To avoid giving toddler Movicol?

[User79853257976]

Toddler DC has had constipation for a couple of months. A nurse reluctantly prescribed Movicol and said to try it for a week and then try to stop using it.

I am concerned about disrupting DC’s gut microbiome long term, especially as we have intestinal problems in the family.

We have tried upping fluid intake and tried natural remedies but DC is not a good eater at the moment so this has had limited success. AIBU to keep going with natural remedies? DC occasionally has a tummy ache but otherwise it’s more of a soiling issue. Any advice?

He poos almost every day. Today was the first time he had a little bit of overflow. At the appointment it was debatable as to whether he was actually constipated or not, since he goes regularly. The nurse seemed to feel it was very borderline if any medication was needed. If you look on the ERIC website it says it is easy to miss the signs as it’s not always simply not going for days on end. I’m going to use the Movicol based on some of the more helpful replies.

Speak to the pharmacist about your concerns when collecting the medication Op, she/he will be able to advice you without telling you what to do. It’s important to get the balance right obviously but what you really don’t want is a child who gets psychological problems due to refusing to go over the risk of pain - that’s MUCH harder to treat than to try the medication periodically when he is constipated. It’s not a long term thing, just now and again when things aren’t resolved by dietary life choices. Get him back on track for just a few days, increase fibre, exercise and fluid intake on a day to day basis and go from there. I work in a pharmacy, the staff are quite knowledgable where I am and very happy to help without any judgment.

I would be really really concerned for your son if you don't give it.

Being constipated for so long will also do damage and it's now very very likely he will withold pooping.

I'm 4 years into a poo witholding hell with my 5 yr old so I want to scream into my phone for you to give him it!

Thanks for your reply. He has had two tummy aches (ever) so I haven’t let him suffer. I’m doing the research to find a way forward. He poos every day so it’s not at the stage it was with your daughter. I have read that it can have some negative effects but I will give probiotics to help with this.

He poos every day so it’s not an emergency. The signs have been very subtle up until today when there was some mild overflow. Constipation doesn’t always mean not being able to go at all. I’m going to give him the Movicol.

Thank you for your kind reply. I knew some people wouldn’t be kind but without putting all my personal medical history on the internet they won’t get it. I’m going to collect the prescription and get probiotics as well.

We’ve recently paid for private Gut testing. No way of knowing for sure but we are working with with a functional doctor, also he was under a GI specialist, many feel movicol strips the gut of bacteria’s. My little boy has chronic pain issues now, also has allergies tbf but movicol absolutely made things worse for us. Just my experience. It draws moisture from the body and has been known to cause tics etc and behavioural issues

Oh - thank you for the information.

Hi OP, just want to say I'm very sympathetic as we had constipation problems with our daughter when she was four to five years old. She went on laxido and that sorted the problem but now I hardly ever give her any but make sure without fail that she has a probiotic powder every morning with breakfast. This keeps her gut healthy and has helped constipation so much.

When it's been a while it's worth trying anything! Our DC was prescribed Laxido, it worked but took a while. Our go is prune juice/puree, also Andrews low dose is good! Xx

My DC was on daily movicol for 2 years from age 3-5 due to constipation, pain, withholding and fear. If I’d tackled it right away we might only have had the constipation to deal with. He had a varied diet etc but nothing worked properly until we used movicol. He was fine by age 7 but I dread to think how bad it would have been if we hadn’t used it and he had regular “overflow” incidents…especially when he started school.

Use the medication as prescribed until he is regular and then wean him off it gradually.

Puréed Mango is great for constipation!

This

Yes the scientific knowledge is this, as taught to me by a paediatrician. if a kid stays constipated for too long several things happen, not necessarily in order. First is the poo liquifies around the solid poo and leaks out. Frequent soiling. Second is the sphincter muscles loose their tone from constantly pushing out hard stool. This loss of muscle causes more soiling. The child can get a phobia of passing stool. It hurts, they refuse, make the constipation worse.

The loss of muscle can take years to resolve. I mean several years. Our kid was 2 when it started and it wasn’t even that bad constipation to start with - just a few hard stools during potty training that caused a phobia, and many years of soiling. Frequently whilst out and playing with friends. Sometimes at school.

Don’t risk your kid going through that. Fruit juices etc. aren’t enough. Movicol works (our kid has no subsequent health issues - very healthy child, no bowel issues, rarely ill. Nip the constipation in the bud now and save yourself multiple years of pain.

@Mailys which probiotic powder do you use pls?

I use Optibacs probiotic powder for children 0-12 years. They also do gummies but I've always used the powder sachets so can't say from experience if the gummies are as effective or not. But a good idea for a back up if your child doesn't like the powder drink. I mix my children's sachets with a bit of squash so they think it's a treat as it's the only time they have it 😊

i have been using movicol for a couple months now and my 3 year isn’t getting any better on toilet. She just keep having accidents and pooing herself. I don’t think she can feel the muscle. Has anyone ever experienced this?

Yes, it’s quite normal if they’ve had constipation issues and stretched the bowel. Ask your GP for a referral to the continence team for support

Yeah my son has had trouble with constipation and movicol has been excellent.

Havent needed it in a while now, fingers crossed!

Keep a bottle of lactulose in your cupboard for future flare ups

@Zigza any (decent) evidence for the claim that movicol is associated with tics or behavioural issues?

@angrylizard mainly personal experience with my 11 year old, various gastro iaaues over the years - he was put on movicol at 9ths - started getting tremors around that time. I started doing my own research when he had huge stomach issues last year which led me to a Facebook group- parents against miralax- some of it was eye opening and really resonated with me. Some was very dramatic but I think it was useful in terms of our situation and I definitely gained some really useful information

some studies www.ncbi.nlm.nih.gov/pmc/articles/PMC6061967/?fbclid=IwY2xjawFjwt5leHRuA2FlbQIxMQABHYKVzVWYNefC03K_ar_GyJsbyYaOCngt0971RiR0DONFbWn4z8qLfQccGg_aem_Gn2h8aqEGgyVpKw1Fj5hWw

So; no.

It's fine to have an opinion or an anecdote but be careful to present it as such, and not fact.

The clinical advice is that you have to treat the problem for at least twice as long as the problem has existed. If you don't do the disimpaction regimen correctly for long enough, the blockage will not be broken down and moved. The poo nurses video explains clearly and simply how to do the disimpaction and the maintenance programme. They include a stool chart, which IMO is essential.

Yes, use the movicol. You’re risking far more by not using it.

In our case, DS was having far too much milk. Not an allergy, but an overconsumption- I didn’t realise it could be a problem. If yours is drinking too much, you’ll need to cut down. The Alder Hey paediatrician we saw explained how too much milk is a prime cause of constipation.