Movicol - Soooo many questions after GP visit !

[Bobbins88]

So this is going to be a long post apologies but we're new to this errr journey I guess. Will start with a bit of background for context sake. I am dyslexic so apologies if this jumps around a bit! Here goes.My son will be 3 in December. He is a picky eater and with his character being very head strong well stubborn really lol 😆 there is little movement on this tho things are minimally getting a little better currently on this front. Not by much but anything is something I guess. He's been picky since just before he turned 2 before that he was BLW and would try anything and ate appropriate amounts as stopped milk at 1 he was not intrested in it after his bottles stopped.

He never had bowel issues as a baby but did have silent reflux needing omeprizol.

With the picky eating he started to switch between what I'd call mild constipation and being loose but not like diarrhea just mushy. The constipation always resolved once he'd have a better eating day both in food type and food amounts. He will not eat veg currently and hasn't for a good while he has literally had a fork of brocoli 2 times in this whole year 😳 no exaduration! But he will eat fruit at times a good variety amount but has gone through fazes of only eating occasional apples with the skin off !

He has never gone longer than 3 days without a poo. Usually 2 days but 3 when he has been ill and eaten less.

He can some days eat all day for like a week but he'll also have stages of Luke 2 or 3 days in a row of eating next to nothing . He dosent have a typical food that he will eat consistently every time so whilst there are safer foods he will eat most the time these can still be refused. He is just not and has never really been food motivated so that's difficult.

So I expect the bouts of short term constipation were diet related due to the days he didn't get much fiber and due to the eat very little days!

So that's the main background sorry it's looong! So about a month and a half ago he was waking up upset crying amd them bringing up fluid that was not vomit. So we went to the gp a lovely Jr doc who was very thorough saw us we did s0eak about his constipation but told her it always resolved and we gave him fruit juice sometimes which seemed to help. She palpate his tummy found no reason for bringing up the fluid there. She did see his nose was blocked and said it could be post nasal drip due to it happening at night. Prescribed saline nose spray issue solved but she noted that his weight had dropped from 50th centile when HV saw him at 2.5 years to 25th centile. So we have him being kept an eye on for that .

So now we get more to the crux of things and questions! Last Friday at family childcare my son went to the loo my mum took him he did a poo that she said took no straining at all didn't take long to come out and was a good poo like no 4 on stool chart . She noticed a little blood in the loo and on wiping . He didn't poo the sat but the Sunday he did and there was a little blood then (red both times) so we requested a gp appointment Monday morning which we did not get till Thursday. We had no more blood and had had good no 4 poos. Que gp appointment different Dr who zoned straight into the constipation not saying wrongly so but dod not seem to have the time for discussion and dismissed my question of IBS (asked as me and my mum both diagnosed with IBS and different auto immune issues). She said the blood was likely due to something constipation had done (despite it happening during a not constipated time??) And prescribed movicol. Very little instruction just that we would need to figure out the dose and to ensure he had 2 soft poos a day ! Can we really expect 2 poos every day like on days when he has a spate of eating Very little how is he going to have enough to poo that much? She didn't say how long to give him it for or how long it takes to work or what to expect or look out for at all.

We gave him half a sachet yesterday with the idea of working up to figure out. He was farty all day and in the afternoon he had a shart in his pants (we potty trained him in august)and he had no idea it was coming bless him. Last night I looked at movicol on NHS Web to see if more info and it states to give when child is constipated which I don't think he was when we saw gp and is not atm so should he be taking it should it have been prescribed? She did also palpate his tummy no issue and he is slim so if figure you'd feel something?

This morning he farted and it was v wet sounding he is good with knowing when he needs to poo and I asked did he need to go he said no we checked him as well that sound was wet ! He had a skid we popped him on the loo and 2 soft blobs followed that he has no idea were coming. This is from the same half sachet yesterday as not had it yet today!

So I am just so unsure now ! Also on days he decides to eat aloy of fruit is movicol still a good idea !??

He doesn't wothold poo toileting wise he announces right away to us and goes lol. He understands getting poo out keeps his tummy OK. Feels like if we go from him knowing when he needs to poo to him not will not do him much good !!

Sorry this is soo long but just feel so lost and unsure and GP who prescribed was just very uninformative and the convo with her was very closed .

Felt like the Jr dr was better but if we request to see them to question all this are they likely to side with the other doc as she is senior to her? Not saying other Dr was wrong but not feeling very informed by them ether.

Sorry again 😔.

[Constipated]

I was just like your son ,but at later age 13 to 18

[Petitou]

Hi there, this sounds tricky and I am sorry don't think I have much advice regarding the movicol but thought it sounds like you should get another opinion. I totally understand the glazed jump down the movicol route. We had it suggested for our child but chose not to do it because we knew it wasn't constipation and would just cause anxiety. One thing I was wondering if you considered if it could be worms. I know it sounds gross but children do get them and blood can be a sign. If he has had an itchy bum, it's definitely worth checking. Apparently worms are cyclical so won't always be symptomatic. Also you could ask the Dr to take a stool sample of they haven't already. It's really frustrating when you feel your not being listened to. If you do go the movicol route, I am sure there are others here who can recommend the regime to clear out. Also call the ERIC helpline. It can take a while for them to get back to you but they will. Hope you get some clarity soon. Good luck.

[Bobbins88 in reply to Petitou]

Thank you! They didn't take a stool sample jot even mentioned it or even bloods to rule things out just said if it was something else he would be alot sicker. No itchy bum no sign of worms in his poo and I know there common in children thos he's very clean about his hands he asks for them to be wiped alot but still possible I guess. Since this post we managed to get him to drink half a sachet yesterday woth alot of fuss crying and in the end bribery of a buiscuit today was he'll he was screaming and crying no he did not want to drink it even with a bribe and it was awful 😢. It must be awful we put juice in it after making it but he full on refused he's usually good when you explained it is medication but he was so against it! Was so upsetting. We have a pharmacist friend who reconed the movicol was prescribed more as a keep it extra soft whilst a fissure healed not a l9ng term take it. He does get short term constipation here and there but he's so picky woth his food that's enviable and there is no help with the picky eating really all the methods suggested have been fruitless and those that say he won't starve himself really underestimate his stubbornness he did 10 hours on one small piece of nursary cake as he did not want to eat all of what else was offered and then did not eat dinner at home ether !! We went through a long stage of him eating barely anything amount wise for days at a time like 2 to 3 days as well as variety being an issue. Now we are getting better amounts wise but variety still a huge issue. I hate that his diet is so processed but without those options he'd not eat . He does eat fruit thankfully but some days it's lots others it non at all and is a guessing game on which one he'll eat. He has eaten brocoli 2 times 1 fork this entire year ! He will not eat mash but will eat chips waffles ect he won't eat pasta I make occasionally he eats tinned pasta. Obvs he will eat cake chocolate crisps ect but he'll also refuse these too sometimes. But yeah we've tried allsprts to get him bk to eating more variety but I feel it's just going to have to happen om his terms and he grow out of it 😞 . But the inconsistent eating means he's not like long term constipated as far as we can tell. The weight loss the 2nd gp dismissed as just his eating tho to me it seems quite a drop even with him having had a tummy bug before the loss. I didn't like the IBS dismissal tho as yes he likely hasn't got that but also I do and so does my mum so it wasn't a far fetched consideration all told. On his next weight check I will deffo ask for the Jr doc she deemed alot more thorough and just seemed nicer lol

[Petitou]

You have my full sympathy. My kids are picky eaters and it is definitely not a case of if they are hungry they will it. I think they can grow out of it as they get older. I keep offering but not forcing anything. Hope the Dr can be more helpful to you next time around. Wishing you all the best!

[Bobbins88 in reply to Petitou]

Thank you! It can be so stressful. When you say your kids picky people for the most part see it as such a small thing or that your not being firm enough! For him that's definitely not the case we had nursary call when he had a day of not eating with them and now we send in a snack bag with himnfor days where the nursary food is not what he will eat (pretty much almost every lunchtime !) But like you say they can grow out of it so fingers crossed ! He's developing well in every other respect his language is really good ! Hopefully she will be we decided to stop the movicol and have found some processed snacks that contain fiber so going to try those to prevent further constipation and perseverance with the fruit woth skin on. Keep serving the veg Hopefully he'll start to eat it. Hopefully yours grow out of it too

[Petitou]

The other thing could also be to check for food intolerances like dairy and gluten as they can cause issues.

[Bobbins88 in reply to Petitou]

His dad was dairy intolerant as a child but he'd projectile vomit if he ate too much dairy. Fortunately no vomiting! Kid loves his cheese 🧀 so poss at times does eat too much but without it we'd deffo struggle to get the calories he needs in him. I'd have to look at gluten as he's not a bug bread or pasta eater but does eat buiscuits and cake a little and chips he eats alot some of those may have gluten but some won't.

[Petitou]

I know what you mean about the cheese. I am always grating it in things to get the protein in as it's one of our only sources that will be eaten. We do lacto free milk though. It's so tricky especially when already limited foods and don't want to ruin or take away any safe foods in the process.

[Bobbins88 in reply to Petitou]

100% ! Fingers crossed 🤞 our fiber ideas work. He loves a buiscuit so going to bake some oaty ones! Shame there's not a vitamin gummy with a chunk of the daily amount needed in it lol !

[ERIC-Charity Partner]

Constipation can be sneaky, even children who poo every day can be constipated. Look for two or more signs: eric.org.uk/childrens-bowel... A poo diary can help: eric.org.uk/poo-diary/ Macrogol's are the first line treatment for constipation as recommended by NICE guidelines. If a child has been constipated for more than a few days they may have a backlog of poo see: vimeo.com/749164276 (Pooper Highway Video) and eric.org.uk/childrens-bowel... Macrogol laxatives are safe used long term. NICE guidelines recommends a physical examination for all children diagnosed with constipation: eric.org.uk/physical-examin... Health Care Professionals may not be able to feel a build up of poo so a history of bowel patterns is needed for a diagnosis.

[Bobbins88 in reply to ERIC-Charity]

Thank you. The gp based on one comment of my son having had some off and on constipation previously. He had not had any for a good few months when we visited. They didn't ask how long of a period or when it started, etc. As a baby, he never had constipation, so only a small amount of history it seems to go on. I must admit my own experience of vowel health comes as someone who has diagnosed IBS so myself I at some points can be constipated at others the complete opposite. Movical may well be safe, but we had no info on how awful it tasted or tips on getting our son to take it despite the gp being aware of his picky eating! We tried juice, but that did not work he was point blank, refusing 3 days, and we managed with a bribe of a buiscuit, but then that stopped working, and everything we tried did not work ! He'd cry and become so distraught, and that was with half a sachet ! We'd never get a full one or more in him. Usually, he's good at taking medication when we explain what it is and what it does, but not with this ! Read that milkshake was the best thing to disguise the taste, but my son doesn't drink a milkshake in a normal circumstance, let alone daily ! Also, how to people delay with this stuff with newly potty trained kids ! Half a sachet, and he had a few incidents where he didn't even know it was coming! Gp also said to take to give the suspected fissure healed but then did not advise if we have to be on it longer or not or ruled out any underlying conditions. Back at the gp next week so will hopefully get some clarity.