Impaction in 3 years old. ALERT Disturbing pictures attached.

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Please help me, my toddler is impacted. I want to 4 sachet a day of movicol and he was so sick and had explosive diarrhoea. He woke up sweating and tired and couldn’t eat. I reduced it to half a sachet a day and now he is impacted again. I aM back to square one.

what should I do. He reacted so badly to it and it scared me. Also this bowel issues caused him to have a rage. And I feel like we back to square one with his behaviour. He is hitting and shouting etc. see attached pics, we achieved poo with such consistency in the day he was in 4 sachet movicol but he got so sick. Does that mean he is disimpactex?

my Gp is useless and I forced him to refer me to specialist so Waiting for referral.

anyone? I need help and advice until referral comes through ?

Look up ERIC which is a society that has lots of advice

www.eric.org.uk/

Ideally you should do a high does of Movicol for 3-4 days to clean everything out and then drop down to a lower dose (1-2 sachets) to keep things moving. My child had to stick on the low dose for 2 years before things settled down.

Movicol just keeps them regular. For impaction you need to give it regularly over until they get diarrhea to ensure the blockage is cleared. I mix it with half water and half prune juice. Then encourage them to have a drink shortly after.

They need to drink extra fluids or they can get dehydrated. Because movicol makes the bowels absorb more water. That might be why he's been sick. If he's sweating as well feeling sick and dizzy. I've been dehydrated before and it's not nice. After spending the whole day in the sandcastle. Something fizzy like carbonated mineral water or soda water usually settles they're stomach to keep fluids down.

There's some medicine you can get over the counter that's safe for children called calfig. That's usually effective.

I think you’ve cut it back too much, both my kids are on 2 sachets a day as maintenance.

I would increase the dose again, but maybe more slowly, and spread the doses out throughout the day. We do half in the morning and half in the evening.

You do need to make it runny to properly clear it and then keep it on the softer side to allow the bowel to recover.

Movicol works by binding with the water you mix it with, it prevents this water being absorbed by the digestive system allowing it to be carried to the bowel where it can soften the poo. It doesn’t cause water from elsewhere in the body to be moved to the bowel. It also includes hydration salts to prevent dehydration so you shouldn’t worry too much about that. Although good hydration is important.

Agree with pp about ERIC website.

Definitely contact ERIC - and there's a really helpful FB group called Movicol Mummies, where you'll get great advice. To disimpact you need to up the dose a lot over a week or two, until you reach rusty tea coloured poo - it's very watery (& they need lots of water to compensate), and slowly come back down over several days if not weeks. They can pass poo around impaction, so just because they're going, doesn't mean it's sorted unfortunately.

We've been there with reducing the dose too quickly - good luck!

Hi, I am going through this too with my DD but she is 10.

it’s been absolutely agonising for her, she’s been in and out of doctors, a and e with the pain and eventually got admitted before they picked up on a scan that she was impacted.

got put on the movicol disimpactment plan which is a higher dose every day for about a week and discharged and slowly started to get better. But they had told us after she had been on 12 sachets for three days, drop downs to four. She felt well enough to be back in school and she lasted a day before she was bad again on bad advice to drop down to 4 sachets! She’s been in bed all day crying and screaming in pain whilst we are on the second day (8 sachets) of increasing her dose again. Whatever you do, please do not drop the amount of movicol so quickly.

I can’t give too much advise than that but they have told us that it will be a very slow recovery to get back to normal. I just wanted to say you are not alone, it hurts so bad seeing your child struggle but we will get there with them

Thank you for your replies. I am still waiting for the referral. He poos 3 times a day but strain to get it out and it’s tiny rabbit looking poo

Just be wary about confusing diharea with overflow

How do I know his disimpacted?

It’s hard to know when they’re disimpacted fully but some doctors say to aim for ‘rusty tea water’ - ie watery poo with just some bits in.

I know it must have been scary when he seemed to get poorly but you do need to keep going with the disimpaction. He needs 8 sachets a day until it’s all cleared, plus lots and lots of fluids. It’s hard but you can do it.

My DD wasn’t treated aggressively enough and has a stretched rectum and urinary incontinence as a result. You don’t want that!

Agree with PP that Movicol Mummies on FB is a great group and Eric has tons of advice.

And you don’t have to wait for the referral to do a full disimapaction. Just crack on.

I am
terriffed to do it without medical advice.
he is constipated again in 2 sachet a day.
he told me this morning he wanted to poo but nothing came out. This is a nightmare. I changed all his diet and it’s not working
oats With prunes in morning
figs with olive oil
prunes purée after lunch and dinner
kiwi after every meal and still not working !

Also can you give two sachet of movicol to 3 years old at once and in one drink !?

I think for your own peace of mind OP go back to yhe GP today, they can examine and say if he is still compacted and advise on correct amount of movical. If you can't get a GP appointment go to the pharmacy

OP, if it’s this bad, things like kiwis and prunes won’t help. NICE guidelines say it needs to be managed with medication at this stage. Here’s the link to the NICE guideline - you might want to bring it to the GP.

www.nice.org.uk/guidance/cg99

And yes, as long as it’s mixed with the correct amount of water (so two sachets have to go in 120ml of water), you can give it how you like.

Do hot Epsom salt baths and rubbing his abdomen help?
Sorry not trying to patronise you.
Is he running around?