Dis-Impaction Regime | Thepoonurses

DIS-IMPACTION EXPLAINED

In our video we explain that if your child has faecal impaction, you will have to get rid of all the stools that are present. We call this "Dis-Impaction."

Only ever undertake dis-impaction if it has been advised by your doctor or nurse, and with direct guidance from them. Depending on your child's age, they will follow the dis-impaction regime until all stools have been flushed out. Please note that all dosage advice in our video is based on paediatric preparations of Macrogol.

The guidelines for doctors from the National Institute for Health and Care Excellence (NICE) lists the following paediatric Macrogol dosage regime for dis-impaction:

WHAT YOU ARE AIMING FOR

The idea behind the dis-impaction regime is that your child takes the Macrogol, increasing daily as prescribed, until the stools reached are watery, with no lumps present (Type 7 on Bristol Stool Chart.)

After you have reached this stool, it is important to hold your child on the same number of Macrogol sachets for 3 full days. Only then can we be sure that all stools present have been successfully flushed out.

Once 3 full days of Type 7 stools have been achieved, reduce by 2 sachets daily until you reach a type 5 stool daily.

Remember: Your child must stay on their Macrogol sachets, as you will now be entering into the Maintenance regime stage.

Dis-Impaction at a glance

If your child is following a dis-impaction regime, you can download and print a "Dis-Impaction Diary" along with many other useful resources to understand your child's constipation from the "Useful Information" Section of the website

What To Expect...

Every child is different and reacts to dis-impaction differently. Some of the things that your child (and you) are likely to experience are as follows:

Lots of stools! The purpost of dis-impaction is to fully empty the bowel. Your child may pass a large quantity of stools all at once, or several small stools.

Time off school - It is not appropriate for your child to attend school during the dis-impaction process as they will likely need the toilet without much warning. We can provide you with a school letter.

Soft, loose stools - You may see some lumps within your child's poo, but don't be surprised if it is all soft/loose. Macrogol laxatives deliver water to the large bowel and therefore any hard lumps present will be broken down.

More soiling - If your child is experiencing overflow soiling (leaking stools in their underwear) this will likely get worse before it begins to improve, as first of all the stools will be softened, before coming out.

Possible abdominal discomfort - If your child has an impacted bowel, you should expect some discomfort as the stools begin to move along the bowel. Plenty of reassurance will help, and possibly some Calpol.

Difficulty getting your child to drink their Macrogol sachets - Some children do struggle, so before you start on big doses do some experiments to work out your child's preferred flavouring. Reward charts, incentives, a special cup or straw, or disguising it within other drinks can help.