Toddler on long-term laxatives

[phdlife]

Ds (2.11) is on movicol and will be for a while, because of a suspected rectal fissure. He has historically been a little constipated (a day or two here and there) but the aim is to keep his stools very soft, so that the tear has time to heal. He eats a LOT of fibre so that really isn't the issue, things just seem to get packed hard in there. (sorry if tmi!)

I'm having trouble managing it, though. Seems that after a few days taking the laxative, he gets incontinent - I once saw a poo literally drop out of his butt when he farted while taking a big step (naked, obviously). (Actually - I'm hard of hearing and we were both talking, so I'm not entirely sure he farted, it may have just plopped out!) He also had one dreadful day where he poo'd 4 times including in his big-boy pants in the carseat - he'd had absolutely no warning they're coming.

I've tried reducing the dosage (well tbh he never gets a full dose of movicol anyway, as he's a stubborn little twerp about drinking water or juice!) but his stools got hard and opened him up again.

I've been doing a fairly half-assed job of potty-training but he never had any accidents til on these meds. Haven't started trying to sort him for naps and nights, do I keep trying or let it go til this is all over?

Any advice/experience please?

Dehydration is a big cause of constipation so try to encourage him to drink a lot more juice. If he eats a lot of fibre but doesn't get enough to drink that can be counter-productive and lead to hardened faeces. A good half-way house is for him to eat very juicy fruits like kiwi and melons... they contain fibre but also a lot of fluid.

Talk to the doctor about the implications long-term usage of movicol. It could be that he's better off with a stool-softener rather than an actual laxative. But do make him drink more fluids...

thanks chil. unfortunately he's decided to be very toddler-ish about drinking and he Just. Won't.

When it comes to toddlers sometimes you just have to pull rank and make them do as you say... especially if it's for their own good. "Just won't" and putting him on permanent laxatives isn't an answer. You have to try harder. Carrot and stick. Rewards and punishments. There are lots of things you could offer him to drink from milk, water & juice up to soups, smoothies and beyond. Be a parent...

Once you get the dose that is right for your ds you should find it keeps everything just moving along nicely.
If not go back to the DR, if he is having a healthy fibre rich diet you may find he needs a milder laxative.
DS2 has Lactulose daily, when bunged up he has Movical & when really bunged up he has a supositary (sp).

can I just make clear - he's not on laxatives because he's constipated. He's on them to keep his stools soft so that the tear in his rectum has time to heal.

My question was really about potty training while he's on them, since this is likely to be several months (not 'permanent'). Sorry if that didn't come out in the OP.

When DD was on Movicol I found that one sachet with her evening meal plus either an orange or kiwi fruit would lead to a big poo the next morning and then she would be ok for the rest of the day. It took a while for this routine to work, and I guess it might not work with everyone.
She was also not a big drinker. Ice lollies is one idea, or make your own by freezing smoothies. Very popular in this house, with DS, DD and me!

DD was on them, and it actually potty trained her, but her issue was constipation and overflow.

It sounds like the movicol is keeping everything as soft as it should be, personally I would carry on with wee training but use pull ups to catch the poo.

My DD started Movicol at 4. The first month you have a high dose to clear (think hers was 2 sachets per day) out the bowel then you work towards finding a maintennce dose to keep things nice and regular but not too regular iyswim.

TBH I had to put DD back into pull ups as she hd no control over her poo for the first month. Then we halved the dose and things became 'normal' down there.

She is 9 now and still takes half a sachet a day. It has no long term health issues as it is not absorbed into the gut. Just passes through and attracts water to the stools which makes them softer.

had a big flash of insight this week - the reason he's not drinking water/juice (milk, smoothies etc. always been fine) is that movicol tastes vile (even the new tasteless stuff, makes water taste sweaty). I have stopped giving it to him for now and he is back on coloxyl. and he is drinking water better now. phew.

Mix the movicol with squash - otherwise it is vile to drink.