Advice on constipation/impaction?

[Pl242]

Hi. My 4.5yo DD has struggled with chronic constipation previously. On the advice of the paediatrician we have been weaning her off movicol and senna gradually over last 2/3 months as she has been on maintenance dose and having no issues since last spring.

But something has gone wrong and she’s currently suffering from a flare up of constipation. We’re not taking any chances and following a disimpaction regime but impact of movicol not yet kicked in. Started process on Saturday.

My slightly graphic question is this. She’s still going to the loo and a poo is trying to pass but she can’t or won’t pass it. But it’s basically at the edge of her anus. So she’s then standing up and pushing it back it in. She’s in a lot of discomfort.

I don’t want her to get terrified of pooing again and start withholding again. But what on earth do I do for her until the movicol softens the poo enough for it to pass?

Thanks for any insight.

If its a big hard lump of poo right at the opening a glycerin suppository might help. It's a small suppository that softens the poo. Also make sure when she's on the toilet er feel at up on a stool or something to get her knees higher than her hips. It's a better position to get it out.

Thanks. We were toying with the idea of a suppository but she has now passed it thankfully. Big old poo and now looser poo, which I think is the movicol. Hopefully it all flushed out of her now!

Ask for referral to paediatric gastroenterologist OP. My DS had longstanding constipation issues, we saw a wonderful PG privately, he was absolutely brilliant, DS had meds to clear blockage, and then ongoing meds, movicol paediatric and pico. For every year of constipation a year of medication is required. A previous consultant suggested suppositories but I just couldn’t cope with that, it distressed my DS & me. Good luck OP, I know how worrying this can be.

Thanks. Yes. We’ve been through all of that. And were hopefully coming out of it re winding down meds. But we do now know what to do to get things back on track which is something. Id just never come across the above issue before with her. Have ordered some suppositories just in case that particular circumstance happens again.