Disimpaction dose

[BabT]

My doctor is resisting prescribing my son more Movicol for his disimpaction in a few weeks. She is concerned he may become dehydrated and lose electrolytes if I keep him on a high dose (12 sachets) for too long and recommended reducing by half (6 sachets) once fully disimpacted and then down to a maintenance dose. From reading everyone’s advice on here I want to reduce very slowly. How can I convince the doctor this is the best option? Please help

[Yaleamanda]

Quote the nice guidelines on disimpacting

[BabT in reply to Yaleamanda]

I’ve checked out the nice website and there is a lot of info. I will have to sift through to find the disimpaction guidance

[Yaleamanda in reply to BabT]

Look at the nice guidelines

[Indigo40]

Can you get bowel and bladder to send a request to the gp? I assume they have given you a guide as to how much to give and how to reduce it? I did a workshop just recently with them and I don’t think they stay on the 12 sachet dose for more than a few days before reducing it.

[BabT in reply to Indigo40]

We are being assisted by the school nurse (no bowel & bladder in our area) who use ERIC for guidance. It states that you should keep them on a high dose until disimpaction is achieved and then reduce. Have you been advised to reduce slowly after disimpaction? The doctor would prefer we give half (6 sachets) after disimpaction and then reduce down to a maintenance dose. She is concerned about my son staying on a high dose for too long as this may cause dehydration / electrolyte imbalance

[Movicolbaby23]

How old is your son? Bear in mind the NICE guidelines are a guide only and your doctor can ignore them if they want to as they’re the prescriber and are legally responsible for dosing your son. They do have a point about the electrolytes …

[BabT in reply to Movicolbaby23]

My son is 6 years old. I would be disappointed if they ignore the NICE guidelines as I’m sure they are there for a reason

[Movicolbaby23 in reply to BabT]

They’re guidelines but one size does not fit all. My GP refused to prescribe disimpaction doses for my son… long story … but they can refuse. Your GP won’t slavishly follow the guidelines if they have a good reason and they may have a good reason …

[BabT in reply to Movicolbaby23]

The medical profession have been next to useless. Now I’ve taken matters into my own hands they’re all of a sudden concerned with his welfare! They’re happy to keep prescribing him meds and not once reviewed them in over 2 years!

[Movicolbaby23 in reply to BabT]

That’s shocking. Have you tried to get him referred to a bowel specialist nurse? I’m on the waiting list for one

[BabT]

Yes it was rejected as they don’t have a bowel clinic in our area. The paediatrician was useless. Waited 1 year to be told I had to adjust his diet (increase fibre and fluid) and shortly after discharged him! I was devastated! Since then I have contacted the school nurse who have been brilliant. We have a care plan in place now at his school and they have adviced a disimpaction which is where I’m now coming unstuck as need the doctors to subscribe enough