Stimulant during disimpaction

[BabT]

I’m going to be disimpacting my 6 year old son next week and wondered if I could continue with his daily stimulant (Senna) during this? The NICE guidelines state it should only be used if disimpaction isn’t reached. Please can you help

[Yaleamanda]

I would carry on using it.

[BabT in reply to Yaleamanda]

Thanks I agree. I had to consult the doctor to get the huge amounts of Cosmocol for the disimpaction and she wants me to follow the ERIC guidelines. I know you’ve mentioned before about reducing very slowly after disimpaction is complete. Is there a reason why you don’t go from 12 sachets down to 6? We disimpacted a few months ago (not fully as only got up to 8 instead of 12 sachets) but found a perfect maintenance dose of 3 sachets which produce 4/5 stools once/twice a day. If I know this is the right amount would it hurt halving it down to 6 and then slowly down to a maintenance dose?

[Yaleamanda in reply to BabT]

Because you run the risk of not finding the true maintenance dose, by slowly reducing the bowel handles the doses more effectively rather being put into shock because of the rapid decrease. Maintenance doses can change over time, so slowly reducing is best.

[ERIC-Charity Partner in reply to BabT]

Dear BabT it's best if you follow the guidelines for reducing the dose eric.org.uk/childrens-bowel...

. It's absolutely fine to drop from 12 to 6 for the maintenance dose. If your child was on the highest disimpaction dose, they will need to be on the highest maintenance dose. Bear in mind that it can take the bowel a couple of weeks to settle down after a disimpaction, so stay on the 6 if you can, but then you can tweak the dose until you get that perfect type 4 poo! You dont need to have 3 days of rusty water. Only two occasions, one following the other, not days. Please check out this podcast with our Nurse on a prolonged disimpaction eric.org.uk/podcast/episode... . Any problem please contact the Helpline, you can complete a web enquiry form for an email response. Best wishes, ERIC

[BabT in reply to ERIC-Charity]

Thanks for the advice I watched this podcast yesterday which was really helpful. The only thing I’m confused about is reducing down after disimpaction is complete as conflicting advice from other mums saying reduce very slowly… too quick and they had to do it all over again. This is the last thing I want to put my son through again so I want to get it right this time.