Movicol faecal loading

[bombaygin]

My DD (10) had her appendix removed 3 weeks ago and now has faecal impaction. We were sent to the children's ward on Wednesday night as she was in so much pain and an ultrasound diagnosed the impaction.

Discharged Thursday evening with instruction to give 4 sachets of movicol per day.

She managed to drink 2 doses Thursday night and has since had a 4 doses Friday and Saturday and on with some more today...

But we have had no movement at all.

Should it be working by now? Do I increase the dose? They didn't say I could though so I don't know what to do.

Also would you send her to school tomorrow or keep at home? I'm not sure what to expect, but I'm thinking maybe she will need to be near a toilet and school might not be the best idea.

Thank you for any advice.

Personally I would keep her at home until she has been to the toilet.
You can call the children’s ward and ask for advice re the dose.

Ring the ward but yes you may need to increase the dose until she's very well cleared out.

There should be a disempaction regime starting at 4 sachets and going up to 12
Weren’t you told anything before leaving the ward?

I’d phone and ask to speak to the on call paed registrar explain and they should either see her again or advise you to increase sachets or similar - do it now as the ward round will be on and if needed the consultant may be able to advise also if it’s the same one you saw during the week.

movicol does take a bit of time to work and yes keep her off school, did you get a Bristol stool chart? Helps to know what stage she’s at - check anything she passes also usually overflow to begin with and it smells quite foul and monitor until she can produce normal stool again and hopefully she won’t have anymore issues.

Thanks for the replies.

I rang the ward and spoke to a Dr who advised to increase to 6 per day for the next few days and then to a max of 8.

We will need GP appointment/phone call in order to get some more supplies as they only gave us one box to bring home.

I will keep her off school but it's stressful as I've just started there as a dinner lady and already had 9 days off with her having operation and in and out since....I am single with no back up, no parents or family to help out. The school have been very supportive so far though

Have you got a discharge letter from the hospital? I've rung the GP's receptionist before, explained we need more of the medication on discharge papers and why and the GP has prescribed without needing an appointment. Obviously only works for certain things but paediatric Movicol should be fine.