Soiling Issue

[BabT]

After 2 years of chronic constipation I disimpacted my 6 year old last October which resulted in less soiling. My son was even getting the sensation of needing to go again maybe 3-4 times per week.

We managed to wean him off Senna (started to give him tummy cramps) and have stayed on a maintenance dose of 3 Cosmocol which produce stool type 4/5 once or twice per day. He does a toilet sit regularly 20-30 mins after every meal.

At the start of December we had no accidents (first time in months) and I thought we had cracked it.

Unfortunately since then the soiling has gradually crept back up. We are now back up to 7 accidents per week! He soils not long after he takes his Cosmocol in the afternoon so I wondered if I should reduce it?

I don’t understand why things have gone backwards when we were doing so well!

I’m really disappointed when I really felt we had made such great progress! Has anyone else experienced this and can help please?

[luffyanddennis]

Relapses are really common I think this could be due to the bowel being stretched and not always fully emptying. I would repeat disimpaction as it won't do any harm. It won't take as long this time as unlikely to be as constipated.

I know when they are at school it's really difficult, how we deal with this is our son is showing only mild soiling is we do "mini" disimpactions term time weekends higher dose by one or two sachets Friday and Saturday normal Sunday...and that helps stop any build up and then we do a full disimpaction at half term etc

[BabT in reply to luffyanddennis]

Thanks for the advice.

I can’t believe there is another build up as my son has x3 regular toilet sits and goes 1-2 times each day. I have kept him on a higher maintenance dose to keep the stools very soft so he can’t withhold which first started the problem over 2 years ago.

I have now increased the maintenance dose in the hope it clears the backlog and reduces the soiling. I really can’t face another disimpaction as we’re left housebound over the holidays.

[BabT in reply to luffyanddennis]

Do you include a stimulant during the mini disimpactions? My son was on Senna for nearly 2 years and we managed to wean him off shortly after the disimpaction. It was giving him tummy as he was finally cleared out. Not sure whether that would help move things along quicker.

[luffyanddennis]

We find for our son when disimpacting better not to use stimulant until near the end, let the movicol sit in the bowel longer and therefore soften the stool better. You could perhaps use on a Sunday? but for our son he was a bit too sensitive to senna so we just used movicol ....but I'd say it's all trial and error and very individual.

You could be right he might be clear and needing a lower dose there's really little way of knowing unless you either try a disimpaction or lower the dose and wait and see if it's a relapse further down the line. Good luck I hope you find a routine that works for your son x

[Tatty74]

Really hear you and have an 8 year old who soils every day!! I really wish I could give him an enema to do a full clear out as I can't remember the last time he has properly.I'm really struggling with it and he does toilet sits but never seems to go then. We're also having to start toilet retraining as he has used pull ups in the evenings and wknds for a few years now due to the chronic constipation.

Trying to do Movicol everyday and Senna at weekends to help push through. Hard to get movicol down everyday as he's a selective eater (ARFID) and will only take in a vanilla Milkshake.

It's debilitating and a long-term stress.

I'm dismayed at the lack of proper support from the NHS or privately when it's been so many years.

Can I ask if your children are good eaters or are they also selective?

[BabT in reply to Tatty74]

I feel for you and yes it’s very stressful.

My son eats a good selection of fruit and some veg. He’s a really good drinker so I can’t understand how we were doing so well after the disimpaction and now I feel we’re back to square 1!! I think my son is still withholding as he’s always too busy playing. Until he learns not to I think we’re going to keep going around in circles.

[Chinawhite]

If you’re struggling to find help, we used a potty training consultant, LittleBunnyBear.com. She was fantastic and does a consultation online. It is expensive, but was worth it for us. Hope you get it all sorted soon x

[BabT in reply to Chinawhite]

Thank you. I’ll make sure I get in touch. Do they deal with older children?

[Chinawhite]

yes, I’m pretty sure she does. She’s a nurse and is part of ERIC ( the bladder and bowel charity) so should know what you should do x