4 year old disimpacting

[Countrylifemama]

Hi! My 4 year old is now on day 11 of disimpaction with 8 sachets of laxido a day… we’re finding his poos are quite runny but not yet brown water they’re like melted chocolate. So not totally clear brown water. So I presume we are still not at the stage to reduce and we keep going?

I think he withholds whilst on such high dose as usually I can hear his stomach rumbling and sounds like he’ll be ready to
Go but he usually rubs his stomach and says that makes it feel better… should we be upping his dosage?

Also when he does sit for regular toilet sits he seems to kick his legs out and what seems like pushing down his bladder/Willy area… has anyone seen their LO do something similar is this to reduce the pressure so he doesn’t poo? I’m at my wits end trying to figure out what to do to help as we’ve been ongoing with toilet issues for 1,5 years on and off 😔😢

Thank you for reading and advice! X

[GoodnightGrandma]

I prefer the natural approach, so have you tried prunes and is he drinking plenty ?
And do you have a step that his feet are on ?
Does he read a book or watch the iPad on the loo to distract him ?

[Lancssss]

My DN has had to go through this a few times although he’s older. I’d carry on for another couple of days if I were you. I’d also try to speak to the ERIC helpline if you can on 0808 1699 949 they’re open 10-2 Mon-Thur and really know their stuff.

[Lancssss]

@GoodnightGrandma

I prefer the natural approach, so have you tried prunes and is he drinking plenty ?
And do you have a step that his feet are on ?
Does he read a book or watch the iPad on the loo to distract him ?

If he’s needed disimpaction and has been suffering for 18 months, prunes is not going to be a viable alternative. Although I agree they can be useful for maintenance when disimpaction is sorted and things have settled down. It’s not always easy to get small children to eat then though! I didn’t have some success with putting prune purée into yoghurts though for my DC.

[JenniferAlisonPhilippaSue]

8 sachets a day! Poor little guy. No wonder he is rubbing his tummy and doesn’t want to go! I presume that his condition has been diagnosed and managed by a Dr? In which case I think you ought to ask them. There must be side effects to this.

[Lancssss]

Of course he will have been diagnosed and prescribed them! Can you imagine the side effects of leaving a child who’s impacted and can’t go to the toilet properly? It would be very, very dangerous so has to be treated, as they are doing.
Unfortunately GP’s aren’t always a brilliant help in situations like this, further than prescribing the necessary medication.
OP some areas do have continence nurses that might be able to advise you, but I’d try ERIC first.
Also a hot water bottle on his tummy might help him feel more comfortable.

[IwillrunIwillfly]

I second having a look on the ERIC website. Definitely don't stop the laxido until he is passing watery stools as you'll just end up back where you started. When you are ready to reduce, make sure you do it gradually and don't just drop to 1 a day. Every child will need a different maintenance dose so keep him on a dose that gets him passing a soft poo every day. As a general rule, you need to treat constipation for as long as its been a problem. So if he's been constipated for 18 months, he may need treatment for that long to allow his bowel to return to normal.

It can sometimes help to get them into a habit of sitting on the toilet for 5 mins after each meal and giving a reward e.g. sticker on a chart for that (it doesnt matter whether they poo or not, it's just getting them into the habit of sitting on the toilet). Don't let him sit for too long. Blowing bubbles while on the toilet can help sometimes help with holding as they tend to relax when blowing!

[acquiescence]

I have been here in this exact situation, 2 years ago. I’m sorry for some of the incredibly unhelpful comments you have received.

It sounds like you need to just keep going until you get to tea- water. I can’t quite remember the timings but I think one disimpaction took around 4-5 weeks for us. If you stop before you get there you will just end up with the same issues and need to do it again. We had x rays done to check. We had issues from age 2-4 and I worried he wouldn’t manage starting school. He now has no issues at all at age 6. We still do daily potty sit and maintenance of 4 movicol per day. For us, breaking the withholding cycle was the key, I’m not sure how this happened unfortunately, one day he just started self initiating instead of withholding. It was shorty after a lengthy disimpaction so maybe when he was the most clear.

I would highly recommend the Facebook group ‘movicol mummies’ if you’re not on there already. Awful name, incredibly experienced and helpful parents.

Good luck.

[acquiescence]

To clarify, we still do daily potty time with the iPad, he sometimes sits there for half an hour or more and usually goes every day before school.

[SusieSusieSoo]

As well as ERIC there is the bowel and bladder charity. Also if this has been ongoing for more than 3 months under NICE guidelines you should be referred. Behind the paediatricians there should be a continence nurse service. They are absolutely experts. Ours is fab.

ERIC have podcasts you can listen to - 2 on disimpaction and a helpline. If helpline is too busy you can send a message with a question & they email back.

Good luck with it OP xx