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Movicol/Laxido advice(7 Posts)
My 21 month old DD was prescribed Laxido following some large poos which caused her some pain and bleeding and led to her not going for a poo for a number of days at a time. I was told to give her 1 sachet daily but I'm stuck in a bit of a vicious cycle with regard to the dosing. It takes a while for the laxido to kick in (around 3-7 days) and then when it does she has 3 or more mushy poos per day so, in line with the instructions, I reduce or stop the dose but then after a few days she stops pooing at all so I start giving her a full sachet again, but then it takes days to work again..and then the cycle repeats. I'm trying to get to one nice, soft poo per day! Any advice on how I might be able to do this?
It is horrible to try to get a balance! For my son, after we reached the very soft poo I found the following day giving half but the the day after full so I was alternating half and full sachets. It got him into a routine of going to the toilet and then I reduced it further after a few weeks. I also changed his diet and made him have weetabix every morning (no more rice crispier or coco pops!) and made sure he drank lots. Good luck in finding a balance
Don't try to get off it too fast. In order to have such big poos, she must have stretched up her rectum (last bit of the gut) through being constipated for a while, or there would be nowhere for the enormous poo to form. If you rapidly turn down the movicol as soon as the poo goes soft, then that overstretched last bit of gut will just fill up again, and set like concrete. Quite often, when you first get really soft poo coming through, it isn't because you've managed to shift the old hard rocks out of the stretched area, but because you've loosened up the new poo coming down enough for it to squidge past the old rocks. So can take a while of tolerating gravy/porridge consistency poo, before you can even think about reducing.
Even when you've got rid of the rocks, the stretched up area still needs to heal up. And for that to happen they need to be pooing way better than normal. So at that stage, you're aiming for scrambled egg consistency poo at least once daily for weeks (months if this has been going on a while).
Thanks so much to both of you for your replies, I really appreciate the advice!
I'll be honest - trying to get the right dosage almost broke me completely. I'd really really suggest contacting the Eric helpline and they'll be able to talk you through it - but there's a bit of suffering the poonamis to work through to get to the right dose.
Basically drop the dose down really really really slowly - I was recommended not to drop any faster than every 2-3 days losing half a sachet each time. We've now settled between 1 and 1 1/2 for DD2 but end up watching her produce like a hawk and the first indication of them going harder than a 4 on the poo scale and we up it a bit to head off any possible re-constipation at the pass... I've now got it almost to where I can tell DD2 to go to the toilet and do a poo by feeling her stomach - but it's taken a lot of literal and metaphorical shit to get to that point.
Seriously though contact ERIC - they really really do know their shit (I feel for their advisors talking literal crap all day) and they'll probably recommend you do a full disimpaction routine to start with and then lower the dose down really really gradually till you hit a sweet spot.
ERIC helpline - Mon-Thurs 10am-2pm, Tel: 0845 370 8008
or email at email@example.com
From personal experience try calling earlier in the day - it can take a few tries to get through and otherwise you're doing that when it shuts down for the day!
What we've found helps a LOT with trying to nail down doses was to start keeping a log of all toilet action. Easier with DD2 as she's older so it's a toilet jobbie (we've been desperately fighting not putting her back in nappies throughout this all) - but initially you can exploit the fact that the gut naturally tends to contract and try to push things through about 15-20 minutes after eating. We were advised to do toilet sits at that time to try to capitalise on that... DD2 has watched a LOT of cbeebies on the tablet sat on the loo after her lunch! We've then started to get a picture of when she's naturally more likely to go (for her 3.50pm seems to be the bloody sweet spot annoyingly when you're doing after school clubs!) and focus in more on that. We've logged the Laxido dose we were giving her and also what it's produced as a result in terms of size, time and the consistency of it on the Bristol Stool Scale (don't google that up while eating!)... that's helped us get more of a feeling of how much we can drop dosage by and when we need to up it a little bit to keep things moving again.
We've now got it where we can generally hover at 1 sachet, and increasingly rarely need to raise it by another 1/2 sachet... hoping we can start to drop that 1 sachet down slightly very very gradually - I've read on other sources to aim for no more than 1/2 a sachet total decrease over a week to give you some idea of how slowly to take it when you're at that level.
Couple of facebook groups it might be useful to look into if you're on FB - one called Movicol Mummies (but can take a while to get accepted into that one), and one called Encopresis Support UK. Between those and ERIC is where I've picked up the bulk of the info to start making a bit of progress on it all.
Oh and www.thepoonurses.uk is also a good resource - don't be put off by the name - it's one of the good childhood continence and constipation clinics in the UK, just went for a memorable internet address.
Basically don't drop the dose too soon - think of a balloon that you've filled with marbles - the only thing that's going to get past the marbles in the short term is sloppy stuff and the balloon's going to be stretched badly... need to really keep at it to get the marbles broken down and gone and then give the balloon chance to deflate completely and re-establish the feeling of needing a poo. The advice I've been given is it taking as long to fix as it's taken to get into that state before.
Thanks for taking the time to reply Miaow, such great advice I'm going back to the drs tomorrow to see if they'll prescribe a disimpaction regime so we can start with a clean slate and will check out your other recommendations. I'm looking forward to all this talk of poo being a distant memory!!
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