Can't get Movicol in

[Bobbles11]

Hi, new here & have read many threads - super helpful, so thank you to all that take the time to reply.

My 3yr old boy is withholding after being constipated a few weeks ago. The constipation caused a haemorrhoid so I guess that is now causing pain for him

Thinking back, prior to the consitpation, his regular daily bowel movement had gradually reduced to about three times a week but didn't seem to be a problem for him so I didn't think too much of it.

Last week, with a bit of lactulose and movicol he went three times again, produced a lot, mostly soft, apart from two harder lumps amid the soft stuff. I have read about impaction here but am not convinced he is impacted as he has never soiled (he is still in nappies). So my first question is, is it possible he is impacted without soiling?

This week, it became very clear he was withholding so the doctor suggested upping the dose of movicol from one to three sachets but I have spent the week trying one way or another to get enough in him - so stressful and have never got more than one sachet in him spaced through the day. He hates the chocolate flavour. Doesn't like juice, smoothies, milk so that doesn't work so I am literally getting one plain sachet in him via syringing in 5ml at a time in front of the tv and with the reward of a milky star each time - it's a painful / slow process!

Lactulose is fine so have continued with 2x 10ml of that though not sure what if anything that is doing, and from what I've read, it suggests Movicol is stronger / more effective? I'm a bit stressed out as, if he does need disimpaction, I can't even begin to think how I would manage to get that volume of Movicol in him. Are there other methods of disimpaction that don't involve Movicol?

This week we ended up seven days of withholding. It was strange, he seemed totally happy and fine until day 7 when he got pretty grouchy and I could see his tummy was rounded. At that point I was told by a pharmacist to give him a glycerin suppository which went fine and it did it's thing! Phew! All soft which I guess is probably thanks to the movicol and lactulose I have been managing to get down him. I just can't believe how long he is able to hold it and carry on fine.

So he's finally been and I'm just not sure where to go from here. Do I need to try and disimpact him? Do we just muddle on with a bit of movicol and lactulose and see what happens this week? Should I carry on with the glycerol suppositories? Just really confused as to what to do next!

Sorry for the essay - really grateful for any advice - thank you!

[Yaleamanda]

You need to add a stimulant to the regime.

[ERIC-Charity Partner]

Hi Bobbles. Sorry to hear you are having a tough time with Movicol. Yes it is totally possible to be bunged up and not experience soiling. There are other signs to look out for such as having just 3 poos a week - and no poos for 7 days can be an even stronger sign that the bowel is full of poo! For drinking, its often helpful to go little and often so you are on the right track with the syringe - you could also try filling a small cup with a small amount of the Macrogol laxative (Movicol) that he can easily finish and try having 'drinks time' through the day. Consider pausing TV shows or activities when it is drinks time and get him to finish the cup, and show you the bottom of the cup when he is done. You can also try keeping the Movicol cold to help disguise its taste better and even freeze it into ice lollies or use the Macrogol water to make jelly. Eating salty crisps before drinking can help to disguise the electrolytes. Explaining to it him may help too, for example "these medicines will help empty your tummy and make you feel better".

eric.org.uk/how-to-use-macr... - this factsheet has a few disguising tips

eric.org.uk/drinking-reward... - this visual chart may help to get him on board with drinking more and collecting more milky way stars

Macrogol laxatives (Movicol, Cosmacol, Laxido) are the frontline laxatives to use but if you get really stuck with them then there are other laxatives your GP can prescribe to soften the poo in the bowel - although it might not necessarily be a stimulant at this point, it might be another poo softener first you would be very welcome to contact our Helpline if you would like to talk about laxative options or just a bit of moral support - eric.org.uk/helpline/

Good luck!

@ERIC