Help please!!

[Helselgar]

New here and would really appreciate some help please.

My 6.5 year old son is having real toileting issues. He potty trained brilliantly at 2 year and all was good until about the age of 2.5, when he constantly seemed to have soiling in his pants. We took him to the doctor who thought it was faecal impaction and prescribed a daily dose of movicol. This helped soften his stools and he had a good clear out, but the soiling still remained. We continued the battle. Nothing seems to make any difference. He brings his knees up and is shaking at times, we tell him that he needs to go to the toilet, but he refuses. He's very stubborn and this always leads to tension and arguments! I genuinely don't think he knows the sensation that tells him he needs to go any more. The doctors just keep prescribing movicol but I think we're beyond this now. I need to go back to them, but any help would be appreciated as I feel as though we're being fobbed off!

[jane-anna]

Have you actually done a proper disimpaction ie up to 8 sachets movicol per day until brown water? Then when you know it's clear you need to reduce to maintenance dose and as others say, regular sits on toilet after meals.

[Helselgar]

Not done that, to be honest I've never been convinced that was what the problem is!

[Luella19]

May I suggest you read a book The Ins and Outs of Poop. I found it very interesting and helpful. I think withholding poo was a major cause of my daughters soiling issues over the years which have now pretty much resolved. X

[Helselgar in reply to Luella19]

Thank you. I'll have a look for that. Can I ask how you solved your issue?

[Luella19]

Hi, with great patience...

I have written quite a lot in this forum if you have a search through. From when soiling issues started age 3 to now age 7 my daughter had good times and not so good. She was never really constipated, but was a bit which was confirmed by X-ray at age 3. the real issue I think was that she tried to hold poo in, the consultant explained last year (age 6) that rather than 'overflow' which you read a lot about causing soiling, my daughter was letting bits of poo escape whilst trying to hold it in, causing the poo in knickers.

From age 3 we used movicol on and off (mostly on) about a sachet per day. The soiling became less frequent but never went away. Age 6 we saw a lovely consultant who prescribed senokot along with movicol, 5ml per day. He also set toilet routine which she had to follow and because doctor told her she did as was asked. 10 mins reading on toilet each evening. This was really helpful to establish routine and discipline whether a poo came out or not. I had to be very strict about her sitting on the toilet if I saw her behaving in certain ways, I could tell when she needed to poo. She wasn't allowed to do things until she tried on toilet (go in garden etc)

The senokot really helped, as it's a stimulant it pushes the poo out and I think it helped her feel the sensation more. She was in senokot for about 8 months, we weaned her off senokot and movicol in February 17.

I think age and maturity play a large part, peer pressure etc. School have been wonderfully supportive throughout. She was still having the odd soiling incident in year 2 and the teachers dealt with it wonderfully.

She takes no laxatives now but I have to watch what she eats and drinks, lots of fruit and veg and I still monitor when she poos to check she is regular and she still likes me to sit with her in the toilet.

It has taken tremendous patience to get through it, it was very hard at times dealing with school, accidents at people's houses, not being able to let her go on play dates all that kind of stress which I'm sure you relate to. Many tears were shed and many hours spent searching for answers and people in similar boat online.

I am still not 100% confident about her toileting yet but I would say 90%. I really never thought we would get to this point and it feels great now.

It's keep at it, it's relentless but you should get there in the end xx

[Helselgar in reply to Luella19]

Thank you! Sounds like a long slog, I will have a look at the book. Do you think I should go back to the doctors and force this issue a bit more?

[Luella19]

I would ask for a referral to a paediatrician if you haven't been offered one already. The gp that referred us did so very happily as I had hit a point where I was becoming more desperate and she could see how hard I had tried over the years. Preferably try to get referred to one with a special interest in gastroenterology. I saw various gps over the years, all helpful but all giving different advice. The consultant was very experienced with our situation and gave more specific advice and gave me confidence and hope that she would get over this. I really needed that last summer as was feeling really down about it all.

[Hidden]

Sounds like you need to take him, by hand, to the toilet after meals even if he says he doesn't need to go. Relying on him to take himself is not working. Train his body to accept the routine and he won't fight it.

[Helselgar]

Update: went back to the GP earlier who has referred is to the paediatrician at the local hospital. Finally may get somewhere!

[Nanoiu]

Please google 'Beating Sneaky Poo' from Dulwich centre. Learn about the stomach to bowel connection - gastro-colic reflex - 20 min after a person has a meal they often feel the need to go to the toilet. Take your son by the hand to the toilet/ potty and have him sit for 10 min or so. Make it a habit after every meal if possible. Our son started soiling when he was 4 and he would not go on his own to the toilet, even if we asked many times.