

Sorry this is really stressful and I sometimes dont know what to do. Any advice would be greatly appreciated x

[Yaleamanda]

Once you have achieved watery stools with no lumps consistently for three days you can start to reduce the doses down extremely slowly ie one sachet every three days until you reach a suitable maintenance dose to remain on.

[Mumuk in reply to Yaleamanda]

Thank you so much for replying back. I will definitely reduce it slowly once he was completely cleared out. If you dont mind me asking, how long did you keep up the maintenance dose for? I read on here alot of children are on it for months sometimes years 😕 ...

Xx

[Yaleamanda in reply to Mumuk]

They need to be on the maintenance dose for as long as the issue persisted in the first place, even then when and if you do start to consider that they may not need the laxative you should reduce down extremely slowly, it's best by half a sachet at a time and over a slow period as to not send the bowel into shock or for them to back up again.

[Mumuk in reply to Yaleamanda]

Ok I understand. Thank you very much for your advice, has put my mind to rest a little lol x

[Le15]

Hello - we’ve been through all of this and I know how stressful it is so hang on in there!

You must reduce the softener (I’m assuming you’re using more than lactulise but perhaps not?!) - perhaps start with 2 movicol a day for 2 weeks at least - then consider going down to 1 - although you might need to stay on 2 for much longer.

From what I understand of the situation, the bowel is stretched and needs time to get back to normal so people typically keep their kids on a softener for at least 3-6 months after a disimpaction. I know this sounds a lot but I don’t really know anyone who had successfully done a disimpactation and come off the movicol within a few days or weeks.

Just to give you some context - we had to disimpact my son 3 times last summer because we kept trying to reduce the movicol too quickly. From September we started him on 2 sachets a day and a toileting regime where he has ‘toilet time’ 3 times a day - reduced to once a day after breakfast now. Occasionally, he still gets bunged up and we have to disimpact him again over a weekend. After seeing a paediatrician at the hospital, we’ve been told they don’t know why he withholds / gets so constipated so we cut dairy out which seems to have helped a bit. But I can’t stress this enough - movicol does no harm to your child - it just holds water to help the poo come out. They can be on it for years (often kids are) and it does no harm and as they get older, they just stop needing it eventually.

Obviously maintaining a healthy diet is extremely important but that wasn’t enough for our son. Just keep your eye on the situation and don’t hesitate to give more laxative if you think your child might be getting blocked up again

All the best!!

[Mumuk in reply to Le15]

Hi thanks for replying back .

Gosh it does seem like a long process doesnt it? I feel really down about it all especially with the thought of him being on a maintaince dose for a while.

We have really cleaned up his diet, switched to non dairy , whole wheat , lots and lots of veggies and fruit, smoothies. He even eats pumpkin seeds ,raisins and raw carrots as a snack and he loves it. He always ask him before he eats something if it's good for his poo lol he also has alot of fluid too.

If you dont mind me asking, how did you eventually take your son off the movicol all together? I know weve got a long way to go before we even think about it , but just be nice to know what to expect later on.

Thanks xx

[Le15]

Well, he’s actually still on it and every time we’ve tried to decrease the dose we’ve had to disimpact again. We started the maintenance dose of 2 a day in September so Its been 4 months already (he turns 5 in March). But to be honest, I imagine he will be on it for at least another 3 months - maybe 6 - maybe a year! The thought of that is hard but until we solve the mystery behind the constipation, we’ve been told that it’s best to just keep him on the movicol and the toileting regime until he ‘grows out of it’ and I’ve come round to the idea. I’ve also stopped speaking to my mother in law about it because she’s obsessed with getting him off the laxative but it literally the only thing that is getting us through!

It’s great that you are keeping to a clean diet and my son is a really good eater - loads of veg, prebiotic foods, water etc. so don’t blame yourself that this is happening. It’s either something physical - so slow bowels that will get better with age - or in the case of my son, we think it’s something psychological. He had bad nappy rash as a baby and potty training was an absolute nightmare - despite him having no development delays in any other areas. It could be that those two things are causing him to withhold. We talk a lot about the importance of listening to his body, not holding the poo in and the ‘naughty poo’ getting stuck. But he just doesn’t understand the importance of stopping what he’s doing to go to the loo.

So see how you get on but there just isn’t a set guideline on getting them off the movicol. It really depends on when your child knows how important it is to go when they feel the urge. And also important that if their mood changes (the tantrums and bed wetting are a massive sign with our son that he has a blockage - even if he is still going for a poo once a day)

I found this book really, really helpful so it’s worth a read if you’re looking for more information.

I hope that helps!

Constipation info

[Mumuk in reply to Le15]

Thank you once again.I will most definitely look out for that book, worth a read for sure x