Disimpacted 9 year old and still soiling

[Natster90]

my 9 year old has been suffering with chronic constipation for 6 years, we are all at our wits end. It is hugely affecting my, but more importantly her, mental health.

At the beginning of July we had a hospital stay for disimpaction via a NG tube. This was effective. Doctor prescribed 5 ml of sodium picosulfate and 3 sachets of movicol as the maintenance dose. This worked sporadically but we still have soiling. The poop is sticky and smelly and like type 6. We haven’t had a formed poo in over a month.

Could she be impacted again? And could it be overflow? Or is she unable to control it due to too much movicol?

She is also very bloated and starting to describe herself as fat which breaks my heart. We are helpless.

Brown bread, dairy free butter and milk… lots of fruit and vegetables and lots of water.

[Yaleamanda]

Sounds like it. Also dairy is highly constipating.

[Natster90 in reply to Yaleamanda]

Sounds like impacted again?

[Yaleamanda in reply to Natster90]

To me it does yes.

[Natster90 in reply to Yaleamanda]

She hasn’t had a formed stool since disimpaction though. Surely she would have done?

[Yaleamanda in reply to Natster90]

Your description points toward her still being impacted. Did they xray after the hospital clear out?

[Natster90 in reply to Yaleamanda]

No they didn’t but she was passing liquid for over 24 hours. She had a huge amount of laxative administered via a tube through her nose and the doctor was the one to confirm it was complete

[Yaleamanda in reply to Natster90]

It's very possible then she wasn't fully disimpacted. How did they know she was?

[Natster90 in reply to Yaleamanda]

Because it was running through her like clear water…

[Natster90 in reply to Natster90]

It went from more solid cow pats, to watery with bits to water

[Yaleamanda in reply to Natster90]

Doesnt mean they are clear. Only an xray would confirm that.

[Natster90 in reply to Yaleamanda]

The doctor was happy she was clear

[Natster90 in reply to Natster90]

But who knows now. They xrayed before to see how much was in her but not after.

[Yaleamanda in reply to Natster90]

Doesnt mean they were clear though.

[Natster90 in reply to Yaleamanda]

I’ve got a telephone appointment booked for next week, going to do a disimpaction over the next few days/weeks and then ask to be referred to a gastroenterologist and a therapist as DD is suffering with her mental health now. Fingers crossed that this all works in combination with the high fibre, gluten and dairy free diet

[Yaleamanda in reply to Natster90]

Ask to be referred to a dietician to mange the food restrictions you are putting in place as this should be carefully monitored. Its best to remove one food group at a time to ensure that you can ensure what is or isn't causing the issue. Also you want soluble fibre and plenty of fluids

[Natster90 in reply to Yaleamanda]

She drinks so much water, well over a litre a day. We have some Benefiber sachets too x

[Yaleamanda in reply to Natster90]

She needs more fluids especially if you are adding fibre.

[Natster90 in reply to Yaleamanda]

I would say she drinks 1700ml a day water, 200ml of apple juice, 150ml of oat milk with cereal - this is not including movicol dose. Not sure how I would get more fluid in her to be honest.

[Yaleamanda in reply to Natster90]

That's a good amount, your previous response said over a litre so was a little ambiguous. I would definitely ask to see a dietician if you are removing food groups and carry on disimpacting. Dont be tempted to rush it, work upto the maximum dose for their age and stay there until you reach watery stools with no lumps consistently for a few days before you start reducing the doses down extremely slowly i.e one dose every few days until you reach a suitable maintenance dose to remain on.

[Natster90 in reply to Yaleamanda]

That’s the plan, I feel like the hospital gave us bad advice about jumping straight down after klean prep. I’m going to go slowly over the holidays when I have time. Fingers crossed. We are also trying to up her water intake - I just bought a bottle off Amazon with measurements up the side and time goals. Hoping she will see it as a challenge. Feel helpless/hopeless but got to keep trying.

[Yaleamanda in reply to Natster90]

Good luck x

[Darosess]

I would definitely try to take out both milk and bread and basically try a bit with only fruits and vegetables. That might be difficult I dont know but usually only fruits and vegetables wont make a person constipated

[Natster90 in reply to Darosess]

I will try that. I just don’t know what else to do. I don’t know if movicol is the answer anymore either.

[Mumanddad1]

Hi i have no advice. But im sorry what you are going through. I to have a very traumatised and fed up 9 year old! I hope we all get there soon. This is a horrible condition. So diffuse to deal with. I never know if my kid is empty or not. I hope you find something that works soon. X