I'm at my wits end with this poop issue...please help!

[5LittleMonkeys]

This is a gross subject but please, please someone tell me that I can fix this.

 

Son is 7 and for as long as he has been potty trained (which happened very, very late because of this poop issue - I think he was 5 when we finally said no more diapers) he has accidents at least 5-9 times a week.  These accidents aren't full out vacating his bowels into his pants but more like leaks or tracks.  At times it's just like he hasn't gotten himself clean when he wipes so I've bought him wet wipes to use, but at other times he hasn't even been in the bathroom and I'll get a whiff when he's close, check his pants and there is definite "leakage" in there.  I'll ask if he was "holding" it so as not to miss out on playing and sometimes he will admit that that is what happened, but then other times he acts genuinely surprised that it happened and says he didn't notice. (How one doesn't notice poop squishing between their butt checks is beyond me.)

 

So, I'm just tired of this...I'm tired of scrubbing poop out of his underwear, and yes, I have had him scrub them on more than one occasion.  In the last 3 days its happened 4 times...all times when he was either playing with someone or having screen time.  I took his screen time away and told him he was restricted from playing with friends until he could go 3 days without an accident thinking yet again that this was just an issue of him not wanting to take the time to go to the bathroom.  Well, today it just happened again and he was just poking around in his room not doing anything specific.  I asked him if he had an accident and he said no, he didn't think so but when I checked he had.  I hate to think that my son is just flat out lying to me...not something he does about anything else...but what on earth is going on!  I sat him down trying to talk to him about it, explaining that I'm not mad, but that we have got to put an end to this and he said that every time he eats he has to poop right away, and that sometimes when he's playing he'll notice that its "squishy" down there but that he didn't realize he'd gone.   Is this a medical issue?  What could be causing this and how on earth do I stop it?

[EKS]

Google encopresis and then make an appointment with his doctor. 

[Mrs Mungo]

I would take him to the doctor.

[Bootsie]

Encopresis is often associated with constipation.  Children with this problem often do not know that they have soiled.  It can be hard as a parent to understand how they cannot smell or feel this, but it is just like you get used to certain odors or feeling a shoe rub and a particular place and no longer notice it.  It can be a frustrating problem for parent and child.  Some of the best information about this issue is available from Nationwide Children's Hospital in Columbus, OH: 

[Whereneverever]

I would not punish him or shame him. It sounds like encopresis and I would take him to see his doctor ASAP to get cleaned out. http://www.webmd.com/digestive-disorders/encopresis

I have a friend who dealt with this with a kiddo and it took a long time to get sorted out. Good luck, mama!

[littlebug42]

I agree.  Sounds like encopresis.  A visit to the doc is in order. 

[Bootsie]

Encopresis is often associated with constipation.  Children with this problem often do not know that they have soiled.  It can be hard as a parent to understand how they cannot smell or feel this, but it is just like you get used to certain odors or feeling a shoe rub and a particular place and no longer notice it.  It can be a frustrating problem for parent and child.  Some of the best information about this issue is available from Nationwide Children's Hospital in Columbus, OH: 

 

http://www.nationwidechildrens.org/motility-center

 

Somehow the link didn't show up in my post.  Having a family member who has dealt with this, I don't have any easy answers, but I know it can be extremely frustrating for parent and child to deal with.  Feel free to PM me for more info.

[bettyandbob]

I wouldn't punish this.

 

In my house his underwear would get a special laundry load. My washer has a "sanitize" temp. There'd be plenty of bleach and detergent. It might get washed twice. The washer may have to be run again after the underwear was finished. I'd have enough underwear and a place to put the offending underwear that such a load could be done once a week. Storage place is likely a container next to the washing machine. If you have a decent machine no one needs to scrub. You just don't throw chunks (sorry, bad visual) in. Stains can go through in a special sanitize load with double rinse and you can follow with running an empty load after.

 

With ds, I'd work on staying on the toilet until finished. He would be responsible for getting offending underwear to storage container. There would be some punishment for not following through on that.

 

Then, I'd make an appointment with the doctor. I'd consider changing his diet. At the very least Id get more water in the boy because dehydration could be part of a constipation problem.

[bolt.]

My DD 8 is the same. We are treating it as a medical condition, and it is much improved by daily lax-a-day (which I think is the same as mirilax). I also make her wear daily panty-liners, which helps her self-manage minor cleanups. Much improved does not mean that there are no accidents: just that they are less frequent, and less problematic in texture. It took a while to get the right daily dose, and needs to be adjusted from time to time.

 

Even so, on a recent vacation, I was not diligent about the lax-a-day (somehow thinking that the constipation might be 'better' than urgency... so stupid of me!) and the daily problems returned. I had a full-blown grown up meltdown in a zoo washroom about it. I'm soooo not proud of myself. It's just it's POOP! And she's nearly NINE! (Yeah, I get it.) I also don't scrub after large accidents. Little panties cost less than $1 each. I don't feel bad about trashing them to save my sanity.

 

My best grasp on it is that the constipation feeling feels 'normal' -- the way 'that area always feels' (always 'holding it') -- so the 'need to go' feeling is completely undetectable until it is very urgent... so urgent that she knows she couldn't get to a toilet if she tried, so some comes out (even though she did not consciously release it) and the combination of shame and lack of problem solving skills leads her to put the accident out of her mind and focus on happier things.

 

We talk and we talk, "It's not your fault that you have troublesome guts, but you are in charge of making good decisions about your problem. Now, what do adults do if they have a problem and suddenly find they have pooped in their underwear? What do you need to do -- right away, try to clean up yourself. Try and see if you can get any more poop out, so it doesn't bother you again soon. If I am with you, ask for help. Otherwise, ask as soon as you see me next..."

 

We are working on the idea that it is better to try for a washroom even if she can't make it, and try not to pretend it's not happening.

 

But, really, the lax-a-day makes all the difference.

 

I try to act like I would if I had a grown adult in my life with this condition, and I ask myself 'how would I want someone to treat me if I had this problem?' -- no shaming, all business. Strategies and coping and planning... except when I'm a person too. Then I have my meltdown, and say all sorts of unhelpful things... and end up apologizing about it.

 

I've invented a holiday: "Fecal freedom day" -- the day your youngest child is potty trained enough that you are unlikely (barring illnesses) to have to touch any fecal matter other than your own for the rest of your life. Someday, oh someday, that day will come.

[5LittleMonkeys]

Oh my goodness.  Thank you so much.  bolt., I think the description in your third paragraph is exactly what's going on, and thank you for being real.  I try to be very patient with him even when I was thinking it may be a issue of him purposefully putting off going...but my patients wear thin dealing with this day after day.  

 

Going to read more about this.  

[Mom-ninja.]

I agree with the others. Take him to the doctor sooner than later.

[dirty ethel rackham]

Please, please, please don't punish.  My oldest suffered from this and he ended up developing social anxiety and depression, despite me working very hard at staying matter of fact about it and not punishing.  We took him to a pediatric GI (actually several until we found one that didn't give us the "do my program for 6 weeks and he'll be cured" talk.)   Because it took so long to find an effective treatment, it took years to retrain his bowel.  We tried the top-down approach (oral meds to keep the stools soft and clean him out) but it didn't do anything long term.  We ended up using the Soiling Solutions protocol with much greater success.   He had the problem from the beginning of potty training, but we didn't actually get a diagnosis until he was 7.    Fortunately, doctors are much more knowledgeable now than they were back then.

[wintermom]

This thread is so helpful for me! My 7 yo son has been going through this since he was a toddler. I did mention the issue with our doctor at our last visit, and she recommended increasing water and fiber, but I think I need to go back armed with some more information.

[MBM]

Sounds like encopresis. My youngest had this and it was a bugger to undo. Btw, his pediatrician was not helpful and the pediatric gastro was only marginally helpful. An online forum of other parents in the same boat helped us the most.

 

The leaks and little poops could mean your son is not having soft poops on a regular basis. He could also not be waiting on the toilet long enough to get as much out as he can. With the impactions, the intestine can lose it's tone somewhat and he might be impacting quickly. Regular, soft poops will help it regain that tone, but they must be soft.

 

If a kid has encopresis long enough, the nerves become a little dulled and the message that they have to go to the potty is not loud and clear. That might be why he is not responding and having the accidents, too. With time and enough regular BMs, that will come back.

 

Because pain is associated with going, someone with encopresis will also tighten their sphincter automatically when they get the urge to go instead of relaxing. This will happen even when sitting on the toilet. It is also why kids will poop in the tub when everything finally relaxes. Making sure the poo is always soft is really important. Use Miralax regularly -- possibly for several years -- if your pediatrician says it's okay  My son used Metamucil for at least two years because Miralax was really new back then. Also, make sure your son is drinking enough water. (That was my son's big problem.)

 

It also sounds like your son becomes absorbed with whatever he's doing. He could be holding it in so that he can keep having fun. That's very common with these kids. What can help is to do practice sits. Those are just times when he has to sit with no pressure to produce anything. Good times would be shortly after waking up, 10" or so after eating a meal or big snack, early afternoon, and maybe evening possibly after bathing when they are relaxed. The idea is that he has to learn to stop what he's doing and go sit on the potty. It's all about creating a habit. Give him plenty of reading material. LOL!

 

It might also be easier to go if he has a stool he can place he feet on while he sits on the toilet. So if he likes that, maybe he could scoot a stool under his feet if he likes.

 

Don't get angry with your son even if he has accidents for awhile. Treat his accidents matter-of-factly, ask him why he thinks it happened and confidently remind him what he needs to do. The less angry you are, the more likely he'll co-operate and relax. By co-operate, I mean he'll want to work hard on the problem, too, but he needs to know you won't get angry if he has accidents for awhile.

 

Definitely begin teaching him why this is happening and what he can do about it. He's old enough to start learning. You could even make reminder charts that he fills in himself.

 

Good luck! I know all too well how frustrating encopresis can be.

[mlbuchina]

We had this same problem with my dd8.  I took her to the doctor, and he had her x-rayed.  She had a impacted bowl, and wasn't going all the way when she went to the potty.  We had to put her on miralax every day for a long time to help retrain her to go to the potty.  The doctor said this happens often, and that while potty training, she must have had a bowl movement that hurt, and decided she wasn't going to go through that again, so started holding it.  This caused the back up, and then the "leaks" started.  She is much better now, and doesn't have accidents anymore.  There is hope!

[Sharon37127]

Please, please, please don't punish.  My oldest suffered from this and he ended up developing social anxiety and depression, despite me working very hard at staying matter of fact about it and not punishing.  We took him to a pediatric GI (actually several until we found one that didn't give us the "do my program for 6 weeks and he'll be cured" talk.)   Because it took so long to find an effective treatment, it took years to retrain his bowel.  We tried the top-down approach (oral meds to keep the stools soft and clean him out) but it didn't do anything long term.  We ended up using the Soiling Solutions protocol with much greater success.   He had the problem from the beginning of potty training, but we didn't actually get a diagnosis until he was 7.    Fortunately, doctors are much more knowledgeable now than they were back then.

 

THIS THIS THIS!!! I can't scream it loud enough.  Soiling Solutions- pay the $, get the book, do the protocol- e...v...e...r...y...d...a...y........  and it will improve and resolve.  Don't do any "top down" meds.  Waste of time and money and extremely uncomfortable for the child.  It doesn;t "solve" the problem. 

 

Soiling Solutions does.

 

If you do the plan, feel free to pm  me anytime as we have been doing it for a while, still doing it, and having great success. 

[Ottakee]

I agree with the encopresis, miralax---which IS a MIRACLE, no punishment, etc.

 

on the undies thing---it may sound gross, but not any worse than you are doing. Go to a garage sale, thrift store, etc. and purchase TONS of undies in his size. Soiled ones get THROWN AWAY. We did with with my daughter with encopresis. Seriously, life is way too short to spend time scrubbing out soiled undies. Just take the thrift store/garage sale ones and run them through a load with bleach on the sanitizer cycle or hot water and save your sanity.

[Pamela H in Texas]

I would guess diet and/or constipation is the issue, especially if you've never had any real time with success.  My kids LOVE our squatty potty (blog post here:  http://hfamcourse.wordpress.com/2013/05/30/review-the-squatty-potty/ ) which also helped me with THREE different issues!  On top of making sure diet is adequately healthy, I'd start here.  Cheap, easy solution.  

 

From there, I'd consider an elimination diet of key issues.  Dairy would be the first to go as it is the easiest and at the heart of so many issues.  If there is anyone in the family with autoimmune, joint, etc issues, I'd do gluten next.

 

If you are interested, I can give you the information for a saliva test.  I haven't checked with them in years.  It should be about $50 and takes a couple weeks.  

 

Anyway, there is also the consideration of emotional issues, abuse, etc.  Dealing with that is an issue we've had to do here and it is *not* easy!  The other part of it is that you don't want to CAUSE an emotional issue around BMs.

 

Anyway, I don't know what Soiling Solutions is, but considering it is related to the alarm for enuresis and we used the ETC's program successfully including the alarm, I could see looking into that.