Disimpaction/post disimpaction queries

[freckleskate]

We are on day 7 of disimpaction with our 4yo. We have got to runny poos so hopefully almost there? (But not clear/rusty waters yet!)

A couple of questions:

- Once you have 2 x rusty waters, do you immediately switch to a maintenance dose, or do you finish that day's sachets and switch the next day?

- Any tips for spotting constipation early and preventing this happening again? We've been referred to the Bladder & Bowel service so hopefully they will be able to advise but we don't know when we'll get an appointment. Also, the referral was actually because for ages everyone thought there were behavioural issues re toileting based on things he said and the fact that he didn't have a lot of the classic signs like tummy ache or appetite loss - and was even going daily/more than daily with some poos probably close to 5 on the chart. The reason we eventually queried it was because he was soiling more than usual for him, and after starting laxatives to see if that might help, he started to have some really thin poos as well as soiling. Anyway, based on the fact that the poo is still coming at day 7 I guess he was pretty backed up (the guilt!). TL;DR are there any other less common warning signs that it's worth looking out for once we're on a maintenance dose that we might have previously missed?

- Any tips on managing fluid intake, especially with school? We know he doesn't drink enough and some days he'd come home from preschool with his bottle still pretty much full - and at school there will be even fewer adults to encourage drinking. He'll down juice, squash etc but that all comes back out so quickly that water must be better for helping with constipation?

Thank you for reading this far!

[Yaleamanda]

No reduce down extremely slowly ie one dose every few days until you reach a suitable maintenance dose to remain on. As for school get an intimate health care plan in place to help with the drinking and support your child needs.

[Rainbow425 in reply to Yaleamanda]

Hi, just to suggest joining the Facebook group "movicol mummies", I've found a lot of advice and support from there.. we're implementing a healthcare plan with school this term - also see if school can provide him with a private toilet if he wants. Good luck!

[freckleskate in reply to Rainbow425]

Oh brilliant thanks, will definitely request to join that.

[freckleskate in reply to Yaleamanda]

Thank you, will speak to GP/HV about instigating a plan.

[Lolsparts in reply to Yaleamanda]

Yaleamanda a lot of the info you post contradicts what the specialists say and as you reply to every persons post I think it’s important to remember that each child’s regime and journey is not always the same as your own child’s. This is not a reply to cause upset but I can see on your profile you have made over 900 replies to people and I just think the information you give should be accurate to not cause confusion. Eg reducing slowly every few days is not correct and on previous posts advising to keep going with the regime as disimpaction not yet met when the pictures clearly show rusty water poo. Thanks.

[Yaleamanda in reply to Lolsparts]

I suggest you join Movicol Mummies and you will find the same information there. I will continue with my comments whether you like them or not, having been on this journey and knowing that this approach does work. If you dont like what I write, read on and have a nice day.

[Lolsparts in reply to Yaleamanda]

Your first post was 6 years ago so either what your doing is not working or you don’t have issues anymore and you just come on here and reply to everyone thinking their journey is the same as yours. So yeah I will skip your replies and read on and hopefully others will too as I can see Eric’s has replied to you quite frequently correcting you on the info you have given! I am not commenting to be spiteful I am commenting so you do not give families the wrong information and make it worse.

[ERIC-Charity Partner]

Dear freckleskate , you don't need to reduce slowly, have a look at our eric.org.uk/childrens-bowel... and also this great podcast by our Nurse eric.org.uk/podcast/episode...

If it took the highest dose to disimpact, you would drop down to the highest maintenance dose for your child's age. =Bear in mind that it can take the bowel a few weeks to settle down, so you may not see a consistent result in that time, after that you can tweak the dose until you get a daily or every other day type 4 poo

[freckleskate in reply to ERIC-Charity]

Brilliant thank you - I found that podcast really helpful. When you say type four daily or every other, do you mean that we'd be aiming for all to be 4s (and just having them at least once a day?). We are onto 3 sachets now and getting 4s most days, but also 6s too, so should we be reducing again? (We are working with GP but generally they say to go by your website so thought I'd ask!)

I never thought I'd find the day I found my son having taken himself to the toilet having said he felt the poo coming in his stomach. So grateful that your website helped us realise what the problem was despite it not being a lot of the typical symptoms!

[ERIC-Charity Partner]

If he's generally doing a type 4 that is great. When on macrogol laxatives it's no unusual to see a type 5 and that's also fine. Type 6 might indicate either a build up of poo, or a slightly high dose of laxative. It's often trial and error at this point. Dropping the dose by half a sachet might make a difference, but you don't want to lose those mostly regular type 4 poos. ERIC recommends checking they are drinking 6-8 cups of water based fluid a day in addition to the laxatives, teaching boys to sit to wee and introducing regular toilet sits 20-30 minutes after eating, focusing on relaxation and not whether they do a poo. Books, toys and games by the toilet are good to help with relaxing.