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Toilet accidents with 7 yo-advice?


T'smom
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I don't know what to do. My 7 year old son was potty trained at 3 and, with the exception of 2 times in the car when we couldn't make it to the bathroom in time, has never had an accident. (Those were pee accidents) Until the last month/month and a half. It started when we were camping. We tried to use the camp bathrooms as much as possible, reserving the toilet in the camper for nighttime and first thing in the morning- so that it doesn't smell/ need to be emptied frequently. But it is there in an emergency, which i thought the kids understood. We were camping for a few weeks and when I was doing laundry, ds didn't have any underwear. When I asked why there was no underwear of his in the laundry, he broke down crying. He hadn't been making it to the bathroom in time (poop) and had been changing his underwear and hiding the dirty ones. We talked to him and he said he just couldn't make it to the bathroom in time. We told him repeatedly that if he had to go, to goin the camper instead of trying to make it to the bathroom. But this was right before we came home, so I wasn't really too concerned. I thought the excitement of camping was keeping him from recognizing the signals from his body. That was about three weeks ago. I just discovered that it has been happening again. He's been not making it to the bathroom in time, but he changes his underwear, throws it away and I don't know it's happened- until he runs out of underwear. I had asked him a few times since we'd been home and he told me it wasn't happening. I did not punish him or make him feel badly about it, but he is embarassed and I'm sure that's why he's not telling me. I'm sorry this is a novel. Anybody had a problem like this? How did you solve it? Should I take him to the doctor?

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That sounds like encopresis. It is when a kid gets constipated and then the poop leaks around the blockage. Your son very likely is not able to control what is happening. I would take him to your doctor and go from there.

 

(We have too much personal knowledge of this in our house. My youngest deals with this and it is extremely hard on everyone. The kid feels bad. The parent feels angry. The siblings are embarrassed. All around an unhappy situation.)

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DS1 had encopresis…basically chronic constipation.  He was on Miralax for 1-1/2 years before it resolved….but it did.  It is extremely frustrating.  Basically, he was responsible for removing his sheets, and putting everything in the laundry room, taking a shower and cleaning himself.  If he had a soiling accident, he was responsible for taking care of that to the best of his ability, although we would help.   These things weren't meant as punishment, but for him to recognize that he had a medical issue that he himself could handle.  He felt better that if he had an accident, by the time I woke up, he could say…"well, Mom, the sheets are in the laundry room, and I took a shower and got dressed."  

 

We dealt with this from about 7 through about when he just turned 10.  

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Yes, run don't walk to the doctor/care provider who can get you set up with a treatment plan. It is unlikely to resolve quickly on its own, and may take some time to resolve even with treatment. But in our family, we are well past the dark days and everyone is happy and healthy (and I know more about poop than I ever thought possible), so there is definitely hope!

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When my daughter was 4/5 ish and started Pre-school she also started having accidents.  What had happened was that she would "hold" it until she got home but then be constipated/blocked. Eventually she started to have leaking around the blockages and become impacted.  We figured all this out several months into school, pulled her out but the damage was done.  She had a stretched colon and continued to have issues, no where nearly as severe.  She got to where she has normal bathroom habits around 10 years old.  She also didn't realize when she had to go.  The stretched colon no longer sent the right messages until it was to late.  Adding fiber only made it worse, it really just took time and remembering to try at regular intervals.  She got really tired of me always asking her if she needed to use the bathroom. 

**We did see a doctor, several times and you should to, hopefully you get more help and better advice then we did.

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Okay. I guess I have a place to start. I'm so glad I have a place to ask questions anonymously. I didn't try to make him feel badly at all. I didn't punish him or anything, I just hugged him and told him that it was okay, that we could buy new underwear. I thought it was crazy to go from never having an accident to having several in a month.

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One thing we did was keep a few pairs of undies in the car…as well as some plastic bags if we needed to dispose of them.

 

There's a book group/online regarding this, and the doctor behinds it is a fan of using Fleet enemas, timed sittings, and basically insisting on quick elimination.  While we didn't like this approach for us, we did find out that using a Fleet enema in the beginning a few times and if DS1 was having a lot of soiling accidents did help.  There's also a protocol for using Miralax throughout the day to empty the bowel.  It may seem weird, but often when that is happening, it means there is a lot of backed-up stool that needs to come out.  We also did insist on DS eliminating in the morning before we left, if at all possible to avoid accidents…but we didn't put him on a timer.  ALso, elevating the feet can help.  

 

http://www.ped.med.utah.edu/pedsintranet/clinical/references/docs/giHandout.pdf

 

 

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This is very interesting to me as I'm dealing with a similar issue however it's not consistent.

 

Mine just turned six, I can't remember when it started but I think to some degree there has been issues ever since she potty trained but then we can go a few days to a few weeks without issues and then back to 5-6 times a day.  Funny part when we travel there is ZERO accidents but as soon as we get home problems start up.  Under those conditions does anyone think encopresis is still a possibility for my kid?  I've just been assuming it was a food issue (allergy/intolerance) but the most likely food in that case is milk which she doesn't drink because it gives her exzema and I didn't know what else might cause it.

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This is very interesting to me as I'm dealing with a similar issue however it's not consistent.

 

Mine just turned six, I can't remember when it started but I think to some degree there has been issues ever since she potty trained but then we can go a few days to a few weeks without issues and then back to 5-6 times a day.  Funny part when we travel there is ZERO accidents but as soon as we get home problems start up.  Under those conditions does anyone think encopresis is still a possibility for my kid?  I've just been assuming it was a food issue (allergy/intolerance) but the most likely food in that case is milk which she doesn't drink because it gives her exzema and I didn't know what else might cause it.

 

Encopresis can have physical and/or psychological causes. I would not hesitate to go to the doctor and talk it over if it has been an issue.

 

 

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This is very interesting to me as I'm dealing with a similar issue however it's not consistent.

 

Mine just turned six, I can't remember when it started but I think to some degree there has been issues ever since she potty trained but then we can go a few days to a few weeks without issues and then back to 5-6 times a day.  Funny part when we travel there is ZERO accidents but as soon as we get home problems start up.  Under those conditions does anyone think encopresis is still a possibility for my kid?  I've just been assuming it was a food issue (allergy/intolerance) but the most likely food in that case is milk which she doesn't drink because it gives her exzema and I didn't know what else might cause it.

 

Yes, this could be encopresis.  It is possible that she is withholding going to the bathroom while you are traveling and avoiding accidents (but not going to the bathroom)?  This may not be intentional, but she may be tense and nervous about having an accident.  If this happens and she gets constipated, then when she gets home and is more relaxed, accidents are likely.   If there is too much focus on "not having an accident" the problem can actually become worse.  

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This could easily be encropesis.  Basically, when a kid gets really constipated sometimes a small amount of stool "leaks" around and "leaks" out.  When this happens the kid can't even feel it!  This can be super embarrassing for kids, so if it does end up being encropesis please try to be gentle with him.

 

There was a thread on this recently and someone posted this link to what I felt was a great website on constipation.  http://www.nationwidechildrens.org/constipation

 

One of my children had encropesis and it ALWAYS was worse when traveling.  Something about not having that "normal" schedule.  So, it could very well be that he has it.  I would take him into a Dr., just to make sure.

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We found out accidentally that Gem had chronic constipation leading to wetting and encopresis (more wetting, though) when I put him on an elimination diet for another problem-which actually turned out to be related to the constipation as well. 

 

I had no idea he was constipated. Or that it could cause wetting. He is now off of wheat, and has had no recurrence of symptoms. He is also allergic to dairy and say, which do cause gut irritation. 

 

For us, food was definitely the answer. 

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Agree here with the chronic constipation.  Daughter, age 7, had a little accident this Sunday.  Turns out that she hadn't pooped since she didn't know when.  We use dandelion tincture, in juice, and ground up flax mixed in with flavored yogurt when she starts getting constipated.  Works really well for us, effective and gentle, no stomach cramping - was recommended by our herbalist. 

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A lot of constipation issues are lack of water in the large intestine. The problem increases when travelling or when kids are out of the house a lot. Miralax and senna products just bring down more water into the large intestine. 

 

An easy fix is focusing on increasing fluids (no caffeine) until the body is hydrated again. Check an online chart for his age/weight to see what's normal, buy some fun drinks, chart what he's drinking, and encourage him. 

 

 

This happens to a lot of kids at this age. It's easy to forget to drink. 

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Another poster agreeing that you need to explore encoperesis.  I would skip right to a pediatric gastroenterologist for an eval, because they should rule out some other conditions.  If it is encoperesis, it can take a full program to help them recover and regain continence.  It is one of those things that often requires a long-term retraining to restore things to normal.

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