Disimpaction regime

In the video we explain that if your child has faecal impaction you will you have to get rid of all the poo that is in your child. We call this 'disimpaction'.

Only ever undertake a disimpaction if it has been advised by your doctor and you are under their guidance and supervision. There is a recommended disimpaction regime, depending on age and this will use large amounts of macrogol to flush out all the poo. Note that all dosage advice in the 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 disimpaction.:

Child under 1 year	Half to 1 sachet daily
Child 1–5 years	2 sachets on 1st day, then 4 sachets daily for 2 days, then 6 sachets daily for 2 days, then 8 sachets daily
Child 5–12 years	4 sachets on 1st day, then increased in steps of 2 sachets daily to maximum of 12 sachets daily

Your doctor will tell you the exact doses you should give your child and for how long.

What you are aiming for

The idea behind the disimpaction regime is that your child takes the macrogol, increasing daily as prescribed, until the poo has reached the watery, runny type 7 poo, with no bits in it, as we can see on the Bristol stool chart.

After you have reached type 7, reduce by 2 sachets a day until you reach type 4 or 5 poo. Remember to continue giving the macrogol, as you are now on a maintenance regime.

How to tell if your child has disimpacted

The overflow soiling is very likely to get worse before it gets better. In the past, we have found parents who thought their child had disimpacted and started reducing the dose but quickly realised when getting back to a maintenance dose that things had not improved.

The child who has fully disimpacted will have a feeling they need to go to the toilet. They may not get there in time, but they knew they needed to go. They will be easily cleaned up and between each poo, they will be clean and dry. If your child is still leaking poo constantly, with no feeling, it is unlikely that the blockage is cleared.

Other advice

For those school age children who are on a disimpaction regime, being on high doses of macrogol can cause poo accidents which may cause distress and embarrassment during school times. So, if it is possible, disimpaction can be undertaken during school holidays.

Remember to always praise or reward when your child does a poo and never praise clean underwear. If your child is doing a poo regularly, the overflow soiling will stop and they will have clean underwear anyway.

All macrogol dosages, whether on maintenance or disimpaction, may be changed as long as this is done under the supervision of a suitably experienced health care professional.