Quick history of DD - chronic constipation virtually since birth, Hirschprung's/coeliac etc ruled out. Quite a long family history of sluggish bowel, especially myself (and I get through quite a lot of Movicol too!). She's been on Movicol of increasing doses since seven months, and she's now 4.9.
She takes a maintenance dose of three sachets per day, which is quite a lot obviously, and her stools are very loose and splattery. I often try to reduce the dose a little, and always regret it as she gets bunged up rapidly and we need to flush her through with lots of extra sachets before going back to three per day.
She starts school in September though, and struggles with bottom wiping, exacerbated by having such loose poo. So again I tried to alternate her maintenance dose 3-2-3-2 and, predictably, she didn't poo at all on Thursday and yesterday (Friday) kept running to the toilet and complaining that the poo was hard and not coming out.
The problem, I think, it's that the poo isn't hard per se (we're not talking rabbit pellets here) but that if the poo doesn't just flow out of her when she sits on the toilet, she interprets that as "hard poo" and then withholds because she thinks it's going to hurt. It's like she literally has no experience of a formed poo, and so withholds any poo that doesn't just flow out of her.
She had seven sachets yesterday (usual three plus an extra two once she started complaining and a further two before bed) so there's no doubt in my mind that all she needs to do is strain to get this small blockage out by the exit, and the backlog will be basically water. But she won't. Claims she doesn't know how to strain, but I think she's fibbing and basically withholding instead because she doesn't want to strain. Again, afraid it'll hurt. I won't lie, I'm finding this SO frustrating because she's making things so much worse for herself (and I know more than most, being a sufferer myself). We also stayed in all day yesterday, and will have to do the same today, and may have to cancel a visit to see family tomorrow, because a car journey of one hour plus with a child stuffed to the gills with Movicol is... dangerous, obviously.
So, since my hunch is this is a psychological rather than a physiological problem (and let's just say she's a very very stubborn character 
) how do I proceed from here? Cut up an adult glycerine suppository (because you can't buy childrens ones OTC, right) and shift the bottom blockage that way?
She hasn't been seen at the outpatients gastro clinic in over a year, so I'll have to see about getting an appointment to talk things through with a doctor, but that could take months, obviously.
Anyone else with any experience of successfully reducing a dose over time? And/or psychological issues due to being used to liquid poo?
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Children's health
Paediatric Movicol experts - advice please
JinkxMonsoon · 02/07/2016 11:57
Hi, I'm sorry you are having such a horrible time.
I can relate to the poo not 'flowing out' when she sits and tries and the horrible splatters from the movicol.
Sorry if you have mentioned it and I have missed it, but have you tired her on a small dose of picosulphate or Senna daily or a few times a week?
It's a stimulant and contracts the bowel forcing it out rather than turning it to sludge which is messy, unpredictable and down right miserable.
My dd literally can not poo on her own and I have the same experience with movicol, it just doesn't make it happen as it should and the poo is never rock hard like people would imagine.
If the stimulant works you could reduce the movicol down to keep her poo a consistency you are both happy with, but without the mess.
My dd starts school next September and I am already worrying about this issues.
You have all my sympathy as I know it is not long and you must be desperate to find a solution. 
Oh that's interesting. I must admit I'd been wary of adding any stimulant laxatives to the mix, because I know they can cause horrible gut cramps and I worried about them making her bowel movements more urgent and increasing the risk of accidents. As it stands with her three Movicols a day, she doesn't have any accidents and has a bowel movement (or sometimes several) daily without any problems. The problems only start when I try to reduce the dose.
But maybe picosulphate + Movicol is an option. It's something I'll have to mention when I get an appointment with the consultant. I guess I'm scared of the unknown though. Movicol works well enough as long as she has three sachets.
She doesn't see a continence nurse Little, but she did see a consultant at his gastro clinic every six months or so. Last time, however, we saw a different doctor who said she'd give us an open ended appointment rather than schedule one for us. That was 14 months ago! I just didn't see the point of making an appointment since things were ticking along well (apart from aforementioned issues) but now I think we need to decide which is better: three Movicols or fewer Movicols + a stimulant.
Thanks all. Still no closer to considering a medication-free life though. Oh well, I can't imagine ever not needing the stuff either 
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