Goal: Complete Evacuation of the Colon and Rectum. It usually requires 2-5 days to minimize cramping and pain when passing a massive impacted stool. Here are 6 options:

Enemas. Administer enemas at home each evening until your child passes a massive stool indicating that the colon
is empty. The advantage of enemas is quick response, minimal cramping and predictable stooling time. Do not use
more than 5 days. Avoid tap water, herbal, or soap suds enemas; these have been shown to cause water
intoxication, bowel perforation, and other complications.

  1. Begin with a mineral oil enema – instill approximately 15 ml into the rectum. This will soften the mass and lubricate the intestinal walls.
  2. Wait 30 minutes and then give a Fleets’ Enema – use 59ml (it is sold as an adult dose of 118ml
    or pediatric 59ml. We suggest you buy the adult size and only use half. You will use the second
    half the next day).

Oral. Magnesium Citrate 5 ounces twice a day for 2 days AND Ex-Lax Regular Strength Chocolate Squares – 2 squares twice a day for 3 doses (morning, night, morning)

Combination. Recommended to do on a day when there is no school. On this day, follow a full liquid diet (milk
or yogurt, shakes, soups, juices, jello, apple sauce)
AM: Give Ex-Lax Regular Strength Chocolate Squares – 3 squares prior to breakfast Dissolve 4 scoops of Miralax (Polyethylene Glycol) in 4 cups of Gatorade, wait for it to dissolve and let your child drink 1 cup over 5 minutes every half hour.
4PM: Administer one Liquid Glycerine Suppository (sold in a pack containing 4 small containers – not the solid)

Expect your child to pass several liquid stools during that day. If cramping occurs, get your child to lay on
the left side with knees bent and apply a heating pad to the belly.

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