Disimpaction help please

[Reighflowers]

HiLong story short my 5 year old daughter has been struggling with constipation since she was 1 years old.

Finally we have been referred to a bowel & bladder specialist at the hospital whom she now has her regular appointments with rather than different Gps. (She's also started to suffer with UTI's)

Before any blood work is done to rule out interlorance/ coelic etc we have been asked to do disimpaction again ( this will be her fourth time 😭)

The specialist who she is seeing believes everytime we have done disimpaction in the past we haven't fully cleared the backlog which is why we end back up to constipation.

I always do the 7 days up to the 12 and then drop down 2 sachets a day as per Eric guidelines.

But this time we have been told to go up to 12 and stay on 12 until we get to transparent water to angel delight to choc milkshake back to transparent water and then drop down in a stepwise manner until we are back at 2 sachets a day achieving type-3-4 poos between 1 to 3 times a day.

We are now on day 10 at 12 sachets and I'm documenting all food and water intake and every single poo and accident to take back to the specialist on Thursday, my daughter isn't at school at the moment due to this and I do have her in pullups .

My biggest question is her poo now resembles curry like yellow newborn baby poo ( if you know what I mean) but In water form

So I'm still unsure of when I should be dropping down to the 10 sachets

I have achieved transparent water and angel delight type poo and then choc milkshake type poo but it now has turned this bright yellowy curry colour very watery

Is all the old poo out?

Is this a sign to start dropping sachets?

I'm really unsure and am wondering during disimpaction has anyone ever got to this type poo

I hope this all makes sense

And I really hope this is her last disimpaction because it's absolutely heartbreaking to have to see her go through this again

Any help advice, stories are most welcome

Thank you 😊

[ToddlerPoo]

hi it sounds like you did stop the previous disimpactions too early, you keep going on the highest dose beyond the 7 days until you get to the ‘rusty tea’ - look at this video it might help, but it sounds like you are close. You still need to keep on the highest dose for 24hrs beyond the rusty tea just to be sure it’s really done as it can be watery and then thick again, but once you get to the end stage it will stay watery

healthunlocked.com/redirect...

[ToddlerPoo]

oh and for info we are on day 15 of highest dose in my 3yr old, it’s taken a long time to clear her but we got watery poo this eve so hoping we will continue to get to the clear rusty tea soon /so it can really take a long time to fully empty the bowel especially if it’s been building up a while

[Reighflowers in reply to ToddlerPoo]

Thanks so much for your reply Yeah a few days ago she got to rusty tea but then not long after had like mushy poo again so have stayed on the 12

Tonight before bed after a few watery yellow accidents she got the rusty tea again but I'm just going to stay on the 12 as we have a follow up this Thursday with the specialist.

I feel she does have a huge backlog I mean this has been going on for years and she could sometimes go nearly a week without a bowel movement and then spend a few days crawling the floors and screaming in pain and then all of sudden just release the most huge ball shaped poo and this would happen regularly

So I'm hoping under the specialist now with more guidance this regime and then the maintenance afterwards is really going to help

She's also on 2.5ml of picosulfate every night to for stimulation and this has been such a positive change for her as she now actually realises when she needs to go to the toilet whereas before it was constant accidents she just really couldn't feel that the (overflow) was coming out

Fingers crossed your little one gets to the clear/rusty tea very soon

[Amanda-87 in reply to Reighflowers]

my daughter was exactly like this from 16days old until 8yrs old, she’s 9yrs old now she has the ACE Stoma which has been a godsend to us she’s only had it 3-4 months but I can see a huge difference we’ve been on the adult dose movicol and upto 15-20ml picosulfate everyday.

I was told off her specialist everytime we do a disimpaction to also up the picosulfte by 0.5ml everytime for 5 days then drop that back as it helps with getting the results you need a little bit quicker.

The ACE Stoma is a very last resort though I hope all works out for her and goodluck Thursday with the specialist xx

[Reighflowers in reply to Amanda-87]

The picosulfate has honestly worked wonders this time round with the disimpaction and just with my daughter in general knowing when she needs to go to the toiletUsually with disimpaction in the past majority of times she was just having accident after accident but this time I feel she has only had a handful of accidents and visited the toilet herself every other time which is great news to us because soiling and accidents was a huge thing we just couldn't get on top of meaning she always ends up missing so much school.

I hope all continues to go well and on the up with your daughter

We've only got today to get through I am going to stay on the 12 movs for now and then take the specialists advice tomorrow after shes had a look at the diary I've been keeping

Thank you for your reply

[Tatty74 in reply to Amanda-87]

This is really interesting as my son is 9 and has chronic constipation since 2. We have just got a private referral to a Paediatric Gastroenterologist and wondering if they may suggest this?

[Reighflowers in reply to Tatty74]

Suggest the disimpaction or the picosulfate or both?Has he even done a disimpaction regime before ?

[Tatty74 in reply to Reighflowers]

Thank you Reighflowers. He has done a disimpaction when he was much younger but has ARFID so it's extremely hard to get even one dose of Movical down him a day. I have to mix it into a fresh vanilla milkshake. I use a combination of Movical and Lactulouse to keep his constipation moving but he suffers with encopresis and/ or overflow. I think a full enema would be a really good first step but they don't do it in the UK for kids

[Reighflowers in reply to Tatty74]

Oh no that's such a shame, getting my daughter to drink them has never been an issue she will do her full 12 movs a day diluted to 62.5ml water absolutely no bother at all so I can't imagine how hard it must be trying to get the satchets into him

But yes my daughter is exactly the same with soiling and overflow every single day from school she will come home with stains in her underwear or has had to be been changed at school up to 3 times a day sometimes , I always pack alot of spare uniform into her backpack.

But we have never ever found a happy medium with medication

If she doesn't take any movical she is severely constipated but then we would find giving her even half a satchet she would have diarrhea for days on end

So I think the specialist this time is hopefull that if we clear all the backlogged poo fully and maintain on 2 doses of movs a day she will eventually regularly poop type 3-4 poops daily but my biggest concern is that when we maintain to just 2 doses she will continue with diarrhea , but maybe if the full backlog is clear this might not be the case.

The specialist also mentioned to me in December after examining my daughter that her stretch receptors are damaged from the years of constipation, they detect when the poop is ready to come out that send that signal to our brain

She explained this would be why she has so many accidents but she doesn't actually know she's having them or has had them

She said once we are able to get the problem under control and the bowel back to normal everything would slowly start getting back to normal again

But with the stimulant ( sodium picosulfate) added in this time round I have noticed a huge difference already.

When I took her to the hospital a few weeks ago before we got referred I sat and cried and begged for an enema just to clear her of the poop because she hadn't been to the toilet for a whole week even with movical in her system, but like you said they told me it was something they couldn't do.

It's just a long hard exhausting frustrating battle isn't it 😪

My three year old daughter has absolutely no issues with the toilet and poos regular and easily and now I think my 5 year old recognises this and a few times she will say she wishes she could be her sister

It's just so painful to hear because I can really seeing it starting to affect her emotionally.

[Reighflowers in reply to Tatty74]

Sorry I also just realised when I wrote has he even done a disimpaction before I was meant to write has he ever done a disimpaction before

I was writing the reply quickly from work and reading back I feel I came across quite rude I apologise for this

[Tatty74 in reply to Reighflowers]

Ahh no not at all and thanks so much for your detailed response - its honestly so comforting to hear from others that are struggling with the same/ similar. I totally get the frustration and hurt it causes our babies and us as parents 😔