Sodium Picosulphate users/Chronic Constipation

[ZoeC]

Dd2 is 2 and has had constipation on and off since before a year I suppose, then before Christmas she went 2 weeks and was in real discomfort so I took her to the gp, laxatives didn't work initially so we had to give a suppository to clear out and she is now on 5ml of lactulose twice a day plus 5ml of sodium picosulphate twice a day to keep her regular. Hospital paed said to continue with this until she potty trains, then go back for another appointment - he said we can reduce dosages provided she still goes but we find she stops if we do. It was a very short consultation and really not that helpful, just said it is very common, behavioural in cause and the laxative use is better than being constipated!

Anyway, that's the potted history - my current questions are: should her poo be quite this liquidy? I just don't know if this is ok because at least she is going regularly, or if it is a side-effect and maybe she would be better on a different medication? It is just so explosive, bang and a full, runny nappy (sorry tmi).

Second question is, as she does not appear to get a lot of warning, and it is this explosive at least some of the time, how on earth do I potty train her?

edited: sodium picosulphate once a day only. Also have had to give two further suppositories when she went a week again - that is what happens if we try to reduce dosage at all.

Mmm - so you've been told to give the picolax everyday? I always found that it did cause 'explosiveness'. We've only ever used it short term as a 'clear-out' and then used lactulose and/or movicol to maintain.

Maybe cut it down to once a day to see if she can stay regular but nit runny IYSWIM?

We had this with dd1. Is your medication called movicol?If so, dd was on this for about a year.
We were told that movicol was designed to be used via doubling doses
i.e. day 1 - 1 sachet
day2 (if no result day 1) - 2 sachets
day 3 (if still no result) - 4 sachets and so on - up to 16(!) sachets!

We used mostly 1 per day except for occasional bad periods, then dropped it to half per/day, then every other day until we could drop it altogther.
What you describe suggests either the dose is too high at the mo, or that she has a blockage and is getting leakage around it. (We had this a few times when we 1st started).
I would persevere for a few weeks, by which time the runniness should have settled. If not, drop the dose.
HTH

Sorry x-posted. Maybe miss a day with the picolax then or ask to try movicol if she needs something everyday but picolax is too much.

sorry, yes I edited to say it is once a day for the picosulphate - it didn't work alone as a clear out hence the suppositories - dd2 was surprisingly resistance to laxatives at first. Just whenever we have tried to reduce dosages she has stopped going altogether. I may try just reducing it a tiny bit at a time, I don't think I dare do it any quicker tbh.

Are, just seen its picolax. Ignore my above post!(Can recommend movicol though - its the biz)

I would definately say the quantity suggests there isn't a blockage tbh, we had overflow diarrhoea in December but she is going loads right now.

Ask about movicol Zoe - I recommend it - loads of MNers do - it's easier to adjust the dose I think.

What are her stools like when you don't medicate her? My ds has had constipation issues for about 16/17 months now even though his stools are usually quite soft. The drugs we initially gave him also gave him exploding nappies which is why I stopped using them and sought alternatives. We did manage to sort him out (physically) after a few months, but he was scared of doing a poo by then and would hold on to it for the better part of a week, by which time it was painful, because they were so huge, even if they were soft. We finally hit on the winning formula this December by giving him poo prizes (little cars, lollipops, crayons, drawing paper, stickers) which we kept up for 2.5 months until he was pooing once or twice a day without noticing that he's pooed. He's 3 1/2 and it will be a while before I rock the boat and try potty-training.

She's been on the medication now since December, trying to think now. Her stools were not overly hard, she just used to go at least 3 days inbetween, up to 10 and then she'd go fully it would seem, going by the quantity. It never seemed that big a problem then as she went without too much problem when she got around to it. December was the turning point, she went 14 days, very uncomfortable and distressed and very upset with the overflow diarrhoea, laxatives did not shift it and it took a suppository. When it came, it was soft but the lactulose etc will have softened it anyway. Has always been pretty soft to liquid since then really, although just seems more-so since the last suppository a fortnight ago.

picolax is nasty stuff, use it for bowel prep in surgical patients to make sure bowel if fully empty prior to surgery, woud deff ask about movicol, is your gp more sypathetic than the paed?

I've dropped the dose by half a ml, so now very soft but not liquid. Will leave it there for now then risk another half ml in a few weeks. She is still going most days touch wood.