GP won’t prescribe anything but Movicol.

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I’m really struggling with what to do next, my child has fecal impaction for the past couple month. GP prescribed Movicol which she just will not tolerate. I’ve tried squash, milk, yogurts, pasta sauces, hot chocolate, nesquick, cereal.. basically anything she eats or drinks which is not a lot as she’s a very picky eater and only drinks milk.

I rang the GP today and asked if there was any other things I could try but she says according to guidelines all she can prescribe is Movicol and it ‘has no flavour so don’t know how she can taste it’.

I’m at a total loss of what to do now as she just absolutely refuses anything with it in, I can’t get one down her never mind up to 12. It just won’t work. She hasn’t had a proper bowel movement in weeks and just leaks multiple times a day. I have a referral to bowel and bladder service but there’s a long waiting list.

Is there anything I could buy myself?

Can you ask for the chocolate flavour it might be easier to hide the taste. Hope you find something to help.

GP won’t prescribe anything but plain Movicol 😔 says it doesn’t have any taste so won’t prescribe anything else. She obviously never tried it before as it has a awful, salty taste.

You can get lactulose (OTC) which isn’t as effective but tastes of sugar so might be more palatable, especially since you don’t need to dissolve it but can syringe the required amount in.

Sugar free gummie bears have a reputation for doing the trick ( read the reviews on Amazon) ...... But seriously would a pharmacist be able to help perhaps?

Hi OP there’s a brilliant FB group call Movicol Mummies; it’s all parents who’ve been through exactly this and can help. The GP is talking nonsense you get paediatric movicol in chocolate (and other flavours) as well as lactulose which can be used to disimpact. A stimulant like picosulphate is often used as well. Call back and insist, ask for a different GP if necessary. And joint the group, the knowledge and advice on their is truly brilliant

Nothing you can buy yourself will be nearly as effective as macrogol (Movicol), which is the recommended treatment for faecal impaction.

I could be wrong, but I'm not sure they even make the chocolate flavoured one for kids any more. In recent years, there has a been a big drive to reduce sugar in children's medicines (idiotic IMO as you invariably end up having to ply them with something much more sugary to hide the taste).

Have you tried mixing it into chocolate ice cream or yoghurt? This is what I always recommend, as the strong flavour of the chocolate in them (stronger than hot chocolate, I would say) disguises most things.

movicol is the medicine your child needs.

how old is the child? Mine started on movicol at age 6 and we had a lot of bribery (drink it cold while watching favourite TV show) to get it down, but it has to be done.

Talk to your child, get her to agree that she needs the medicine and work together to find a way to get it into her. Once she has got used to it the first few times and has felt the benefits, it will get easier.

@Jeezypeepers

Hi OP there’s a brilliant FB group call Movicol Mummies; it’s all parents who’ve been through exactly this and can help. The GP is talking nonsense you get paediatric movicol in chocolate (and other flavours) as well as lactulose which can be used to disimpact. A stimulant like picosulphate is often used as well. Call back and insist, ask for a different GP if necessary. And joint the group, the knowledge and advice on their is truly brilliant

It's good to know that the chocolate version still exists but, looking in the BNFc (children's medicines 'Bible'), just now, it's not coming up as an option to prescribe, which may be why the OP's GP hasn't issued it.

It may be worth asking your pharmacist, OP. If the GP issues the prescription as macrogol (the generic name, not a brand name), the pharmacist has more freedom about which version s/he gives you. However if the prescription says a specific brand, e.g. Movicol, the pharmacist is only allowed to issue that particular one. Confusing I know, but maybe show this thread to the pharmacist?

All kids are different of course but we found lactulose worked well for our DD who was having bad trouble with constipation and overflow etc ... bless her heart. Not long after she takes it she poops like a rhino 😱

Sugar free gummie bears have a reputation for doing the trick

Sorbitol is the ingredient to watch for. I once, by mistake, bought some jam intended for diabetic people. That was an - interesting - experience. Not one I wish to repeat.

The chocolate flavour is only in the adult range. Our v sensible and pragmatic GP prescribed that and told us to give half a sachet. If you have loads to take then it sounds like the half adult dosage would help anyway. It doesn't need a lot of liquid to take but once taken it helps to drink a lot of any other liquid over the day to make it work effectively. It also doesn't have to be taken all at once, you can make a jar and keep it at the back of the fridge, it is easiest to take when v cold.

Agree you should try another GP, this one isn't helping, and whilst there ask for an urgent referral to the Paediatric Continence Team too, no child should have to stuff for months and they'll help with longer-term management. Have you seen the ERIC website?

We also found that the super-thick chocolate milkshakes were better for taking it if using the paediatric plain.

Best of luck.

Dulcosoft is your answer. It's tasteless and undetectable. Unfortunately I have to pay, but after 18 months of daily soiling and 6 months trying to drink movicol it's a miracle. (Dd7, not myself).

Here is a link for ease.
And yes it is the same, it is a macragol like movicol which is just a brand name. Laxido is another brand, cheaper and hence more disgusting.
And no, not all kids can be convinced to drink movicol. It costs me £20 a month, money very well spent.

www.amazon.co.uk/dp/B01ASEE5NK/ref=cm_sw_r_cp_apa_i_x8TgFbC58NQMG?tag=mumsnetforu03-21

Your GP has clearly never had to use movicol if they think it doesn't taste of anything!

Lactulose is very good, has a slight caramel flavour. So long as you can tolerate lactose. Some children struggle with that too though. Cali fig was always good too until they changed it to all sweetener and it tastes horrendous, even mixed in with stuff

Thank you all very much! Can dulcosoft and lactulose be used for disimpaction?

Obviously I will still be trying to get the Movicol into her until I can talk to the GP again or get an appointment with the bowel and bladder service.

I’m on Movicol mummies too, they’ve been very helpful

We did a mini disimpaction with movicol and sodium picosulphate liquid, advised by specialist nurse.
You can use dulcosoft for disimpaction, but it will cost you!
No experience of lactulose.

My DS (6) point blank refused paediatric Movicol, but will quite happily drink the cheaper Laxido with a bit of squash. In our case, DS has issues with the texture rather than the taste and the Laxido seems to mix in better

Movicol paed chocolate is in the bnf, just found it and we still have it in our dispensary. It's not very popular though, parents often tell us they prefer the plain and dress it up with their own flavours etc.

I agree with previous posters, ask for it to be prescribed generically as Macrogol and you and pharmacist can then pick from a variety of brands.

I don't know if you mentioned but have you tried using a straw?

Best of luck

My DD will only take movicol if it is mixed in with fairly strong Robinsons orange squash. It has to be orange, if I make it with blackcurrant she refuses to drink it. I wonder if the orange has a stronger flavour and masks the movicol more effectively?

Movicol paed chocolate is in the bnf, just found it

Hmm, when I view the BNFc via SystmOne I can't seen it but, when I look directly on the BNFc online, you're right - it's there. How weird - but good to know.

If it's salty, try it in a caramel sauce on American pancakes, just don't let them see what you are up to, and eat "the same" with them.

I have the same issue except my patient is canine, I wrap his pills in food and give at the table, if I gave in the kitchen no chance.

When dd has having bowel issues I made "sweets" from chocolate and dates, worked a treat.

My DS was on lactulose for years, it stopped working and he was switched to Laxido. He hated the taste at first but lots of bribery, cheering etc really helped. We make it up with the required amount of water, a good amount of Ribena and then put it in the fridge. The colder it is the less he seems to taste it. He also used to hold his nose which seemed to help but doesn’t do it anymore. We’ve never had to do a fusion action though.

Fusion action??! Disimpaction!

How old is dc? My ds was under hospital from age 3. When he about 5/6 we went through a stage where his impaction was bad and he was refusing his medication. TheGP had quite a firm Chat with him - and it made such a difference having a professional tell him what we had been trying to say. It made such a difference coming from someone else. The doctor made him realise he could help control this problem and make it better for himself.

Movicol btw is not a laxative- it absorbs water and makes stools easier to pass. It’s needed to maintain healthy bowels. But if the impaction is bad you may need to use a gentle laxatives like pics sulphate alongside it to get things moving. You also need to drink lots of fluids whilst using Movicol and consider dietary factors.

You need to speak to another gp and insist. There are other medicines you can give for children. My dd would not take movical, they prescribed the chocolate flavour and still she wouldn't. My gp was very understanding and prescribed lactolose. There is also another medication called docusate which you can get on prescription and I have been told there is a couple more medications that can be used. Don't be fobbed off.
You will find it better once you have spoken to the continence team as they are usually very good.
If you don't get anywhere with gp then I'd honestly go to a and e. If your child has not passed a movement in weeks as you say then that is serious, painful and unfair on them . Good luck