Movicol advice-disimpaction over several weekends or just increase the dose?

[krisskross]

Hi,
I've posted several times about my DS aged 7 and his constipation, so i won't give you another long history.

To cut a long story short, we saw a paediatric gastroenterologist privately.

He could not feel any impaction in his abdomen, but said there may be some bits and suggested disimpaction. As DS is at school, he suggested doing it over several weekends- increasing from his usual 2 sachets to 3 on a friday, to 4 on a saturday. Has anyone done this?

Having done a bit of reading about movicol i am now wondering if instead of doing this, we should just be gradually increasing his dose by half a sachet every couple of days instead? Especially as no doctor has actually felt impaction, its more that he is in pain going to the loo and never feels emptied. Could the problem be that the movicol dose is too low?

FWIW (and sorry for too much info) he goes to the loo morning and evening and it has the consistency of a slushy drink and he is in a lot of pain doing it. Sometimes its pellets. He never soils.

(Obviously there is a prob causing the consitipation to start with- but we will deal with that once his pain from all this is better)

Thanks for any advice

My ds aged 3 has 4 movicol a day but you can have up to 12, depending on what paediatrician says of course. Movicol only softens the poo to make it easier to pass. Sometimes you need a stimulant as well to make the bowel release the poo - senna or sodium picosulphate. With the movicol you need to drink lots of water as it absorbs the fluid in the bowel to soften up the poo. Maybe worth another chat with the paediatrician?

Our DD1 has has to undergo disimpaction a couple of times.

I'm a bit perplexed at the advice of doing over a couple of weekends. We've done it over 7 days ending up on 12 sachets on day 7. And then back to the two sachets a day maintenance.

I've only ever seen it done over weekends with a teenager who refused to do through a full disimpaction regime (usually 7 days, can be longer) because he was so scared it would make him have accidents at school. It did actually work, but it took a lot longer to get anywhere than with traditional disimpaction. Maybe he's thinking that he's not full-on impacted, but has a little bit of a backlog, and doing weekend increases would help him catch up, but that because he can't feel anything doesn't need the full on version?

Thanks everyone, yes nocool I think thats his logic. All rather confusing. As we have no experience of this I am.concerned he may still be feeling the effects on a Monday. I'm really thinking we should first try upping the dose a bit
....had I known we could I'd have asked about it when I had the chance.
Anymore experiences? Thanks everyone