He won't drink movical and the senna has not worked...what now?

[HumphreyCobblers]

4 year old DS (possible asd, severe receptive and expressive speech delay) has had ongoing constipation issues, not completely bunged up but constantly moving small amounts through. It has meant he has had to go back into nappies as I can't ask nursery staff to deal with this otherwise, it is really stinky and sticky. He doesn't seem to have the urge to go to the loo and do it any more.

We tried lactulose, then movical. He will not drink the movical. The doctor prescribed senna but two nights running it has not made any difference.

His diet is most likely to blame but we are powerless to change this any time soon.

Does anyone here have any ideas? Sorry for the way TMI here! I am on my fourth nappy of the day and the house reeks. Poor DS, it can't be comfortable for him.

I don’t know how if he would drink it but have you tried chocolate movicol?

It sounds as if he has severe impaction with overflow.
Are you supposed to be doing a disimpaction programme?
What are you putting the movicol in?

Do read the advice on the ERIC website if you haven't already.

What will he eat? Can you hide movicol in his food and up his drinks?

You might not want to hear this, but Movicol is the best treatment and will work so much better than Senna.

You may have to get creative though.

Thing is, mixed into water it tastes awful. I find that strong squash disguises it pretty well. And given first thing in the morning when they're thirsty helps!

You can also dissolve it into a tiny amount of water (like a tablespoon per sachet) stir and leave until fully dissolved and syrupy looking. Then you can mix it with anything - smoothies, custard, yoghurt, make into jelly, make into ice pops, etc.

it is chocolate movical and it is going into chocolate soya milk. We tried the ordinary in squash but no luck. He sometimes will drink a few mouthfuls.

Would it be more runny if it was impacted? We have been assuming it is lack of fibre, he eats no fruit or veg apart from dried bloody mango. He will drink apple juice from a carton but wouldn't have movicol in that either

Will look at that website now, thanks!

This morning I mixed it up well in the milk and gave him a straw, he did drink a bit of it.

If it is runny and smelly it is very likely to be liquid passing the blockage. That would fit with loss of sensation too.

Will he eat milky cereal? Things like coco pops are good for disguising the taste and texture.

You can also phone or email ERIC - they are very helpful.

Dried mango isnt good if he isnt drinking loads of liquid.

He eats these things

peanut butter
dried mango
potato waffles
chips
sausages
toast and butter
rice cakes
bread sticks

all these are brand specific

I want to cry now, reading that list. I care so much about food

oh I assumed that the mango would be helping not hindering

thanks for the responses. I will try and come up with a movicol plan

Dried fruit is great as long as he is drinking enough liquid to rehydrate it en route.
If he doesnt drink plenty it can contribute to the blockage.

Has he had an abdominal Xray?
That is really the only way to see impaction.

An amazing tip that my HV gave me when this happened with my son was, bizarrely, about position on the loo. If he will do it, the best thing is for him to sit with his knees HIGHER than his bottom. I used sit DS2 with stacks of books under his feet and then read stories to him! It made a massive difference and apparently there is proper physiology behind why it works. It was a revelation to us and is really worth a try - but I would keep trying with the Movicol too.

no x ray yet

the stuff coming out is incredibly sticky rather than runny

I used the plain movicol and made the squash stronger to make it. It really is the best option. They think my ds will be on it for life so it was worth persevering with it for me. I’ve gradually reduced back down to a normal amount.

unfortunately he will just get off the loo after two seconds, he is not really bribable either

I will definitely keep trying with the movicol, I have just syringed some of the diluted stuff directly into his mouth. I also got him to blow up a balloon to see if that moved things along a bit

thanks for all the replies, I really appreciate it

Prune juice .... a half pint glass gets me going within an hour ( I would suggest half that amount for a child) ... make sure it’s ice cold though or it’s a bit gross.

Do you know you can use more than one sachet of movicol in a drink? I was only told that last week but it has made life much easier!

I wouldn’t bother with trying to sit on the loo at the moment. Keep him in nappies, keep the movivol going. The sticky stuff is likely to be overflow. Still got the big ‘release’ to come I think!

Best success we’ve had is strong squash and lots of praise. I teach in an ASD unit and we often do movicol at 9am and 3pm as children tend to take it better at school. Will he do better at nursery? We have the advantage of being ASD specific so geared up for things like this but it’s worth a try.

Orange juice and a bit of lemonade as a treat disguised plain movicol well for ds.

Does he not eat pasta shapes in sauce? I've known people hide it in that before.

I can see he's clearly particular about food and drink but would a new cup for squash not motivate him at all? Poor you and poor him.