How fast does Movicol work? How long does Movicol take to work?


 

Check out my no-nonse ebook - Kid's Constipation - Crack It!

Check out my no-nonse ebook – Kid’s Constipation – Crack It!

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With thanks to http://www.quickcare.org/gast/constipation.html – their site is great for general info – though laxative dependency isn’t something we really see – their site shows a fantastic animated version of this diagram.

this is by far my most asked question!

FAQs? No – wordpress tells me this is almost the only question people search for that finds my blog

So, Movicol, how fast does it work, or at least how long does Movicol take to work?

Problem with constipation is that by the time anyone realises, there’s already some build-up. It’s that that makes people feel so – yuk!

This is because the amount of stool inside makes you feel sluggish and bloated. If you drink clear fluids that often helps, but eating fibre at this stage seems to just make you feel more bloated. This is why people who feel constipated eat simple carbs like bread and rice as these tend to be almost fully absorbed so they don’t add any more to the bloated feeling.

We forget this when trying to treat it. Movicol is like dynamite – if you give enough for the job it will work (though in most cases you should be in close liaison with your healthcare provider).

When to try it – relax!

When you know it will work, relax, find a time when you won’t need to worry too much how it affects you – time off or school holidays or Bank Holiday weekends. You never know if you’re going to be quite sensitive to it, or need bucket loads. Nobody does until you try it.

Bowel transit times and other ‘medical’ factoids

The normal bowel transit time in adults is a couple of days, in toddlers only about 12 hours. For this reason, it doesn’t work straight away. Because it is a starch attached to water it is a bit like food rather than fluid and it takes time to work through. If you think of cooking rice when there is the gloopy rice water before you rinse it – Movicol works like this – you couldn’t squeeze the water out of it even if you tried. But equally, the bowel doesn’t absorb it. While you always think of the bowel as your ‘insides’ ironically it sort of outside. It is open at the top and open at the bottom. If something goes in at the top and is not absorbed, it will come out at the bottom. This is how it works. When you make up the sachet, that minimum volume will all reach the end of the bowel, you can add more fluid, but that original amount all reaches the end.

Now the less lovely part – what happens then?

Ok, deep breath, here goes!
The food & drinks you eat all mix with fluids in the stomach. The clear fluids are absorbed quickly there as are simple sugars like glucose, most of the rest pushes along to mix with more enzymes to help absorb it. At this stage each Movicol molecule is still attached to its water.

They continue like that through the small bowel and enter the large bowel at the same level as the appendix (the caecum). This is inside your abdomen (of course) just above your right hip. It then passes in an inverted ‘U’ shape along to the end of the large bowel. Some nutrients are absorbed here but generally water is absorbed so that the stools get drier and drier as they get to the end.

Now the action bit!

The Movicol molecules continue being pushed along attached to the same water molecules. When it reaches the impacted stool (the stool that’s backed-up) it can do a number of things:
1) form a normal stool and by weight of this push that ahead of it out (‘rocks’)
2) remain loose and build-up a head of pressure sufficient to push that ahead of it out
3) remain loose and effectively break-up the stool ahead of it out as small bits or loose stool rather than expected ‘rocks’

It seems to be a variable proportion of these which varies from person to person.

I hope that this makes some sense – and makes taking this medicine easier.
It is hard to remember now, but in the days of lactulose and senna alone, treatment was much more difficult.

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46 responses to “How fast does Movicol work? How long does Movicol take to work?

  1. Thank you for this info. My son is 7 and we flush his bowel every morning using bowel irrigation. He was on 0.5 sachet of movicol each night. However, his movements were quite constipated and he had a few soiling episodes so we increased his movicol to 1 sachet a night. However, he’s now soiling 2-3 times a day. Seems to be a big difference between 0.5 and 1 sachet. Not sure what to do?

    • Hi Leanne – I feel for you!
      Do you have a medic looking after you both – often need very close follow-up if soiling?
      All I can really say is that soiling seems to happen around 7ish and tends to need enough of a laxative to get it out – if tolerated, movicol is currently number one choice,

      If still soiling I would go back to your doctor
      Hard in this sort of scenario to know if not enough to push out impacted stool or may have removed it all and be soiling because now on too much. First explanation usually much more common.

      Wish you both well
      Drsharryn

  2. Hi.
    Please could someone help me. my son is 8 in a few days and he is suffering constipation. This is the first time he has suffered with it.
    Today is the 8th day he has not been t the toilet and he is on 8 sachets of moovicol a day and still nothing is happening.
    Please can asome one give me some advice.

  3. I have justspent 20 hours approximately with pains in my lower abdomen like “diarrhea pains” and when having the urge to run to toilet nothing happens, just a teaspoonful. I went to my GP this morning who examined my tummy in those areas and he told me I had Constipation. (I had examined myself via the rectum earlier, found nothing). GP then gave me MOVICOL and told me to go home and take 2 sachets. It has now been 4 hours. I am in terrible pain still and no action other than the “teaspoon amounts”. I have been drinking water and black tea and had a couple of dry savoury biscuits. When do you think I should I get some relief please.

  4. For Leanne-I hope you are getting somewhere by now. Thank-you for asking the question I had too.
    For Drsharryn-thankyou what a great article, diagram+helpful comment.
    In my child’s case we were going in endless circles. Her ‘poop’ would suggest all was fine. Movicol would be reduced when poop got ‘too loose’.
    However, if taking your ’10 reasons to take your child’s constipation seriously’ as signs of constipation, it sometimes got rather confusing!

    Missing one bowel movement (child was pooping at least daily), everything went back to square 1.

    Gradually increased from 2, to 3 and so on until 4 over a couple of weeks. Child would have really loose (almost undigested) poo at start of the day, but later, or the next day soft stuff-but in copious amounts…So, kept going based on the other ‘signs of constipation’. Eventually my child produced an huge ‘No 2’-but it included ‘malteser’ shaped ‘1’s, much darker 1’s and numerous really really dark brown-almost black grey rock hard bits. I was astounded.
    After liaison with her paediatrician, we increased to 5… After a couple of days free of ‘rocks’ We returned to 4. I’ve no idea if there is more to come away.

    For the first time in nearly a year, she’s started going to the loo herself of her own volition.
    Amazing!!!
    For months I had been asking the question, had the initial impaction all gone? (I still don’t know for sure… but a load has certainly gone!)
    So thankyou+good luck Leanne.

    • Hi Ann. Thanks for this. Still having problems. Things are good and stable on say 0.5 sachet, then he starts soiling so we increase it to one or 2 sachets a day. Poop becomes so soft he cant hold it, so we reduce and things are better for a week or so, then soiling again. At the end of my tether. Am tempted to try the gradually increasing dose over s a week or so to see if it is impaction but would need to keep him off school for that. Also not sure whether its soiling cause of movicol or cause of constipation!

  5. tanveer ahmad

    can movicol be given during preg ancy?

  6. my colon has been blocked for over a month been taking two sachets a day still having problems only pass small amount been eating normally, pass alot of wind what do i do next tried an enama that did nothing as bowel empty

    • Hi Brian
      It may well be worth seeing your doctor as your enema didn’t really work. They do if there is stool at the end of the colon.

      2 sachets is actually a fairly small dose, though I’m sure it doesn’t feel that way when you are trying to drink it
      VBW
      Drsharryn

  7. Few questions that I had 1) Is movicol habit forming ? 2)Are there any long term side effects ? 3) Does it affect the absorptions of nutirents from other foods ?

    • Hi Vivek – sorry for the delay replying.

      Movicol is not really habit forming – it is just a physical bulking agent that passes out and is forgotten. It requires being used for a prolonged period to allow the bowel time to settle back to a normal diameter.

      It acts primarily on the last bit of the bowel which does have some function in absorption but relatively small. It really only reduces fluid reabsorption in the bowel though it also contains some salts to avoid problems with these

      I hope this helps
      BW
      Drsharryn

    • I should also have said that there aren’t really long term side effects. It does still need long-term treatment though to get fully back on track

  8. Hello Leanne
    Happy New Year! I wonder how you are getting along? I hope all is good for you and your family and 2014 brings good health.

    Ann T

  9. Hi, I have been discharged from the paediatrician so would like some advice. My 14 year old Autistic daughter has been on Movicol for 3 months now, He said to keep her on for 6 months. She was on 8 sachets and slowly reduced to 2 sachets following the paediatricians directions. She is in nappies as has no control over her bowels since starting Movicol, But I don’t know if the dose is to high and whether to reduce it to 1 sachet. On the bristol scale she is between a 5 and a 6. Obviously I would like her to get control over her bowels again but not at the risk of messing up the what progress we have made. Any help much appreciated. Sara

    • hi – you’ve taken a very sensible approach. It is very easy to stay on too much maintenance Movicol.
      What you are doing after the big clearout is to keep things moving to let the stretched biwel slowly get back to normal size. Crucially during this period your child should be well and back to normal. You are aiming for a normal stool every day or second day, and that if you miss a few doses you’re not set backwards.

      From what you say, that may well be the problem. Maintenance doses may be quite small.
      VBW & sorry for delay sharryn

  10. I had my piles removed and the doctor gave me movicol I’m in my second day now and nothing happened yet how long will it take to work

  11. Just been given Movicol this week by a friend after my GP said I must not remain constipated and keep on psyllium & senna. I’m still blocked despite having taken my regular psyllium & senna plus 3 Movicol a day, but then again I’ve suffered constipation since birth, so after reading this column will progress to 8 sachets tomorrow. So thanks everyone

  12. Is movicol safe for pregnant women and if does how must we use it

    • it’s a difficult one to answer!
      the manufacturers can’t say it will be safe as they won’t have tested in pregnancy – very difficult and not required to market the medication.
      logically it is a starch which stays in the bowel and holds onto water already in there ( doesn’t sucj it out from the body). There are salts added though which can be absorbed.
      probably the best idea is to discuss your own personal situation with your GP / doctor as it will be a risk/benefit assessment for each medication during pregnancy

  13. Hi
    In your experience is it usual for a child (6yrs) to need 4 Movicol, maintenance, with periodically up to 6 to clear occasional ‘backlogs’. Under 6 monthly paed review.
    Just feels like a lot for a little one to be taking for nearly 2 years now! Anything less, and they show all the signs of getting backed up again (and indeed complain about ‘poop being stuck’.)
    On a positive they now have regular bowel movements that they can feel, and are clearly feeling a lot better and confident having pretty much lost continence (pee and poop) when impaction was first identified.
    We continue to work with a dietician -there’s clearly food intolerance going on, but difficult to know whether gut motility or food the problem first.

    It can be very difficult to work things out at times as sometimes think they are on too high a dose, but then turns out the looser stuff is actually coming ahead of dry stuff that follows a poop or 2 later in the day!!
    It kinda feels literally like ‘flying by the seat of my (child’s) pants.

    Paed seems relatively happy with our ‘regime’ so no investigations eg xray planned. Seems to think everything just got really stretched. Pity your book didn’t exist a few years ago!! Seems constant diarrhea bugs were ‘overflow’!

    Thanks
    GM
    PS found your great ebook on Amazon. What a great resource, along with your blog. Funny, I was initially put down as anxious mother having child with constipation. Turned out I was super anxious mother with child who had severe constipation! Suspect it could have been a lot worse if I’d not read this and been lucky enough to have a paediatrician see my daughter. .

    • Hi gutsymumma!
      With the usual caveats about not having seen or examined your little one personally…4/day is not unusual. You’ve clearly spotted that the same dose everyday just doesn’t work – and adjusted yourself for it.
      Sometimes they eat more, or less, better quality, or poorer quality. Also affected by how much they drink and how much they exercise. The same dose everyday wouldn’t work.
      The Movicol is a fairly inert substance and often when settled you can reduce Movicol a bit and add in a small dose of one of the pusher needs like sodium picosulphate or Senna.
      Couple of years of treatment is often necessary and no ill-effects just to allow the bowel to shrink back in the background. Hopefully this is happening as she seems better in herself.
      Hope that helps & thanks for the lovely book comments – can I quote them?
      Drsharryn

      • Thankyou! Yes, please, by all means quote them. Your book really was a lifesaver for my little one, huge support for a struggling mumma, and has helped friends too! Fine though our GP was, it took a seeing a paed (and one very persistent Mumma) to eventually get things on track. Really wish there was more awareness out there that even the best diet, exercise etc doesn’t mean you’ll not get bunged up, and sometimes wetting can be a sign of residual poop (that’s cunningly hiding!)

        Paed explained things that you talk about in your book-but somehow reading makes it easier to ‘listen’! I’m one of those rabbit in headlights mothers! Brain leaves home on entering clinic!
        Best wishes and thankyou!

    • Huge apologies for the delay – a busy family christmas and then a vanishing january! embarrassed ++.

      again as ever general advice as I (unfortunately) haven’t see your wee one in person…

      Once children get emptied out they generally need relatively small doses of almost any laxative just to keep oiling the system if you like. The big loose floppy bowel just doesn’t contract very well and takes many (MANY) months to shrink back to normal.
      For some children a sachet or two of Movicol works best. For others a small dose of one of the ‘pushers’ – senna or picosulphate for example. Some children find that anything over a sachet of movicol makes them need to go quite urgently when they do need to go and that is quite distressing. They also might avoid exercise as that can mame that symptom worse.

      Often a combination of a small dose of each type works well after the big clearout. The trick is finding a regime that works in terms of symptoms most days and you don’t get set backwards if you miss a few doses – stuff happens & doses get missed in most families sometimes!
      Another option is to find a regime that works and a plan B like an extra dose of senna (or even couple of days) to get over any blips. Nobody eats/drinks/exercises the same every single day so no dise will be perfect for every day – there’s a bit of trial & error & playing by ear.

      best of luck

  14. PS apparently being hyperstretchy can predispose individual to constipation. :/ Being flexible isn’t always that great!

  15. Thank heavens for Dr Sharryn! I’ve been reading this thread tonight and am so grateful you have answered so many peoples plights…. So I am now hoping I can ask my own question about my lovely 8 yr old….

    We’re on Movicol and have been getting type 4s for 3 months or so – great! Then its all gone wrong and now we just get soft wedges in the pants and seldom a solid nice type 4. My nurse said she must be impacted, clear her out (thou her tummy wasnt bloated and her appetite was normaly) but after 3 months of wedgy poops I decided to do it. We got to 6 sachets and I cleared her out for sure, but as expected she wasn’t impacted as no dark poo came out, only runny brown then watery. We then dropped to 4 then 2 sachets over 3 days and I got a great type 4 poo on Sunday, then here we are again on Thursday and I am back to wedgy soft poos in pants.

    Do you think I am not giving her enough of a maintenance dose to make her do one firm type 4 a day? I keep thinking I am giving her too much in 1.5-2 sachets a day because its making her poo soft and its not forming in one big type 4 poo but coming out in wedges.

    Sorry for the graphic detail but would be soooooo grateful for your thoughts. And those of any parents on here too.

    Thanks

    • hi kaye – sorry to hear all that
      I tned to go and havea think and then give just general information which might be helpful for you. It is always best to see your own doc too as they can ‘lay her hand on her belly’ and see how she is and what she looks like. Leave it with me.
      The dilemma you face is common – is your child still bunged up and Movicol bypassing the impaction or are they on too much movicol. It is really hard to know.
      I’ll come back with something (hopefully!) sensible
      vbw drsharryn

    • Hello Kaye
      Firstly I’m really sorry your daughter and you are going through such a tough time. I’ve no magic answers either, (apart from suggesting we clone Drsharryn to make her more widely available!!), but would be keen to pick your brain/exchange ideas!

      These are some things that have helped us..
      Getting a paed/GP to answer lots of questions! so I understand a bit more about what’s happening.. (glad you have a nurse).
      If my child is able to ‘go’ first thing in the morning and after each meal it seems to reduce accidents (there’s no ‘pressure’, but she is just encouraged .. to sit on a pot/the loo. Just relaxing, reading a book/playing) (This is great in theory but not always possible!) Squatting appears to be far more effective for her for some reason. (ie less accidents or ?build up if can do this)
      Food/activity diary: we picked a few dietician’s brains as in our case food intolerance/sensitivity certainly affects gut speed/control and pain (internal and external)…. then get ‘holding’ if sore.
      Is your daughter aware of the ‘poop arriving’, or have any idea if she is bunged up?

      I’m very interested in your observation of bloating as that’s something I’ve not quite got my head around.. sometimes it is fine (just causes wind), but other times is associated with pain or loss of continence (follow through wind 😦 I’m not sure when it is gas or constipation. A lot of the time it has turned out to be constipation.
      Does your daughter bloat gradually or suddenly? (maybe Drsharryn can give us a Paediatrician perspective on this?)

      I found Drsharryn’s ebook really useful for giving us clues.
      Again for us signs that it might be constipation, rather than too much Movicol=change in appetite, food preference, mood, way of running, occasional pee leaks.

      Thanks for your detail of ‘poo’ -gave me more to think about too!
      The colour thing is interesting.
      Do you ever get mixed stools?

      Hope you find some info that is useful… wish you all the best.
      GM!

      • Hi GM
        Thanks for your reply.
        Re bloating, I can definitely now tell when she is bloated. Her tummy is normally flat, and it feels hard to touch and you can’t push the soft tummy in if u give it a little prod!

        What I have realises since posting originally is that as movicol makes the Poo soft, that’s why it keeps coming out in droves all day in the pants, so I’ve reduced the dose to just 3/4 a wager per day

      • Contd… And that is sufficient to make her do just type 4s. Some nights there’s a type 3 in there with cracks on the surfaces so the next day I give 1.5 sachets and that rights itself again . I’m so much happier now that I’ve got the dosage right, and although I disimpacted her, I know she wasn’t impacted at all, it was purely the high dosage of movicol that was causing the accidents.

        As for colour, yes it’s usually the milk chocolate colour but sometimes when it resembles dark chocolate, or bits of it do, you know that’s old poo coming out that may have caused some constipation.

        Hope this helps, it’s good to be able to compare and support each other!
        K

  16. PS to Kaye
    Drsharryn mentions many variables, eg diet, exercise, fluid etc. However, I noticed her blog on anxiety/stress a while back. For us it was interesting and useful keeping a diary-we were looking at particular food irritants, but noticed they were worse in certain situations. Although my child appeared happy ‘on the outside’ it turned out the ‘butterflies in her tummy’ were accelerating/exacerbating things. So, though she appeared able to deal with ‘challenging’ situations (eg talking infront of class) the ‘stress’ went for her gut (like a lot of folk!)
    Hope you find solutions soon.

  17. My daughter is 10 & has gone on to movicol after feeling sick and aching for 2wks, the doc said constipation! We started 2 sachets aday on fri n she didn’t go toilet until Sunday when she was going everyday even tho they were hard rabbit droppings, she has been pooping like tht for yrs so must be an awful lot of back log! I’m dreading school tomoz incase she needs to go n she holds it at school as is shy bout using the school loos! Hopefully she will be better soon but this site helped a lot thank you

    • Hi Kim
      At least at age 10 she will be aware of the urge to poo, but don’t worry, 2 sachets
      Won’t make her stools loose. You would need to be giving her 6 sachets to make it chronic watery stools and if u do that you shouldn’t send her to school for a couple of days.

      My dr advised me to disimpact my daughter
      After she had been producing rabbit droppings, just to make her really empty and start again . It wasn’t the best 3 days of my life but she wasn’t sitting on the loo the whole time, just when she got the sensation she needs to be

      • …Needed to be near a toilet and school makes that difficult. So: don’t be frightened of keeping your daughter home to disimpact, start 2 sachets Thursday, 4 on Friday, 6 on sat and if it’s water you can go back to the maintenance dose of 2 sachets a day, if that’s all she needs to make her produce a type 4 once a day.

        Hope that all makes sense!
        Good luck
        Kaye

    • I’m over 50, and had a similar problem. The solution for me was as follows:
      – Stopped eating glutenous foods.
      – Replaced breakfast cereal with 2 pears and a probiotic.
      – For something sweet I ate prunes, probiotic yogurt, or high cocoa dark chocolate.
      – Took 2 sachets of Movicol in the morning (1 hour after or before breakfast), and two in the afternoon before dinner. Reduced fibre intake, and drank 3 litres of folders water each day. Initially, I was more constipated (the impacted feces was expanding). But on the 7th day, with waist twisting exercises, things started to move. The feces was initially like a ribbon (moving past through the impacting I guess) , then got bigger and started to get watery, I then dropped the Movicol back so it was not runny (see the Bristol Stool Chart). It then started to get a healthy texture, and I noticed two distinct feces coming out at the same time; a light fluffy stool, and a dark heavy stool. It seems the dark heavy stools were old feces from the impaction.
      I’m now taking one dose of Movicol each morning for a month, so my bowel has a chance to shrink back to normal size. I eat about 30g of fibre (pears, prunes, almonds, slippery elm and psyllium husks) and drink 3 litres of filtered water a day.
      I tried lots of different things including enemas, but only a Movicol worked. Before I would poo once a day if I’m lucky, but now I go at least twice a day without any difficulty and my belly is shrinking a little each day.

  18. I am mid 60s like many have had constipation since a child. On medication for a bladder issue. Normal for me is a BM every morning but for 3 or 4 days a month everything just stops, no feeling of needing to go but normally clears with just 1 Movicol. 3 weeks ago BM changed, no feeling of needing to go, took Senna and movicol could feel poop at end of rectum but wont come out. Feels like a switch has been turned off. Saw my MD he has advised 3 movicol a day and to go see him in a week. Now onto my second day of movicol and still nothing happening except wind. Very sore from trying to push something out. Any advise would be appreciated

  19. My DD is 3 and has always suffered from hard small stools. I suspect a mild milk intolerance as it always seems worse when her diary intake increases. She uses the potty/loo to pass urine but has never used it to poop. We used to use a pull up but then she just started to just go in her knickers. Then it got worse, she would intentionally hold it in, but still soil her pants. So it got to the point I was cleaning her up and changing her underwear every half an hour or so. I figured this was what she was doing so took her to our GP who has given us movicol. I was told to give just 1 sachet, after a day her poos turned liquid and she was going every 20 minutes. I’ve kept her on one sachet but goes less frequently now but still very loose. I’ve not noticed any dark hard pieces in there, except for flaky tiny pieces that stick to her bottom like glue making it very tricky to clean her. What I’m wondering is should I up up her dose assuming the backlog is not cleared or should I reduce her amount to help her form proper poos? Sorry for the graphic descriptions, but I’m baffled by the whole thing! Because she hasn’t produced any old poop I can only assume it’s still in there but it’s been a week now?

  20. I have recently developed constipation,which I assume is due to having H Pylori off/on for past 2 yrs. My dr. treats it, a few months later I have it back. My digestive system has suffers as a result.I suffer from chronic gassy rolling up/down my tummy, however I have not been able to dispel anything in past 5 days. I spoke with a Dr. on Web md. he suggested Movicol, however I am unable to locate it. Would I need a prescription for this. please advise.

  21. what age can my daughter at 5 months and one weeks, in 3 week time will be six months go on solid food I am worried as she been having painful poop since newborn until now, been on warm water with pure orange juice or apple juice not helping much, can I give her movcol now so she doesn’t have painful poop anymore

    • hi sonya – i’m sure Movicol is ok at 6 months and weaning around them too. Can wean bit earlier if necessary.
      Extra water and juice can work well – I would avoid apple juice though as makes constipation worse. The cloudy one is OK though.
      You asked lovely factual questions rather than opinions!
      Very best of luck!
      drsharryn

  22. Hello DrSharryn
    A quick question that you may or may not be able to answer.
    There is a fair bit written here about bloating etc. In your experience is it ‘normal’ to see really rapid bloating with constipation/bowel issues? ie flattish belly to looking like expecting triplets within a very short space of time? (in either adult or child).

    It’s a question we’ll follow up with own care providers in due course, but curious.

    Many thanks.

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