Picosulfate for ova a year for my 4 year old please help

[Jassy81]

Since my daughter was 1 she suffers constapation and she was on 8 movicol and 20 ml of lactolose a day it wasn't working so she was given picosulfate to she has been on it for a year and docs say keep giving it her but I carnt as she is pooping all day and its uncontrollable and she is already underweight what can I do i clear her out and try other stuff after but she just gets blocked up again within days please help

I dont no if anybody can see this I'm new on here

This is a quieter area of MN maybe post it in chat for traffic if you feel it's urgent it will probably get answered soon here but not as quickly as in chat

Have you tried varying the dose? Sounds like she is having more than she needs. We vary between 5 and 10mls a day alongside movicol

She is only on 2.5 ml should be a daily dose but she is like water so I just give her that now on a Fri when she finishes school as school says I carnt take her in if she is that bad on her picosulfate and she still takes all her movicol at 8 and her lactolose at 20ml a day and she dont open her bowel on that so I have no choice but to give her picosulfate

And how do i move it to chat

Have you looked at the ERIC website?

It does sound like she is either having more than she needs or you are still going round and round in a cycle of constipation and overflow and never getting anywhere.

First thing I would do is chuck the lactulose as it is very mild, not helping and so pointless.

The next thing is that you should be aiming for her to have a poo the consistency of thick gravy. Consistently, everyday. You need to work out exactly how many Movicol and how much Picosulfate it takes to get that sort of poo.

And then slowly slowly back down, literally changing the dose week by week until she is just doing soft easy to pass poos and then stick with that dose for ages. Months in fact.

At the moment it sounds like you are rollercoastering between too much and too little and so getting nowhere and her bowel doesn't know what it is supposed to do. The ERIC site is amazingly helpful.

My ds has been taking Movicol and pica sulfate since he was 3, he’s now 8! Although we are down to just i sachet of movicol which we will be stopping (finally) over the next 6 weeks and very, very rarely need the pica sulphate.

It takes time to get the dosage right, and it’s forever changing as they grow. dS dosage has always been set by the PACE team at the local hospital- have you had a referral yet or is it the GP that has been setting the dosage?

During our time at the pace clinic, ds has also been tested for celiacs, diary and other common allergies but was given the all clear. He has a well balanced diet and eats pretty much anything. (much better than the other ds that lives on just a few specific items) how is your DDs diet? As she is underweight, would you be able to ask for dietician referral?

Water is very important. It’s usually the main cause of constipation in older children. As ds has got older, he’s now realised this and is very sensible about drinking little and often. But this wasn’t the case when he was younger

Movicol needs water to work, it’s a softener which makes the stools easier to pass. Pica sulphate however is a laxative. So I would be concerned with the amount being prescribed.

Once ds was pooing every 24-48 hrs, I had to reduce the PS. Till eventually it was no longer needed daily, just as and when he hadn’t been for 2 days. This time period has increased slowly, so now He tends to only need it very occasionally, sometimes during school holidays due to change in routines and eating habits,

You probably have done this but have you tried testing for gluten intolerance?

Yes she had a referral and discharged as I had her pooing on picosulfate every day even though she was like water and she is on the max on movicol and that does not work if its alone only when she is given picosulfate she will poo and I was told to lower movicol to mk her not so watery but she got blocked up within days and yes they have tested her her all sorts of stuff all normal tho and doctors no don't seem to help they say keep her on her pico sulphate that works on its own but she is like water and carnt control herself at 4 and she tends to burn up and cry when she has that to im just stuck if school says I carnt take her in if she is so bad and then we are stuck in the house all day every day when she is on picosulfate

When you lowered the Movicol, how much did you lower it by?

Really just lower it by one sachet for a week, sticking with the picosulfate plus lots of water, see what consistency poo you are getting, take it very very slowly.

Don't be tempted to do any serious cut backs.

I took away 1 every 2weeks

The pico works on its own without any other laxative but it makes her verry watery and she carnt control it

So she's on 8 sachets of Movicol a day? Gosh, that is a lot. And she can't poo on this dose, only when you add in picosulfate?

That suggests to me that she has a major problem with bowel motility. Has she ever been tested for Hirschprung's disease? Because my DD has suffered from chronic constipation since she was a baby, and that was one of the first things mentioned. It was also said that Movicol, being a stool softener only and not a bowel stimulant, is ineffective in children with Hirschprung's.

So, what you're describing is a red flag for me. I can't believe you've been discharged when your child's bowel functioning is still so very poor. My advice is you ask for a referral back to a paediatrician/gastroenterologist.

Yes 8 movicol and 20 ml of lactolose + picosulfate wat gets me tho she's been sent to hostpital to have enemas done 3 times and the last 1 didn't work and she had to go bk in the next day to have a bigger and more potant 1 done she is 4 yrs old and verry little

I now don't like gravy

I think you need to rule out something like Hirschprung's for sure.

Thank you for all who responded it was much appreciated i will mention it when I take her to the doctors