Disimpaction with movicol not worked- what now?

[zippyswife]

Ds 8 has complained of stomach aches for well over a year. We finally got to a consultant in august who diagnosed chronic constipation and advised a disimpaction regime of movicol and bisacodyl. We followed this but never saw the hard bits or amount I was expecting to. After the disimpaction regime he was still in pain, possibly more so. She x rayed him again and said that it hadn't worked and to do it again. Which we did. He was still in pain so another x ray confirmed he was still fully loaded and it hadn't worked. We've just completed the disimpaction regime again and I don't think this has worked either. He is still in pain from the minute he wakes up every day. Consultant has advised to do a dairy/sugar free diet and that they will do a transit study. It seems to me the disimpaction hasn't been resolved. What can be done now? Are there other options to movicol? Is it normal that he's still in pain after disimpaction?

What was the regimen that you followed? Sometimes the standard process isn't enough.
Have you watched the Poo Nurses video? Spoken to the support service at ERIC?

The first and second regime was movicol up to 8 sachets for 7 days then maintenance movicol. The third time it was up to 12 sachets and I stayed on it for longer as it didn't seem to have worked so I think he did it for 12 days.

I haven't spoken to ERIC I should probably do that. Thank you.

I haven't seen the poo nurses video is that on the ERIC website?

Sodium picosulphate was the thing that changed everything for us. But maybe works in similar way to biscadyl

www.thepoonurses.uk/

Give plenty of fruits eg bananas,
Oranges,
Very ripe mangos.
Plenty of warm water,
Plenty of Vegetables & she will be fine

You really mustn't give extra fibre for impaction, especially not bananas. That can be dangerous.

When have you given the bisacodyl and how much?

I really don’t want this to be perceived as medical advice especially since this is a child, but yes there are plenty of other things that can be tried. I have had years of medication induced constipation although fortunately much better now. For me movicol never helped (although I really struggled to drink it, I did it anyway). Bisacodyl and glycerine suppositories were what would help me when I was really bad - now I just take dulcoease (stool softener) and use glycerine suppositories when needed. I’ve also had micralax mini gel enemas in the past or bisacodyl suppositories but they only work it stuff has made its way through. Picosulfate is another option.

I find that when it was bad, even if the bisacodyl worked I still needed the glycerine suppositories to help me pass what was there.

Really hope you can resolve it, it’s horrible. And yes, definitely no extra fibre until it’s resolved.

Don't they do enemas?
You have to get rid of the blockage surely. Not just soften whats above it.
I've no experience with DCs but this is what works for me.

You can also get a more concentrated version of what’s in Movicol (think it’s Macrogol) called Dulcosoft I think - that way you can take the same dose and drink the water separately if he struggles to drink the sachets

There is a free telephone help line on the ERIC website OP.

Would lactulose help?

Prune juice helps, my DS 5 years old was the same, he used to be on laxido sachets for it

My son has suffered with constipation for years and he still has to take at least 1 sachet a day now. He has done a few disimpactions over the years you sometimes have to stay on it for a good few days at a higher dosage last time my son did it he was on 12 sachets a day for 5 days and then started reducing when it was like water hopefully your sons situation improves ive only just found out recently that my son has anxiety which seems to affect his constipation a lot 😕