Can’t disimpact daughter feel so helpless.

[Ffswhatnoww]

My 5 year old has chronic constipation, I’m guessing due to her very limited diet and then withholding.
This has led to impaction which is being treated with Movicol. The thing is I can’t 1 into her never mind going up to 12 if need be. We have the chocolate one and she still won’t take it. She can taste it every time.
The next step is picosulfate and a high dose of lactulose but the problem is I won’t be able to get that into her.
She won’t drink chocolate milkshake, juice, Fruit shoots, just milk which doesn’t cover the taste. Tried cereal, yoghurt even stews and mashed potato.
I just feel a bit lost and hopeless. She’s not passing bowel movement just lots of little blobs through the day.

What an awful situation for you both. I've read suggestions of trying very cold drinks e.g. squash and using a straw - both to help with the taste.
Plus a reward chart or treat for each dose.

And I think you can get a plain one rather than the chocolate.

We are the same with autistic 6 year old DS. Feel happy if I can get two down him max. We have just had s consultation with our incontinence team and they are suggesting different medication so might be worth asking? They have said something about a stimulant. My neighbour's son has liquid senna which she says tastes much nicer.

It's really tricky isn't it? I have heard putting it in thick chocolate milkshake or mousse can help. If you can't get it into your daughter in any way, please get medical advice because impaction can cause additional problems which can be avoided.

We got the plain one and did extreme bribery with chocolate buttons to take the taste away. The flavoured ones were pretty disgusting I think. We had this on and off for several years and it was very stressful! You have my sympathy. The ERIC website has lots of good advice

DDs consultant gave us the plain one and told us to mix it in Ribena, not ideal but it worked, she couldn't taste it at all.

We had the Pico Sulphate too which I surprisingly did get her to take.

You have my sympathy it was an awful, stressful time.

Also make it with very cold water as well as a PP said and mix it really thoroughly.

Plain is better - much more hideable.

Also picosulfate is a tiny volume so much easier to manage.

Get the plain one and hide it in squash. I can't think of anything worse than flavoured movicol.

I know it’s a bit random but could you freeze it and make it into lollies? Bowel impactions are horrible - go back for more advice otherwise to the dr because children that have restricted diets are plenty.

Movicol is a lot of liquid to get into them.

I’ve tried plain one, I’ve got plain and chocolate at the minute. She won’t take squash,only milk

As a “long term” option, try mixing all bran with chocolate - I think it’s about 29g of fibre per 100g. You could add nuts (pistachios are higher than most) and coconut for variety, or chopped dried fruit (prunes would be good)

DS1 was hospitalised last summer when impacted (when he was 4) and is on lactulose permanently. It’s a nightmare

Is she on cows milk? My daughter was terribly constipated and the milk was the culprit, switched to almond and soy and the effect was immediate. She's 12 now and I can still tell if she's had a milk drink by the time spent on the loo.

Only thing she’ll drink is cows milk. No ribena or squash unfortunately 😥 I have both the plain and chocolate. Tried making lollies but can still taste it

Have you tried asking her what she'll take it in? We used to get it into DS in the Plain version in orange juice or squash - and he was a calpol refuser due to "taste"....

He could still taste it but I did a whole lot of explaining why he needed it, and also it was a massive help working out what caused the constipation (in his case dairy) and we do fruit / veg counting to get the right amount into him so he doesn't have to take it.

One of our patients said that fresh apple justice is the best thing to disguise Movicol in. Could you get the adult sachets as they are double the strength of the peadiatric ones. So you'd have to give less.

I was a chronically constipated child back in the dark ages. My mum used to give me this:
lloydspharmacy.com/products/care-liquid-paraffin-150ml

I quite liked it! It worked reasonably well.

Except for one occasion when I had awful pain which I clearly remember, the constipation didn't bother me that much. It was my 'normal'. My mother was more concerned about it than I.

I'm a really fussy eater - can't stand any type of Movicol, but lactulose is fine - it just tastes sugary.. maybe try that? Plus you don't need anywhere near as much :-)

Have you tried glycerin suppositories ?

We put plain into milk and poured it on weetabix.

Are you on Movicol Mummies Facebook group? Loads of people in the same boat and loads of threads on how to get the meds into them.

We ended up giving it in milk (sometimes cow sometimes almond etc) with a scoop of nesquick. It's the only thing to make it palatable for them. They don't get the nesquick at any other time (to help bribe them to drink the movicol).

Does she have additional needs, because I think that makes a huge difference to how you approach it.

If she's autistic do you have a local outreach service who could help you with strategies?

Glycerine suppositories was what worked for us. We had the movical laxido and lactolose which was a constant battle after two weeks of not going a doctor prescribed us the suppositories and we never had any issues ever again. I do believe you can buy them over the counter

She doesn’t like weetabix, it just seems to be that she doesn’t like anything and what she does like she can taste the difference, just a bit scared about how bad it’s going to get before we find a solution. Don’t really want to go down the suppository route unless really need to

Could you melt some chocolate and whisk the movicol into the chocolate? Then drizzle the chocolate onto something like fruit or cake?