4 year old wee and poo accidents

[Lenkab]

Hi, I'm new and am so pleased I have found this community!

My little boy is almost 4 and we have been toilet training since he was 2.5. He still has wee and poo accidents every day with very rare dry days. Nursery have not been able to help and we have tried everything, rewards, incentives, etc.

My issues seem different to others as his stools are very loose and runny, so I don't think it's a constipation issue and he seems to struggle holding them in sometimes. I also think the runny pops may be food intolerance related. Has anyone had experience of this? I also think he may have an overactive bladder as he wees a lot and frequently during the day. Nursery have also commented on this.

He is starting school in September and i am at my wits end (like others!) as we have tried everything to get this sorted.

I have been referred by the GP to a specialist children's bowel and bladder service, but the wait is 6 months and we don't have an appointment until November.

In the meantime I have been to see a private paediatrician through my health insurance at work. He has told us to stop using pull ups at night and start him on a bed wetting alarm, along with prescribing him on desmopressin at night. This seems pretty extreme to me given how young he is, but we have started this week to give it a go.

Any help and advice would be appreciated. Reading these posts I am keen to try and get a referral to Evelina.

[AliStan]

Sounds like you need to push to get that referral to specialist to really get answers! General pediatricians try to be helpful but they are still generalists and it can be a frustrating conversation. If it is overactive bladder (which my daughter has) then regardless of how much or little wee they have in their bladder they can still have accidents. You say he wees a lot but what we found was that she went often but actually wasn't ever doing very big wees (although didn't seem like that when accidents happen!).

With us we found that trying to get into a timed routine helped . She goes religiously at all break times at school and that seems to more or less eliminate accidents when she's there. At home we struggle a bit more to keep to the routine so that tends to be where most of her accidents happen. If we're out if we see a loo, she and I have a race to see who gets there first and then she always has a little try ("might as well now we're here"). You could also try a vibrating watch which you can set to go at a certain interval and it tells your child that it's toilet time. The watch worked for us for a bit (and stopped me needing to nag for her to go) but she got bored after a while.

In terms of night time, the consultant we saw told us not to even bother worrying about nights until we had some sort of control during the day. Just hearing that has taken so much stress out as we both feel comfortable that she wears pull ups for now. We have focus on daytime issues and she knows we're working on that and then we'll think about nights in time. For me, I don't have so much washing anymore and that alone was draining and stressful so eliminating it has helped!

Hope that helps a bit but know you are amongst friends on this site. We've all been there in some shape or form, I'm "lucky" that we don't have poo accidents so hopefully others will also give you some good advice on that.

Best of luck x

[emmasue]

This sounds like my daughter. When she was that age, she was having up to 14 poo accidents a day! They were very runny so we assumed, GP included, that she couldn't be constipated. We finally got to see a paediatrician and it turned out that she had a blockage in her gut. After putting her on Movicol, she started pooing on the toilet! It made such a difference. She is still on Movicol 4 years later. Every time we try to wean her off, she has accidents again. However, if we keep her on two sachets a day, she is fine. We are trying to address other issues at the moment. She has a processing delay and the paediatrician is having her assessed to see if she has autism. But I think the reason she keeps having accidents is that she holds her poos in. When she is on the Movicol, she can't hold them in. So we need to figure out how to get her to stop doing this, which is not easy.

Has your paediatrician felt your son's tummy? I am surprised that your paediatrician hasn't said that it is constipation. Apparently really runny poo is a sign of constipation. Keep pushing for the specialist appointment. You could call and request any cancellation appointments. I hope you get help and support soon. I know how hard it is and how much is put on you, the parent. But remember, none of this is your fault. It is probably a medical issue and once treated, things should improve.

[Georgina1475 in reply to emmasue]

The wetting could be related to being constipated as it puts pressure on the bladder. Worth getting his tummy examined if just to rule it out. Also soiling is a normal sign of constipation so it's worth checking as a little poo softener daily maybe needed which may help the wetting. My son had the same symptoms when he was constipated. Daily sitting and practicing going to the loo helped get him into a good routine so that when he was ready and on the right medication we have been able to stop soiling. I'd definitely suggest a visit to your gp just to get these things checked.