Anyone got experience with toddler constipation and Movicol?

[geeraf]

And willing to discuss?? It's absolutely a TMI topic, but I just don't know what to do next and it's driving me crazy. I promise I'm not the poo troll!!

Don't read on if you don't want the whole pooey story...

DD is 3.2, potty trained since around her 2nd birthday. In the last couple of months she's only been going a couple of times a week, and in the last few weeks there have been skid marks in her pants and it's taken up to a day of I need a poo, no I don't, yes I do, before she's done one. Nursery said they thought she was constipated due to the skid marks etc so I called docs and they prescribed movicol over the phone.

I've given her half a sachet a day for about 2 weeks now, it's definitely super soft but is still taking her up to a day to do anything and the skid marks are way worse as she's doing a little bit every time she feels she needs a poo but not going to the toilet. This can happen 10-15 times before she goes properly.

I just don't know what to do. I've looked up withholding as that's what it seems like to me, but it doesn't really give much advice, all the stories seem to just end with the issue resolving itself.

Can anybody help or advise? Should I still be giving the movicol if "hardness" wasn't really the issue in the first place? I'll call the doctors again next week but can't get hold of them tomorrow due to work (they have to call you back and I can't answer the phone at work). Help??

DD has been on Movicol since about 6 months. She's 3.5 now. Some days she definitely still struggles to do a poo. The whole thing takes ages (upwards of a day). But other days (probably most of the time) she has very little time to react. It's made potty training quite hard, and fairly traumatic for her.

Wece tried reducing doses many times but it spells almost instant blockage!

If your DD doesn't seem to need the Movicol, I'd reign it in a bit, because it really does give 'results' IYSWIM. However, for my DD the hardness of her poo never really seems to be the issue. The Dr described it as her gut/intestines just don't work as hard as they should to push things through.

Plenty of water is good. Also lay off bananas (if she eats them) when she gets clogged up. They're great for digestion when it's working well, but seem to make it worse when there's a problem.

That's exactly how it seems, that it's there and it's not rock hard or anything, but she just doesn't know how/won't push it out. I've tried every trick I can think of and I don't know if she just doesn't get it or she just can't.

I might try and somehow sort it into quarter sachet doses and see if that helps any. The first day she was on it she did three poos on three consecutive days and I though here we go! But then it's back to skid marks and needing to go all the time but not producing anything. So frustrating!!

I would get her examined, she may be impacted. I’d also have a really thorough read of the ERIC website for kids bladder and bowel issues, it’s really helpful and they’ve got a helpline you could telephone.

My son used to have issues with impacted poo, so a hard poo causing a blockage then all the poo behind it that was soft couldn't get out. Q lots of medicine to get the hard bit out which in turn made the poo behind it liquid. We used to have issues with soft/runny poo coming out around the hard bit. Been in for an enema more than once to remove the impacted poo.

The bowel gets distended when they are constipated and stretches so it then can harbour too much poo before they feel the need to go. My son rarely got 'the feeling' of needing a poo as his bowel was so distended which made it lazy.

Are you using enough movicol? We used to have to use loads to push it through (with go advice)

He's 12 now and still only poops about twice a week, he has no issues tho and doesn't have medicine, both of mine grew out of it eventually.

When they start to withhold it then it's an issue as you go round in circles.

Great, thanks both. I'll have a read of the website and see if I can get her in at the docs next week. There's so much come out of her in the last couple of weeks it's crazy, but need to see if they can tell if she has a blockage, that would make sense with the little bits that are coming out I guess!

Good luck, it’s so hard when you don’t know what to do for the best for them. My Niece’s Mum left it for years & years without sorting it, and a he’s been left with long term problems that her Dad is now trying to sort out. As a PP has said it can change the shape of their rectum which affects the nerves. There’s really good detailed advice on the ERIC website though, so hopefully you’ll be able to make a plan you feel happy with.

We’ve had movicol for my baby since he was 3 months old and he had a sachet a day, it really has never made a huge difference to him as there would always be a really hard bit he struggled to get out for ages followed by liquid, all movicol did was remove the pain he was in (which is great obviously) but didn’t help the issue. He’s 8 months almost now and a different GP changed him to lactulose a month ago as he said it was softer on his stomach and he’s now going a few times a day with no struggle and normal poos. It’s definitely resolved the ‘hard poo’ issue. Might be worth asking.

I will add that he is also having less milk and more solids now so that could also be playing a role in his poo constitution!

Oh lord yes.

DS is 3, will be 4 in February. We go through an endless cycle of being on Movicol but then it causing all his poo to be so soft he doesn't seem to know when to go. But then he doesn't go at all for a couple of days. But when he does it's usually a big one but still soft.

The symptoms of having marks in his pants and load soft small ones in the day fit with constipation but then he will always eventually do a big one and it's never hard so I'm just completely confused as to whether he should be on it at all.

GP not been much help so far but we need to go back.

It's horrible. I feel like we've done something wrong and got so confused about what's best for him.

Have you ruled out food intolerances such as gluten?

A few friends of mine have also found artificial sweeteners such as those in “healthy” diluting juice to be the trigger

Dapedthings my DS is slightly older (4 end of December) but our issues are very similar. He was potty trained easily at 2.5 but was withholding poo/constipated, so we needed movicol. We eventually weaned him down to two half sachets a week, then nothing, all seemed well. Then he started withholding/being constipated again and the skids etc started. So we are currently back on three sachets a week! He's not going every day but we're having very little skids so I'm hoping he's not constipated. It's so frustrating!

tempnamechange98765 It really is frustrating. Just had two small bits in his night nappy before bed. But so much straining. This is after nothing since Wednesday afternoon so it will be one sachet tomorrow and hope for the best.

DH works with doctors and has a meeting next week with a paediatric constipation specialist and is going to ask some advice from her.

I have more experience than you could possibly know 😩

She could be withholding, i.e. she just doesn’t want to poo, because it’s yucky or it sometimes hurts and she’s just trying to hold it in all the time, hence the skid marks. That then leads to hard, constipated poo and the cycle continues.

Personally? I’d increase to one sachet - dont worry about quarter doses! One sachet is still a very low dose. Worst case scenario is the poo goes a bit too runny, which is no big deal in the grand scheme of things, especially when you actively want to clear out the bowel.

In my experience it’s better to hit it hard, get the bowel cleared out, and then decrease the dose back down to a level that results in at least one good bowel movement a day. One thing to remember is pooing every day isn’t good if it’s only a small amount. Insufficient poo still results in a bloated, backed up gut.

This website is fab too: www.thepoonurses.uk/

PPs have already explained it with the issues of soft poo escaping around the impacted poo, which I was coming to say!
When DS2 was impacted, we did 1 sachet on day 1, 2 on day 2, etc up to 12 sachets in one day to clear him out, then gradually back down again. He did have diarrhoea and wore a nappies again for a few days at the worst. That was years ago and he is still on a sachet of movicol a day at age 8. Once the impactation was gone it took ages before he felt like he needed to go, because it was so stretched out.
Most recently the bladder and bowel clinic nurse recommended adding senna to the Movicol - she said Movicol will make poo soft and easy to pass, and the senna will stop his gut being lazy/slow and stop him being able to 'hang on' by making things contract (or something like that, I'm not medical!!). It really really works and was the key to our little puzzle of ongoing skid marks, soft poo and hanging on.

Not literally adding them together btw, just taking both each day!

I think honestly that it's just that she doesn't want to. She's a pain to even make it to the loo for a wee as she just doesn't seem to want to bother. She doesn't see that weeing in her knickers is an issue, she stands there holding it in for as long as she can then waits for some to dribble out before saying she needs a wee. I think the poo is an extension of that.

I don't want to give her too much of the powder as it's so soft already I'm worried it'll just liquify and then she can't stop messing if that makes sense. My gut says there isn't a blockage as when she does go there can be so much coming out it's crazy. She's been properly Wednesday and tonight. It's all so confusing!!

fllinn did you have to get the senna by prescription? I think my DS' bowel has definitely gotten lazy.

dappledthings keep us posted on what the paed says. I've heard a lot of poo issues in children are down to dehydration - they should apparently be drinking 900ml a day?! My DS probably has half that at an absolute maximum!

OP, my DS does that too with the wee. Mainly when he's clearly having too much fun to go to the toilet, he waits until a tiny drop comes out before saying I need a wee. I have heard that can be linked to constipation too.

I did get it on prescription as they just prescribed it at the same time they advised it, if that makes sense. I'm not sure if it has to be prescribed or age and dose guidance etc. A trip to the GP may be helpful to discuss your child's individual needs.