Post disimpaction still soiling

[Em_xoxo]

Hello all!

I'll start with a back story and explain our situation as best as I can.

So, my son (4 y/o) has been on a daily dose of Cosmocol (1x sachet) for around 2 - 3 years now.

When I first spoke with GP (2021) they got him on Cosmocol and it seemed to help with soiling. Roughly 6-8 months later he had some soiling issues again, but this was resolved after upping the dose for a bit.

More time goes by and soiling returned again at the end of summer last year (2023) and has been happening daily for mostly 9-10 months now. Spoke with GP again and he suggested just to up it a bit to clear him out, however I have since got myself clued up on disimpaction so we decided this is what was best for my son. Got to 8 sachets and achieve watery poos (tiny specs in it)

Symptoms are: constantly soiling, not having the urge to poo and not aware he had soiled himself.

Since disimpaction we did the following maintenance dose:

- 4x sachets for two days (poo still very loose)

- 3x sachets for two days (still loose)

- 2x sachets for two days (poo is starting to form).

So we're up to the current day, we've done 2x sachets for the past two days. Poo seems to be starting to thicken up, but he doesn't have the urge to go for a poo and we are still getting soiling.

I have read on the ERIC site that soiling can still happen, so just wondering if anyone else is experiencing this and if it's daily, a lot of soiling etc. And should we reduce the daily dose to 1?

We are at the point where it's so stressful and we just hope we can fix this before he starts school in September.

Hope you all stuck with me! All help and advice welcome!!

[Yaleamanda]

It doesn't sound like you have disimpacted properly. Did you work upto the maximum dose for their age until you reached watery stools with no lumps consistently for a few days before you started reducing the doses down extremely slowly ie one sachet every few days until you reached a suitable maintenance dose to remain on?

[Em_xoxo in reply to Yaleamanda]

I believe we did get to that point. He had the maximum of 8 for a couple of days and it was coming out like brown water. It's so hard to know though. Should he have stopped soiling? On the ERIC site it does say that soiling can continue for months after because the bowel is stretched and they are not getting the poo signal. Which sounds like what's happened. He never knows he's soiling anymore.

[Yaleamanda in reply to Em_xoxo]

Did it look like tea with no milk? Are you encouraging regular toilet sits after every meal?

[Em_xoxo]

It was lighter than tea. Like I guess if you were to have bad diarrhea. So at first it was runny poo and then we did achieve watery poo on at least two occasions like ERIC says. I do wonder though because he doesn't have any issue eating, how does disimpaction work then, will it stay consistently clear? Maybe we need to go again with it. I really don't know and finding it all very stressful!

We are going to make sure today that he has regular toilet visits to try and avoid the soiling and hopefully come through this.

Can I ask, are you a professional or a fellow parent going/been through the same thing? Just wondering 😌

[Yaleamanda in reply to Em_xoxo]

Just a very experienced parent.

[Em_xoxo]

UPDATE: Got him to sit on the loo post breakfast and he's done a sausage type poo, although not completely smooth in texture. This is the first sausage type since disimpaction. He didn't have an urge though, but I believe that is due to the stretched bowel.