Should I just try a&e?

[rollonretirementfgs]

Dd7 has had a problem with constipation since she started eating solids. She has been on no idol on and off for about 5 years. The problem just seems to have got worse. We are at the point where she hasn't had a proper poo in MONTHS! just small amounts in her knickers all day every day. I understand this is overflow that goes around the mass of poo that is stuck. Dr fobbed me off a few weeks ago with the usual "keep taking movicol" and we have done this... up to 8 sachets in a day which just made her overflow poo runny, didn't shift the mass.
She is now having tummy pain, struggles to wee, hardly eats and has a sore bum from the constant leakage. What should I do now??

I think you're right to take her to a and e. You can't carry on like this bless her

Has she ever been seen by a gastroenterologist? Can your GP do an urgent referral?

Poor thing that must be so distressing.

As a side note, have you tried removing allergens from her food yo see if it makes a difference?.for example some people with coeliac disease get constipation when they eat gluten

Sounds like she needs to be seen.

If you haven’t already then look at the ERIC website.

How long did you keep up doing 8 sachets a day? How many sachets does she have now daily?

Here is Eric guide to disimpaction

https://eric.org.uk/childrens-bowels/parents-guide-to-disimpaction/

NICE guidelines say you need to go up to 12 sachets a day for up too two weeks and then if it still isn’t clear they will add in a bowel stimulant.

Go back up the GP today

Your gp should have referred you to the continence team years ago. They were incredibly helpful with my dd8 who has had the same issues since a baby. She may need sodium picosulfate as well as movicol. I’m not sure how useful a and e would be but it might be worth a try

I agree with this. She needs to be under the continence nurses. Can you ask for a school nurse referral as well?

My DC had chronic constipation/lazy bowel and I was being fobbed off for years. It was only when I changed doctors and broke down in the GP, that we were referred to a consultant at the hospital. My child was severely backed up, which is probably the same as yours. They had to put them under and manually excavate and then they used Botox internally to relax the muscles. This helped to train them ito go regularly. DC had 3 lots of Botox over a period of about a year and touch wood, all is ok 10 years later. The longer you leave the worse it gets as it impacts on their social skills and it is harder to rectify when they are teenagers! I would demand a hospital referral to see a consultant, you are within your rights to do so as it is quite dangerous as it is toxic waste that must be expelled, not including the anxiety/mental health of the child and parent.

It's well past the time a paed gastro should have been involved with care. Encopresis needs addressing and a few sachets of movicol won't do it. I'd be pushing for a referral urgently.

Thank you all. GP has nothing til Tuesday. Phoned 111, they gave me an urgent referral to Gp saying they have to see us within 6 hours with the referral. Phoned GP... refusing to see us and say I have to phone at 8am tomorrow like everyone else! What in earth? Going to take her to a&e... tired of no one listening and her continuing to suffer

I have been thinking of doing this but she hardly eats as it is. Think I will have to wait until she is feeling better before I try submitting the few things I can actually get her to eat

Up to 12 a day for 2 weeks is what we have to do for our son when he gets impacted, he also now has 4 a day, plus sodium pico sulphate (and has a suppository daily too) to keep him in an even keel. It's not pleasant to clear out but the maintenance meds he has now means that it's only once or twice a year.

Let us know how it goes. Hope they help

Well I took her to a&e we were there 12 hours, she had an X-ray and it showed she was so backed up she literally couldn't fit any more in! They gave her 2 enemas and eventually the blockage cleared. Still a way to go but have some new medication and a referral to constipation clinic and a consultant. I was made to feel like a terrible parent, they kept asking me why I'd left it to get so bad? Why didn't I notice the sores around her bottom? Why didn't I do this and that? I feel so guilty for her going through all this pain for so long. Hopefully now she is in the mend and we can manage it better

I’m glad they saw you but fuming on your behalf that they’ve tried to blame you when you have been back and forth to your gp for years. Your gp should have referred to continence team years ago, this isn’t on you op.

It's insane when they try to blame you I was instructed to return to the hospital if my sons condition didn't improve within 12 hours so I did only to be abused and castigated by the Dr (new one) telling me I shouldn't waste their time and demanding to know why I had returned my Dr made a complaint because the information he gave me was also incorrect and could have led my ds into even more pain

You poor thing OP. Glad it got sorted and you are now in the system for some proper help

As an aside. A question. I was a bit like this as a child, although nowhere near as bad. Way back then, the treatment was suppositories, so clearing from the bottom, rather than the top. Is that out of fashion? It was very effective.

When my eldest daughter was little she had the same issue, not as bad, and the dr gave me a glycerine suppository for her, sorted her out in minutes! When I asked about this for my youngest I was told by a dr that this was a very outdated method and why would I want to go sticking things up a child's bottom? Thinking about it now I should have slapped the stupid man. But, I don't understand why they don't use them now? As you say, they are so effective 🤷🏻‍♀️

Thank you so much for all your replies though everyone. Surprising how words of wisdom from strangers can really help,

We had lots of poo issues with DS1. It was SO distressing for everyone. Glad you got sorted.

It's weird, and a very English thing. Europe uses suppositories for all sorts of things. DM was Italian, and often got cross she couldn't get certain things here, as she had a sensitive stomach, so they were better. Also they get absorbed better. I suppose its a cultural thing.

glycerine suppositories are still used but they tend to be not very useful with severe impaction. Microlax or bisacodyl enemas are worth a go--they are available OTC here.

I am glad they've helped her, I bet she feels so much better now. But please don't feel bad by what they've said. You did try to get her help, but your GP was useless.
Fingers crossed thing get better for her now