To ask if there’s life after Movicol?

[Rainatnight]

Sorry, posting here for traffic. DD (3) has Movicol for constipation. Told to up the dose to 3 sachets a day to clear it all out. The floodgates opened so to speak, all good.

However, after a few days now with no Movicol, she’s got really soft poo (basically the runs) and seems to have no control over it (she’s toilet trained).

To make matters worse this whole experience has given her a dreadful rash so we can only really clean her up in the shower.

I’m really fed up of dealing with so much poo, frankly.

Does it go back to normal? When?

The Dr said she should be on one sachet a day for three months but we’ve held off doing this as she just still has the runs from taking nothing.

Any thoughts?

Once you clear the blockage, the 3 months is to retrain the bowel / give things time to shrink back (poo based innards stretch just like your stomach and if you don't carry on you'll be back and forth on Movicol for ages)

But does that explain why she still has the runs? I’ve just dealt with my third shit today. I’m slightly losing my mind.

She might be suffering from overflow. So still constipated but soft matter overflows basically causing the runs. If it was me I’d reintroduce a little Movicol as per doctor’s orders.

Hi Rainatnight
Hard for her and you. You might try upping her fibre intake to firm up the stool if this persists. We did this with our son as the movicol can make the stool sticky and hard to wipe.

Oh that’s interesting thanks. Sounds counterintuitive, I wouldn’t have thought of it.

Dd had movicol for about 4 years. It's been about 8 months since stopping and things are back to normal now but it did take a long time and the dose had to be tapered off very slowly and overseen by a consultant as she was taking other medicines too.
It's really important iirc, to not stop suddenly or too soon as the memory of the previous blockage can cause children to withhold and start the cycle again.

We had this for a year or so. I think the movicol made it too hard to control so she'd have seven or eight soft sticky poos a day and end up with really sore bum. Frustrating as she was toilet trained but I don't think she could control it.

We went on holiday and forgot to take the movicol and somehow something just clicked and she started to go normally. On reflection I think we persisted with movicol when we didn't need to and it made matters worse with lots of little poos when she wasn't constipated anymore. But also it could just have been coincidence.

It was really rough for a time there so you have my sympathy but it will pass.

However, after a few days now with no Movicol, she’s got really soft poo (basically the runs) and seems to have no control over it (she’s toilet trained).

this is a sign of constipation/overflow.

You need to continue the movicol. DD was on movicol for a few years. if children are chronically constipated, the bowel stretches. It takes a long time to 'shrink' back into shape. Many children are on movicol throughout their childhood.

but please don't don't it. The runny poos indicate that the blockage is higher up and you just have stuff leaking through.

what has your doctor said? are you supposed to be on movicol continually?

Think in terms of nappy rash cream for the rash, whichever one works for your daughter (Sudocrem when mild, Metanium when bad, suit our son)

Thanks, all. There have been so many poos today and her bum is such a state. And we’re on holidays too, which is massively complicating things.

rainbow I completely see where you’re coming from but the soft poo seems very different from the overflow she was getting pre-Movicol, IYSWIM. Yes, doctors said to stay on one a day for three months so we will start doing that now. She had one today. I just got slightly freaked out that she might have had too much.

costa What did you do? Did you put DD back in nappies? It just doesn’t help the rash out though, does it?

And yes, we’re putting Metanium on.

I really want this to be over.

Was this a GP? Because they really don't come across this often enough to be totally familiar with it.

Honestly, I would cut out the movicol for now. (And my DS was on Movicol and then Sodium Picosulfate for about 8 years). My DS's paediatrician said that as the parent, I was more able to work out the dosage for DS than she was, and to be guided by what was happening.

So I would continue to not give it until the poo solidified a bit, if it then goes hard again go back to half or 1 sachet, and keep increasing it until the blockage is removed again. Going straight to 3 sachets when you don't know how a child responds to it wasn't the most sensible thing to do. You want it to be soft, and slightly runny, but not uncontrollable.

In all honesty, without knowing WHY she was constipated, and why she suddenly has diarrhea, it's all guesswork anyway (and most times they don't ever work out why!). It might have been a one off to make her constipated, and she is fine now the blockage is gone, she might have picked up a touch of a tummy bug, eaten food she doesn't agree with, who knows. All you can do is respond to what is going on with her.

[www.eric.org.uk] for anyone who hasn't found it yet

Movicol has a lag time as when you take it it works on poo coming in from the small intestine and acts by holding onto water ( by osmosis) whereas the colons job is to remove water
I suspect she is just continuing to have the effects of the previous movicol and her stool will firm up when it has worked its way through
The volumes sound too much to be overflow
Once the poo is soft and cleared out it is likely she will need to stay on it for a while but perhaps not 3 sachets - often one is enough if the initial clear out is successful.
Good luck

Try the ERIC helpline
www.eric.org.uk/helpline
They helped me so much with my child’s constipation, as the GP recognised the problem, but did not give the correct treatment plan and it kept reoccurring.
Might be worth keeping allergies and intolerances in mind as (after 6 initial months of movicol, then a few months off) problems reoccurred and an intolerance was found to be the underlying issue.
Look up the Bristol Stool Chart as dr took me far more seriously when i could evidence months of diarrhoea, rather than looking like an overly anxious parent.

I haven’t read the whole thread so this may have already been covered.

Movicol basically uses the water in the body to soften the poo making it easier to pass. It can take a few days to kick in and a few more days to wear off. Once the poopathon starts, you need to keep giving DD a regular dose (usually 1 sachet per day) for a while to keep it going and give the body a chance to get back to normal, if you don’t youll end up in a constipation/ poopathon loop!

Messy as it sounds we switched to using cotton pads and olive oil when DDs bum got a bit sore from all the wiping, this helped along with metanium etc

When there is a blockage that has been cleared out the rectum can remain stretched so it doesn’t give you the signal that it’s full and you need to poop. Hence why she doesn’t have control anymore, she can’t sense when she needs to go! This will get better. You’ve had pretty sound advice on here and definitely look at the ERIC website!

Ds was a withholder and ended up on Movicol. The multiple sachet days lasted a fair while and he needed a tiny amount each day for over a year but it did end and it seems a distant nightmare.
Good luck.

Has she definitely been prescribed the child version? This happened to us and was a nightmare and it turned out she’d accidentally been prescribed the adult stuff. Was very distressing for all of us.

IF you have adult movicol (which is unlikely) it is double the dose in each sachet of the paediatric dose. So give half as much.

I agree with PP; it must be horrible on holiday, but think you need to persevere with 1 sachet daily.

Try to get referred to a PACE clinic at your local hospital (paediatric constipation & eneurisis (sp) clinic). Ours is nurse practitioner led with a paediatric consultant. The nurse is at the end of the phone to help you day to day as you settle down to sorting the constipation, but sees us quarterly for check ups, x ray if blockages are felt, transit time tests etc etc.
Most important though is get professional help so use ERIC for that whilst you wait for a referral.

DD had Movicol from age 3 to age 7. She's finally now doing well off Movicol.

I hope this was a one off for your DD.

There is an end eventually. I went through all this with DD she is fine now, but DS age 4 is horrendous, he wont go with movical.
I found the daily duplicax stool softener help regulate DD it is natural poo softener it brings water from the body into the bowl.
I used to give her a daily dose of 3 mill with movical, I stopped movical after 3 weeks, using the duplicax daily for nearly a year, with lots of water each day, I reduced every few weeks, it helped regulate her bowel.
I think she was about 5 when it settled.
Its awful. Goodluck

*Bowel

You need to disimpact as per the ERIC guidelines (GPs are mostly clueless about this). You will increase the number of sachets every few days till you get to 8 sachets and stay at that level till you have bowel movements that are like a cup of tea (rusty coloured). Ideally stay at rusty tea water for 3 days before gradually reducing so you can find your maintenance dose.

Best tip is to join the "Movicol Mummies" group on Facebook which provides so much info and support.

Forgot to link: www.eric.org.uk/pdf-a-parents-guide-to-disimpaction