6 year old bowel issues and movicol

[Owletterocks]

Can anyone help? My 6 year old ds is leaking poo almost daily. This has been going on for over a year. I took him to the GP initially because of this and abdo pain and he was started on movicol, his pains got so bad he was grey, doubled over and clutching his side so I took him to a&e, they said constipation and put him on the empacted regime of movicol which said to stop once he had cleared but every time we did he stopped going to the toilet at all. I have since had him on one sachet and then 2 sachets daily. If we miss a dose he doesn’t go for days and leaks poo so we have been vigilant and made sure this doesn’t happen but he is still leaking poo or not making it to the toilet on time. I have no idea if it’s too much movicol or not and am getting no guideance from the GP at all. I am starting to wonder if he has another bowel condition or intolerance that has been missed. I am at my wits end, he also wets to a degree daily, we have been referred to the continence team at last but there is a big wait. If anyone has been through similar and has any ideas I would really appreciate it.

Sorry for the lack of paragraphs! Was typing too quickly. Also meant to mention that he passes big blobs of soft poo that sticks to the side of the bowl and is hard to flush. Not sure if that’s significant or not

Not a doctor

My son is on infant movicol and he is on 1/2 a sachet a day. I’d get a second opinion and make sure it’s the infant one you’re using (purple and white)
Movicol hyrdrates the poo in the lower intensitines so that it’s softer, so it might be that he’s getting too much if it’s leaking. Is he holding it in at all? I’d hes leaking and trying to hold it in it could be making things worse for him? X

If he's leaking then he's still constipated. So he needs another clear out
I'd suggest going back to go and asking for a referral. In our area we have a constipation nurse.
Also look at the ERIC website.

Sympathies as two of my children have had this issue and for DD it took about 5 years before she came off the movicol. DS2 still takes it and is still a long way from being sorted.

Just to add we were expressly told by the doctor that movicol can’t be switched on and off, he would basically need to be weaned off it - so smaller dose each few days then every second day etc

Your son needs referring to a paediatric gastroenterologist/specialist constipation clinic to get him on the right drug regimen & his bowels moving regularly. The period before puberty is crucial because they are still growing and it can be sorted with appropriate treatment. If it doesn’t get sorted, these problems (soiling, continence) can continue into adulthood. Start pressing your GP much harder for effective treatment. Specialist clinics are much better at working through the different drugs/doses until they get it right.

If he is leaking then he is still blocked, my DD ended up on 16 sachets a day at one point but this was in hospital, she was on it for about 4 years. Definitely go back for a referral, how many is he on at the moment?

Maybe daughter had leaking and constipation. She was tested for intolerances and she has fructose intolerance. The other one they tested for was lactose.

Once we cut affected foods out her diet it cleared in about 2 weeks.

What is your son’s diet like? Would you be willing to work out what is triggering the issue?

The wetting is quite likely linked to the constipation.

I would push for a gastro referral. We are waiting for our first appointment and here it’s a 6 month wait. We are currently on 2-4 sachets of movicol and 5-10ml of sodium picosulphate to keep things moving.

Thanks for the replies, he is definitely on movicol paediatric and has been referred to the continence team but we have just received a letter to say he is on a waiting list.

His diet is fairly good, he will eat most things the only thing he point blank refuses is pasta and he doesn’t really like drinking milk.

That’s interesting about intolerances, I will make a GP appointment and try and get one of the good GP’s. The last one told me that no one would do anything about his accidents, felt like crying after that. He is getting upset by it now he is older. I would be willing to try anything right now so a definite yes to working out triggers.

He has started to say that some foods will make his tummy feel funny so that is what’s made me think of intolerances. He was a refluxy baby as well, vomited until age one

You need to get a referral to a consultant.

Ds was like this until he was 4, we spent a week with movicol “clearing him out”. He also prescribed Sodium Picosulphate along side the Movicol- it made a huge difference.

The consultant described it as “giving the bowel some oomph”. He has been clear of any issues for over 2 years now.

Download a Bristol stool chart too, we recorded types of poo until we got to number 4.

It wasn’t until our consultant appt that I fully understand what was going on and how to help fix it

Has he been tested for coeliac? Before I was diagnosed I couldn't stand the thought of eating pasta!

I am not medical, but I have been through it with DS, it sounds like overflow diarrhoea, in which case there most be blockage, harden poo inside the rectum expands and the new wet poo leaks around it, you son will have absolutely no control over this.

See your GP, for a referral to a Paediatric Gastroenterologist. Some are better than others the first one we saw, completely useless I have to say, the second was absolutely amazing and got to grips with the problems immediately and DS has been fine ever since.

I was honestly at my wits end before we saw amazing paediatric Gastroenterologist, my DS was 12 by this point, and I felt desperate.

And we have been going through this for years and no one had been able to solve this issue.

The first thing the consultant said was to examine DS just by feeling his tummy, NOT up his bum as had happened in the past.

Consultant took the time to explain to us very simply what was going on.

The plan was to clear impaction, with Movicol paediatric mornings and Dulcolax evenings.

Messy but did the job!

He now has 2 sachets movicol daily in the morning and then 1 5ml spoon of Dulolax every evening.

DS also had allergies testing as sometimes allergies can cause constipation, they are came back clear.

The consultant said, for every year of constipation equals a year of medication and if it’s stopped to quickly we would soon be back to an acute stage. YOU MUST NOT MISS A DOSE.

It is not a quick fix, as the rectum expands and your child loses the feeling that you and I have when we know we need to poo, but with the medication keeping your DS regular, that feeling will return in future.

Good luck OP, I know how worrying this problem is, and it is way more common than you think, but with the help of the right specialist it can be solved.

I’ve been having the same issues with my 11yo since he was out of nappies. He sees a paediatrician but it’s still happening. So I’m of no help but know what it’s like, it’s so common apparently.

We are trialing dairy free at the moment, which might be making a difference. It’s hard as as he’s so much older I’m relying on him updating me so not seeing it first hand etc.

I think he has been tested for coeliac is that the IgA blood test? If so it was in normal range. Is there any point repeating it?

The thing is, he always needed prompting to go to the toilet but he did regularly pass fairly normal looking poo’s. His constipation was not obvious so I think it went on a while. The trigger for treatment was ando pain that was ongoing and that has definitely settled down. He can’t feel it when he needs a poo, he will be sat on the toilet and poo and then say he hasn’t done one.

*abdo pain

Oh and his poos don’t really look like anything on the stool chart. They are like a big lump of mash

Honestly I would get a celiac test done and then trial gluten free. Don’t do gluten free before a celiac test as otherwise test isn’t accurate.

Also trial dairy free. I would personally do both and then see if settles.

Does he have juice? My friend’s kid’s horrific constipation was sorted when they went on holiday and dropped the diluting juice.

I think you need another route

As a refluxy baby and now constipation I he will have a messed up microbiome. A really good probiotic eg biokult will help.

You need to see a gastroenterologist (this is different to continence) it was years before ds was referred (chronic constipation, severe reflux and he was still in nappies at 7).

The mash consistency is because of the movicol acting as softener, as pp's have said he probably needs something like Pico sulphate or Senna to push the poo out.

Thanks everyone, the pro bio tics are a good shout and easy enough to try.

I am just glad to be reassured that there is an issue here and I am not going mad. The GP’s make me feel like I am making something out of nothing.

Google "Encopresis" it's a bowel issue which my daughter has. She has had constipation and leakage since she was 3. She is now 8 and is finally showing an improvement.

She got referred to the continance team and they were wonderful. She has also had movicol in the past and actually found it made the issue worse.

There are many types of meds to help constipation. (Sorry if you know this) some add water to the poo, some are softners to help the poo pass and not feel as painful and some are bowel stimulants which act in the muscle wall.

Movicol does add water to soften. But unfortunately this can in my daughter's case make the poo so soft all that comes out is mush and she physically doesn't have the straight in her bowels to push this out. So she just gets in a mess and bad pains and cramps.

Her nurse recommended a stimulant senna and an occasional use of lactulose as a softner. She has been told to take up to 7.5mls or 1 tablet of senna (sennakot) up to 2 tablets a day if necessary.

The main problem mostly is the bowel has been stretched so the child doesn't feel the usual need to push until the bowel is full.

It's good you are seeing the continance team soon. It is a long road but my daughter is so much better.
There are a few Facebook encopresis groups for support.

We also use a routine of regular sitting on the toilet and have been advised to use bubbles to blow when sitting on the toilet as it relaxes the bowel and sphincter.