Age 4 soiling

[Goskel]

My son is 4 and we have done disimpaction once with laxido and things seemed to improve after and we slowly reduced the dose down. He then started soiling again so we increased laxido again. He was having two sachets a day and was pooing everyday a few times. Problem was it was then 5 times a day but very soft so even if he got to toilet on time it stick to legs and bum. So yesterday stopped laxido and still has gone 5 x in pants soft and not a proper stool plus still smells very bad. Do we need to do disimpaction again? It seems wrong when he has diahreah so often . We do seem to be going backwards though. We ask him are you pooing he says no and he is. Really struggling with how best to help him. He does have dairy allergy but tolerate baked milk products and we we’re introducing more dairy but certainly no milk. We were thinking to cut out all dairy, have stopped laxido but now am thinking maybe disimpaction needed again. Any ideas? Also this all seemed to start following a heavy virus and I am just wondering why Gp does not offer up to a stool sample or no investigation just laxido and go figure it out through trial and error

[Yaleamanda]

When you disimpacted did you reach watery stools with no lumps consistently for three days before you started reducing the doses down extremely slowly ie one sachet every three days until you reached a suitable maintenance dose to remain on? Does he have regular toilet sits after every meal?

[Goskel in reply to Yaleamanda]

Yes we did just as directed above . We can do the toilet sits more but tbh he sits and if anything there just sticks to his leg so has to get off and be helped to clean up as sticks to him.

[Yaleamanda in reply to Goskel]

You definitely need to disimpact again don't stop until you achieve watery stools with no lumps consistently for three days before you start reducing the doses down extremely slowly. Keep him on a maintenance dose of laxative too.

[Le15]

I know how difficult this situation is and it’s so hard that there is no definitive answer. We have been dealing with soiling issues for 3 years now with our 5 year old son due to constipation. We’ve had stool samples, blood tests - the works - and there isn’t anything physically wrong. That’s why the drs will focus on the laxatives. Often children withhold poo because of anxiety - either previous pain going to the loo or some other anxiety around toileting that they will grow out of. You may never know why! I can’t tell you how many times we’ve tried to get an answer from my son and he just can’t tell us why he holds the poo in. Once the blockage in children becomes really bad they have lots of small, smelly accidents that look like diarrhea. They lose their ability to feel when they need to poo. The laxatives and daily ‘toilet time’ are the key long term but you’ll probably be on 2 sachets a day for over 6 months while he gets the feeling back and may even have to do disimpactations every once in a while over the next few years. It took me a while to get my head around the volume of laxatives and the time this takes to sort out but they don’t do any harm and I wish we had not tried so many times to come off them.

If I were you I would definitely do another proper disimpactation. Lots of laxative (we build up to 9 sachets of movicol in one day) and wait until water is running down his legs. It takes more than just a weekend so we take time off school to do this and it’s messy. Then go down to 3 sachets a day for a few days then down to 2 and daily toilet time after breakfast (or whenever works for you) with the iPad for 20 mins. Your son will get the feeling back of needing to poo but it takes time. These books really helped me…

Best of luck x

Books

[Goskel]

Thanks we will disimpact again he woke up this morning having pooped in his night nappy still like ice cream consistency and smelly it’s good to know we are not alone

[Yaleamanda in reply to Goskel]

You definitely need to disimpact again don't stop until you achieve watery stools with no lumps consistently for three days before you start reducing the doses down extremely slowly. Keep him on a maintenance dose of laxative too.