The ‘POO DOCTOR’


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My constipation posts have definitely started the most debate!
Do you need help with constipation? Need to find a cure for constipation?

Probably worth re-iterating few points:
There is no magic Movicol dose

It might even change day to day! Depends on what you eat (even more what you drink!) and what you are doing. Exercise stimulates the bowel (remember Paula Radcliffe got caught short during a marathon), and in adults large quantities of alcohol can act as a bowel stimulant.

Remember it’s in the top and out the bottom – it’s not absorbed – the molecules are too big.

Some of the electrolytes (salts) are absorbed though. Yeuk tasting stuff! All parents should try it – and then imagine taking up to 8 sachets a day – can make you quite nauseous. But it works – just like dynamite!

Large doses are short term and only for disimpaction

The end of the bowel (rectum and anywhere up to the rest of the colon) will be stretched to accommodate the poo that’s built up. It can be emptied from the top (Movicol or similar) or much more rapidly from the bottom (small candle-wax like suppositories or enemas). How fast does Movicol work? It depends, but effects usually take about 4-12 hrs to start.
Once this is emptied your child should feel back to normal (you can’t feel whether your bowel has returned to normal size or not). Only small doses are then required – sometimes with a small dose of pushing medicine (senna or similar).
This is just to keep soft and regular (every 2nd day OK) to allow the bowel to shrink back down over a year or so.

it is often hard to know if Movicol hasn’t worked yet or if just on too much

Fancy medical tests may help, but something like a suppository will often make it clear if there is anything there. Most children are cleared quite quickly, it’s those in early teens who have always been impacted that can take much longer and often they have rock solid lumps to feel in the abdomen.

When your doc examines your child get them to show you where the poo is felt – means you will know when it has passes

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5 responses to “The ‘POO DOCTOR’

  1. Gosh you’re really going through it!
    Again always with the proviso that haven’t actually met or examined your wee one.

    Couple of comments sprung to mind – lactulose and Movicol work in the same way but Movicol massively more effective. Movicol strictly shouldn’t work in purée as it needs the 62.5ml of water to work – the starch binds to this water and then all acts to bulk up the stool at the large bowel. It is hard though – and many people find they can only get the child to tolerate it in other things.

    Sometimes children are too busy!
    Things do go up and down and can give extra or less in whatever fraction you think – doesn’t need to be full or even half sachets. 10ml / 50ml doesn’t matter once made up to the 62.5ml.

    Some foods do constipate – biggest culprits are bananas and eggs which both act as binders. Clear apple juice too. Also milk but only as children feel full so don’t eat foods which would have provided fibre. Also simple carbs such as bread/ rice/ pasta as these are fully absorbed and leave no residue.

    Foods that help with constipation are water, dilute fruit juice, and after. Initial disimpaction, food with fibre in it – just causes pain & bloating before that.

    It’s hard to know how quick Movicol goes through, but generally 6-8hrs in babies and up to 48hrs in adults. Young children generally 12-24 hrs.

    Hope some info useful to you
    BW drsharryn

  2. There is a strong reflex to pass stool after breakfast regardless of when taking Movicol.
    Having stool accidents probably needs a trip back back to your doc as may still be impacted
    BW drsharryn

    • Thankyou for this post:
      The reflex information has proved invaluable. When little one (or indeed rest of the family!!) can act on that ‘first urge’ they have a good day…(hopefully it might explain why things went really pearshaped starting school-as they weren’t able to act on this, until routine changed.)
      However, it seems gut problems go back to infancy.. a picture still unfolding.. but moving in the right direction!)

      Stool accidents-needed a trip to a paediatrician, but treatment outcome showed that they were impacted-just took months to clear.
      Still get build up 😦 if don’t keep a close eye on things.
      My (not so) little one is also now more aware of when she is getting backed up.

      We are very lucky that some Paediatricians will write ‘blogs’, and indeed books! as certainly in our case, is gave me essential information that drove me back to the docs and onto a paediatrician when ‘simple measures’ didn’t work.

      It is tricky as a parent (who has frequently had a dodgy gut!!) to know what is the norm and what is not!! Gut instinct tells you something is not right for your child.. but a doc (even the best) cannot go just by this!!!

      Best wishes

  3. Anyone else checking this advice out – go on drop in a rating too!
    BW drsharryn
    drsharryn.com

  4. Hi
    Very interesting rereading this a couple of years down the line.. I wonder if you have come across children bloating ++ with apples-either juice or apple itself (latter seems to have an interesting laxative effect if given carefully and sparingly.)
    There seem to be many theories around.
    Bloating: as a Paediatrician do you find there is a way to differentiate between bloating due to gas, or due to constipation (by this I mean a poop stuck somewhere along the way). eg massaging a child’s tummy I can sometimes ‘feel’ gas-and can gently shift it along until it is released!

    Thanks!

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