TMI Alert Constipation - is this how lactulose works?

[lemniscate]

Previous threads on here suggested DS (3.9, loads of wee and soiling accidents) has constipation (thank you everyone who suggested it!) and GP agreed. Started on lactulose on Tuesday night - 5ml am and pm.

Still lots of soiling, but instead of being soft and explosive as before it is now dark, fairly hard and sticky. Only one big poo since Tues, the rest has just been a small amount in his pants with nothing extra when he sits on the loo.

Is this how lactulose works? I was sort of expecting the floodgates to open and it woosh out like diarrhea, or for him to have an uncontrollable urge and a big hard poo come out, but it appears to just be continual small deposits of very sticky stuff...

It's very distressing for him because he is embarrassed and upset every time it comes out in his pants and we had a hysterical time cleaning him up this afternoon when it happened while out at the theatre :(, so I would almost prefer one massive explosion than all these small bits.

I did warn TMI . Sorry...

Personally I'd up the lactulose until he has a massive clear out and add a stimulant (syrup of figs from the chemist). ..it's a softener not a stimulant so he may still have lots up there that needs a big shove to help shift the backlog (as it were!) Lactulose is great for keeping things moving once they ARE moving, but sometimes you need to get it going, especially if he has been constipated awhile.

My empathy...had years of it with my DD1 (thankfully now outgrown!)

Thank you :) He loves prunes so I can probably let him overdose on those for a few days! Will nip to chemist for some syrup of figs too.

I was given that for my baby with constipation and it made no difference at all. So he now on movicle too.
Yes it makes pooh sticky.

Lactulose is sugar that causes the poo to absorb water to help it go through easier, but I don't think it actually clears the blockage so to speak.

Although given this was a couple of days ago, hopefully the situation has now been adequately resolved

my son is 2 y 9m and has a daily sachet of movicol and this has regulated his poos really well, maybe try switching his meds if you dont feel its suiting him x

Talk to you GP again about what is best for your DS (allowing for age and exact symptoms).

Lactulose is a bulking/softening type of laxative. It doesn't provide a single "depth charge" (IYSWIM). My guess about the hard bits is that they are the impacted faeces which caused the previous constipation now being moved out of the body because of the additional push from the lactulose formed softer/bigger/faster ones now forming up behind.

So even though he dislikes the process, you can tell him (honestly and accurately) that things are on the mend (and that you'll look for faster methods too).

Movicol is best in my experience. You can vary the dose. We ended up in hospital (extreme case!) and had huge amounts of movicol to clear her out. Then twice daily to make everything soft, regular and painfree (she was terrified of pooing) then down to a daily dose. She is on 3 doses a week now and has a good clear out the morning after ! She calls it her poo meds. If she is feeling a big "bunged up" she will ask for an extra dose.

BTW if he has a stretched bowel his poo will get lodged in that section and only the move liquidy stuff will get thru. (imaginee a gargen hose with one section mage out of tights? as the poo gets to the stretchy bit it just expands and then can't go any further! ) As his bowel matures the stretchy section will improve and all will be fine. Movicol keeps everything moving thru to give the bowel a chance to "toughen up" I hope this helps (the consultant explained it better!)