Constipation - Overflow and school

[McSteamyorMcdreamy]

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So 1st full week in reception and DD has had a constipation overflow incident. She was smothered and extremely upset.

She has some developmental delay and whilst she has been dry for months and months poo has always been an issue. After some great advice on here she had been doing really well. Poo Land app etc and we thought we had really turned a corner.

She was great all last week but she is now (visibly) constipated and GP says what happened today is overflow and that due to previous poo issues she may have a more longer term condition, encopresis. He has prescribed movicol but I know this isn't going to fix the big problem overnight.

I will of course speak to her teacher tomorrow (nanny picked up today) but how am I supposed to manage this on a daily basis? Both DH and I work full time. I can't leave work everytime she has an incident, but I also don't expect her teachers to have to deal with it either. Her teachers were absolutely brilliant today.

The thought of my little girl covered in poo in class in front of all of her friends just makes me sob.

Any advice at all? I'm desperate

My DS started with constipation when he started reception, it's tough! He wasn't drinking enough and had hyper mobility which can affect intestinal movement. He had developmental delays too. He was actually still in nappies and has an EHCP which made things easier as he had TA support most of the time.

Are you under the continence team? They have been fab for us, and easier to get in touch with than the GP.

Just speak to the school. We put a plan in place for getting children with longer term toileting issues changed with minimal fuss and as respectfully as possible. We also offer the support of the school nurse service to support us all to ‘fix’ the problem. There is no need for you or her dad to leave work to come and change her. The school will have walked this path many times before, let them help you and your daughter.
I know it’s hard, but it’ll be ok in the end.

@Bobbybobbins

Thank you so much for your reply. GP has said he would issue an urgent referral to our local team. Might just give them a call tomorrow to see what they say. She is under SENDCO at school. I did think about sending her in a pull up in case of an accident but because she had done so well with her pooing leading up to it I don't want to put her back if that makes sense.

She only had a pull up on at night as she only did poo's during the night/in bed. Safe space for her I suppose. As soon as she says she's tired we know it's actually saying "I need a poo!"

@PathOfLeastResitance

What a lovely message. Thank you ❤️

How much movical does your DD have? Would Lactulose be better so you can give a tiny amount like 2.5ml?

Agree that a referral to the continence team would be helpful. Has the GP suggested using Movicol for a disimpaction regime to get her clearer then use a daily dose as a maintenance regime? This can be really effective in kids.

I was also going to ask what continence team input you have had so far? I would suggest a very large step next to the toilet to lift her feet up and improve her sitting position. The change makes a massive difference to pooing.
Constipation & Your Pelvic Floor: Position Matters! - MOTI Physiotherapy (motipt.com)

Also have a read of https://eric.org.uk/ - lots of useful info there.

@Barbiesback I have been told for first 2 days 1 sachet in the morning and 1 at night.
If no movement on the 3rd day to give 1 in morning and then 2 at night.

It was hard enough getting the one sachet in her. Vile stuff!! Even mixed with some juice.

Did they mention a disimpaction regime?

@McSteamyorMcdreamy I've seen the sachets for adults I'm not sure if they are the same size for kids. I would ask for Lactulose you only give a small amount and it's basically like a 5ml calpol teaspoon. A&E gave me some for DS recently as a one off.

It was horrendous trying to get my DD to take the movicol, especially when she was on 8 sachets a day. She could apparently taste it in absolutely everything!

Try not to worry too much, get a plan in place for if this happens at school so she knows who to go to and they can be as discreet as possible about it. They are there to help and they won't want your DD to be upset about it

@Shinyandnew1

No he didn't, I did see it in the leaflet though. I will see if anything happens over night and if nothing will give it a go.

@Barbiesback can you get that OTC?

They can’t go to school whilst you’re doing that though-can you speak to the senco?

https://eric.org.uk/childrens-bowels/parents-guide-to-disimpaction/

@Shinyandnew1 Understood!! I will speak to her at drop off tomorrow morning. My mum picked her up today.

We’ve been under the Bowel and bladder team with DD for many years, and I’d strongly advise against giving DD lactulose instead of movicol, movicol is a stool softener and will help with the wider constipation issue, especially if she’s quite backed up, whereas lactulose does soften stools but also stimulates the bowel and can therefore cause pain and discomfort in children.

If your child is still struggling after a few days, your GP may recommend a disimpaction regime using movicol and also potentially including a synthetic bowel stimulant such as dulcolax.

Fingers crossed it all resolved for her soon OP💐

Have you tried a glycerine suppository? It was the only thing that brought relief for my youngest, the movicol made it worse as soft poo was backed up behind a really hard poo. Not nice putting one in but attacking the poo from the bottom end was the only thing that worked for my youngest. It also took away some of the discomfort of passing a hard poo.

Look at the protective pants for soiling, not sure if they will help? Eric.com sell them. If you do a disimpaction she would potentially need 10 days off school, Dr's can give you a letter to give to the school.

my DS is under a consultant for constipation and takes movicol. Apparently you can get a chocolate flavour one or the regular one can also be put in hot chocolate. My son drinks it in orange juice but it has to be really well mixed in.

Movicol should be mixed with water first, and completely dissolved in the water before you add anything else. If you pour the contents of the sachet into a cup of juice, it won't work so well. We found orange or blackcurrant squash was the best way to disguise the taste.

Don't worry too much, OP. It's a more common problem than people realise. The Reception teachers will have dealt with it before.

This has happened to my dd on many occasions- it’s not nice for them. Mine is on half a sachet now at age 8 and much better but was having a really tough time of it in reception and had a few overflow issues. We’re under the continence team who are brilliant. You might need more movicol each day but you need the specialist advice from them. The consultant we had told us constipation is often a slow recovery- I think it was something to do with the muscles in the colon needing time to recover.
we put movicol in fresh apple juice which my dd takes really well.

I second this website, fantastic information on managing constipation/bowel (& bladder) issues, including cartoons, for parents/carers & children