faecal impaction/movicol

[edpsychreport]

My son, age 6, is on movicol for faecal impaction.

Paediatrician said the impaction is slowly clearing but to remain on 4 sachets a day. He had diahorrea from birth and we were never aware of constipation (ie no straining or solid poos) hence delay in diagnosis. He has had wetting and soiling/overflow incidents since toilet training due to the impaction. His poo is now like porridge (number 6 on bristol charts). The soiling has reduced from 6 or more times a day to just once and the wetting has had a similar improvement just about once a day now. Hence it all seemed to be improving.

A friend had told me to test speed of passage of poo with sweetcorn and that it should take 24 hours. I have no idea if this is correct advice but he ate some for dinner and it passed within 45 minutes. Is this normal on movicol??

Any advice welcome especially from anyone who has experience of movicol on a child who did not appear to be constipated until x-rayed.
Thanks.

[vintageteacups]

My dd is 9.5yrs and has been on movicol since about the age of 3. She has chronic constipation but tbh, I'm a bit now that they haven't ever tested her for anything else and they have only gone on what I've told them; no x-ray/scan/nothing.

I hate her still being on movicol and at her next appointment, will be seriously asking them to sort her out with an x-ray or scan I think.

For faecal impaction, isn't it more short term in that they use numerous sachets to clear the blockage and then reduce to make sure they stay clear?

DD has only been on 1 sachet a day (2 when she was really bad but only for a couple of days).

How long have they said your ds should do 4 sachets for?

[edpsychreport]

Thanks for this.

Next appointment with the paed is early Aug so he is on 4 a day until then unless there are any problems, so far it is a great improvement but not perfect as still having occasional accidents but mainly when we are out and not getting to toilet promptly enough after eating etc.

I presume the paediatrician must be clearing the impaction more slowly ie 4 sachets a day for 4 months rather than the dose on the sachets but really dont know. His x-ray looked awful not surprisingly as the soiling/wetting side effects had been going on for at least 3 years.

[vintageteacups]

Gosh - I guess FI takes a lot longer to clear.

Have you looked on the ERIC.org site? It's very good and as well as getting info, there's a really good forum.

[sallysparrow157]

Vintage - a scan is not going to fix things - an x ray will expose her to radiation so will not be done unless necessary. Constipation in kids is diagnosed on the history and examination and response to treatment. Movicol is a great treatment as almost none of it is absorbed by the body, it just sits in the bowel and draws more water into the poo, so it's incredibly safe. 1 sachet a day is a pretty small dose for a 9 yr old - what happens if you stop it?
The sweetcorn thing is nonsense btw and bowel motility/gut transit is generally not the cause of childhood constipation (and movicol doesn't really speed up gut transit, just makes poos softer) so i wouldn't worry about that at all.
The accidents will be cause he is used to having impacted poo in the rectum all the time so he won't be used to the feeling of needing a poo - that will improve but will take time.

[vintageteacups]

thanks sally. If dd stops taking it, it's hard to go again. This is what makes me think there's more to it.