Laxative Trial After Enemas

When transitioning off enemas many children get constipated. The goal of starting a laxative trial when your child stops doing enemas is to prevent your child from getting constipated.

What happens • Your child will stop the enemas and they will take laxatives once a day. during the laxative The laxative should trigger your child to have at least one bowel movement a day. trial? • Have your child eat meals at the same time every day. • Your child should stay close to a bathroom as much as possible. Taking laxatives may make it hard for your child to know when they have the urge to go. • Have your child sit on the toilet after meals. This is when the colon is moving, and your child may have a bowel movement. • Your child’s stool should be soft and formed. Giving your child fiber supplement will help make the stool the right consistency. Ask your child’s healthcare provider for how much fiber is right for your child.

What type of • We recommend a laxative with Senna as the active ingredient. Senna laxative do we helps the intestinal muscles contract, causing a bowel movement. recommend? • Senna can cause cramping, nausea and loose stools. Your child may take a water-soluble fiber supplement to help prevent watery stools. Ask your child’s healthcare provider for how much fiber is right for your child. • A laxative is different than a stool softener, which just softens the stool but does not trigger a bowel movement.

How do I know if • We will help you figure out the right amount of laxative for your child. my child is getting This will take about a week or two after starting the laxative trial. the right amount of • If your child goes a whole day without having a bowel movement, it means they did not get enough laxative the day before. If this happens, laxative? your child will need an enema to remove the stool from the rectum. You will give your child more laxative and continue with this new amount to see how their body responds. • If your child gets diarrhea or has loose, watery stools often, it is possible that too much laxative was given. You will give your child less laxative and continue with this new amount to see how their body responds.

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To Learn More Free Interpreter Services • Reconstructive Pelvic Medicine • In the hospital, ask your nurse. 206-987-1240 • From outside the hospital, call the • Ask your child’s healthcare provider toll-free Family Interpreting Line, 1-866-583-1527. Tell the interpreter • seattlechildrens.org the name or extension you need.

Laxative Trial After Enemas

What happens if If your child has a few voluntary bowel movements but is still soiling a lot, my child is still we recommend that you go back to enemas for a year and then try potty training again. Every year, your child will likely get more mature and soiling? interested in having clean underwear without poop (being fecally continent). This will increase the chances of success.

Senna guide • Senna, also called Sennosides, can be bought over the counter without a prescription. Some insurance companies will cover the cost of the medicine if you have a prescription. If your child needs Senna liquid or you would like a prescription for other forms, ask your child’s provider for a prescription. • Generic brands of Senna work just as well as brand names. • Check with your child’s healthcare provider first before giving any type of medicine to your child. • If you choose one method, it is important to stick with it because the products work differently even if they are the same strength.

Here are the common forms and amounts (dosing):

Chewable chocolate 15 mg in each square squares

Tablets 8.6 mg, 15 mg or 25 mg in each tablet

Liquid/Syrup 8.8 mg/5 ml

Seattle Children’s offers interpreter services for Deaf, hard of hearing or non-English speaking patients, family members and legal representatives free of charge. Seattle Children’s will make this information available in alternate formats upon request. Call the 8/21 Family Resource Center at 206-987-2201. This handout has been reviewed by clinical staff at Seattle Children’s. However, your child’s PE1640 needs are unique. Before you act or rely upon this information, please talk with your child’s healthcare provider.

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