Movicol disimpaction query

[1000Stars]

Hi, my 5 year old son is on paediatric movicol...we are on day 6 and 8 sachets. It ends tomorrow with the final 8 sachets. The gp has said to continue a maintenance dose of 1 sachet a day. There are 20 sachets for this maintenance dose. My question is do I just continue to give 1 full sachet a day or should I gradually reduce it over the 20 day period, like give 1 sachet daily for a week then 1/2 , then give 1/4 dose for the final week. Thank you

Have you got to chocolate sauce/ rusty brown water stage with his stools? If you haven't then it's too soon to reduce down and, even then, continence teams advise reducing down by two at a time. I'd also say that his maintenance dose might not be one sachet, it might be two. It seems like your GP is not massively clued up on what is actually involved. I'd advise having a look at the ERIC website and also Google The Poo Nurses, there's loads of great info there.

Thank you so much. I've just been on the poo nurses website and it explains everything clearly. Thank you

You need to keep going until almost clear liquid; maintaining dose usually starts at half the dose required to clear out.eg if you get clear on 8 sachets youd start with 4 per day.

GPs aren't, in my experience, clued up on chronic constipation management. If you reduce the dose too much/too soon you start the whole cycle again. The bowel has been stretched and will just fill up; so the maintenance dose needs to continue for a long time whilst the bowel heals. And gradually reduced.

My eldest was on movicol for years. On a very very gradual reduction

Much too quick reduction. I think dd was on 2 for around a year and a half, although she went down to 1 fairly quickly after alternating 2 and 1. I think it was around 3-4 years of slowly reducing it (and occasionally giving an extra one) before she totally stopped it.

Thanks everyone. Sounds like a long process. I'll get in touch with the GP and request more sachets. Wish I could just buy them without a prescription, GPs are only doing online appointments and its really hard to get one.

I think you can buy the adult version without a prescription and it's literally twice the strength so half a sachet adult is the equivalent of the children's sachet. We forgot them once on holiday and had to do that.

However, cheapest method is to ask the doctor to set up a repeat prescription. Once you've done that, there should be a way you can get it without going into the doctor-I can ask my pharmacist to order it for me, he puts in the order and I collect the medication about 3 days later from him. It's brilliant!

As a general rule it takes at least twice as long as the problem has existed to get near anything approaching a cure.
Follow the Poo Nurses programme. They really are good.

@1000Stars You're welcome! We're so lucky that we did our disimpactions under our continence team (and our GP is so good that she just prescribed whatever they asked for). We're currently under urology, gastro and colorectal for my daughter so I know how tricky the process can be, hope you start to see some positive results soon!

We went through this with my DS. His consultatant, who was absolutely excellent. Said the basic rule of thumb is a year of medication for every year of constipation. DS had movicol in the morning and pico at night. He is grown up now and doesn’t have constipation anymore.

If you do have to buy an adult box pro tem, and adjust the dosing, Asda sell the boxes of 20 (or maybe it's 24?) for £9.95 or thereabouts at the pharmacy counter; so I assume other supermarkets do too. Boots will have it, too, though they're always more expensive.