Lactulose for disimpaction?: I attempted starting a... - ERIC

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Lactulose for disimpaction?

gillini115 profile image
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I attempted starting a disimpaction regime on my 3 year old withholder with chronic constipation following advice from the ERIC helpline. I can only get max 3-4 sachets in him a day my mixing it in yogurt, juice, ice-cream etc but no more than that. He drinks so little I am concerned about dehydration.

Is it possible to disimpact using lactulose? I came across a paper online that showed it was just as effective as the PEG. Does anyone have experience of this?

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Yaleamanda profile image
Yaleamanda

Never worked for us.

ERIC-Charity profile image
ERIC-CharityPartner

Dear gillini115 ,

It is difficult to disimpact with lactulose, because you can't give an increasing dose. When using lactulose it's very important to ensure that the child drinks plenty (900ml - 1000ml for a 3 year old). Lactulose alters the surface of the poo to allow more water to be absorbed, but you need to introduce that water to the bowel in the form of plenty of drinks.

gillini115 profile image
gillini115 in reply to ERIC-Charity

Thanks for the reply.

Ok, what is the dosage you give a 3 year old to disimpact? Even if I don't get complete disimpaction if it difficult to achieve. I would like to get to a point where I can give a stimulant without causing my son cramping. As he seems to be able to withhold the laxido poos even though I have upped the dosage.

Can you even do a combination of laxido and lactulose??

ERIC-Charity profile image
ERIC-CharityPartner in reply to gillini115

Here's the guidance for disimpaction: eric.org.uk/childrens-bowel...

You can add lactulose in when giving laxido, just don't exceed the stated dose.

Make sure you're mixing the laxido with the correct amount of water before you add it to drinks/food etc. eric.org.uk/how-to-use-macr...

Wagamama profile image
Wagamama

I disimpacted my son with movicol/laxido along with 5ml of sodium picosulfate which is a stimulant instead and that worked a treat together. Helps them not soil themselves as much and works faster together. It was prescribed by his consultant though so might be worth an ask.

gillini115 profile image
gillini115 in reply to Wagamama

Interesting. Yeah, I will ask about pico. Although I'm gonna need to ask for another doc as my GP doesn't think my son is impacted even though he is soiling constantly throughout the day and so just told me to keep at it with the laxido at 1-2 sachets as it all children get constipated at somepoint 😑

Wagamama profile image
Wagamama in reply to gillini115

Hope all goes well. Just bear in mind that sometimes laxido itself causes soiling. My daughter had really bad constipation and had two sachets every single day which was really good… and then suddenly one day she started soiling….. all the time!! and lots of people on here tried to convince me she’s impacted again… but one other mum suggested I gave it a break for a few days… and then she stopped! Turns out, she was growing out of constipation and the laxido suddenly was too much… so instead I started managing doses on a daily basis based on how regularly she was going and what the consistency and volume was… I reduced to one and then sometimes she’d need nothing at all for a few days. And that way I weaned her off it and she was fine. Took us until she was about 7 years old… but just a straight constant stream of laxido I found, in my daughters case suddenly became too much and it was THAT that caused soiling …(I have used the adults version of that myself and believe me, it can cause accidents if you are on too much) that’s why I recommend using other stimulants too… along side it if confident he’s still impacted.

Both my children have had a really tough time with this but we are nearly there with my youngest. Still not perfect but hey ho… I’ve been in your place and got two T-shirts it’s no fun at all.

Wishing you all the best xx

imworrie profile image
imworrie

Lactulose isn't defined to be a laxative for disimpaction, it just is used a s a stool softner

14crosstitch14 profile image
14crosstitch14

Try icepops, now that the weather is getting warmer, they'll eat them all day long. Its liquid. Water is probably best, we used an old fruitshoot bottle, just poured fruit juice in. She drank that like it was never given. Which we don't it was from her mum's. Sennacot also may help.

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