4yr old soiling

[mummykj]

At the moment my 4yr old is soiling his pants several times a day. He’s been on movicol since he was 1 year following severe bouts of constipation but he’s now not been constipated for a long time. I was advised to keep him on movicol until toilet trained. His diet is rich in fiber and he drinks a good amount, is active and wees in the potty fine (although sometimes a bit lazy and slow). We’ve tried rewards - stickers, charts, treats, toys etc and often he’ll have a good phase of going to the potty most days with encouragement and no accidents but then after a couple of weeks regresses again and gets very emotional and doesn’t want to go to the potty - eventually he will and will pass a big soft poo - so not constipated. He says he can’t feel the poo come out but I can often tell he needs to go because he goes quiet and looks like he’s clenching so I think he can feel it and tries really hard not to go - scared? Anxiety related? I’m just lost! He tells me he finds it hard and I think he just doesn’t want to do it, he’s rather busy himself with other things. Any advice please?!

[Wagamama]

My daughter had this exact same thing! Not constipated anymore but started soiling. I would reduce his movicol asap.

I’ve found that movicol can remove the sensation of needing to go. It did this to my daughter.

Have a look through this thread from a few days ago...

healthunlocked.com/eric/pos...

Xx

[AANN1977]

Hello there. Have you tried the sweet corn test, to check his gut transit time? I think it should take around 24-36 hours to appear, but if it’s taking longer, maybe there is still a block somewhere? Occasionally, my daughter would get out a a big, soft poo that we thought would have cleared her out, but it turns out, she still had more in her. Good luck.

[Jfraser1]

My 4yr old can have big soft poos but still be constipated unfortunately. It can get backed up so essentially your boys colon could be full of soft poo. It may be getting stretched thus loosing tone and sensation and may be a reason why he says he can’t feel it? Might be worth upping the dose of Movicol to move things along. Not as extreme as a disampaction but enough to make things loose. Keeping it soft also prevents him withholding as it sounds like he may still have a lingering psychological issue around the toilet?

I introduced Senna alongside the Movicol wich really improved things for my son. The Movicol is great for softening and bulking out but a stimulant like Senna is sometimes needed too to keep things moving!

It’s so frustrating trying to figure out what to do, trial and error I think. Good luck x

[Helen71price]

We struggle getting to know the right dose of movacol, it's so frustrating, we give her half a dose every other day but she was still withholding so have now tried a full sachet every other day and yesterday she had quite a lot of seapage now today she had a tiny bit but was quite hard, afraid to give a dose every day Incase it causes her to go without realising and when she's in nursery can be quite upsetting for her. She hasn't had a proper bowel movement for 2 days in which she asked to go so we thought we had a break through with it but has had a few seapages since, we are really at our wits end and don't know what else to do x

[Frustratedmum1]

I would be tempted to stay on movicol even if it is at a low dose. I have taken my son of it a couple of times thinking he is to wet and it has come back to haunt me. Recently I thought my son was to wet so I tried dropping his movicol. He then doesn't go everyday and the behaviour slightly deteriorates but his poo is still a bit wet in my opinion. We were told to increase and things have improved the messing is not so bad. What I found with my son he doesnt understand the sensation because they have not had it before. I have to say to him if you start crossing your legs your body is saying you need to sit on the toilet. It is hard to believe.

[AndrewT]

Dear mummykj,

Maybe, just maybe, you are Overdoing the Movicol. I have to say that I know, very little about this, our children had 'Cali-fig'- but not often-, my sister used Lactulose- again not often. Can you not simply have a 'word', with the Nursery, and put him in a Pull Up? I worked, technically 'Helped Out', at a Nursery some years ago. Children wetting, or soiling, wasn't that common- but not that uncommon either. We just Dealt, with it, in a very 'Matter Of Fact' way. (Clearly IF a child had a persistent 'problem', then that would have been different- however this was not the case.)

A final thought, sorry to ask this but....Is it the CHILD, who has the problem here? Does he not just 'Go', when he needs to? Whilst it isn't a Pleasant job, to clean a Messy child up, I can vouch for that, are you necessarily 'Pressuring' him to be clean? Sorry but this just occurred, to me. I'm quite sure that Everything WILL 'Come Good', in the end.

Sending you ALL, my best wishes.

AndrewT

[mummykj]

A bit of an update - after a few bad weeks of him not wanting to go at all out of the blue he started doing tiny poos on the potty with encouragement so I decided to do a disimpaction with movicol to clear him out and start afresh. After the inevitable very runny poos I decided to stop movicol after reducing the dose over a few days. He’s not had any movicol now for a week and the poos he has done have been soft type 4. Today he took himself to the toilet on his own and did a poo - this feels like a miracle! He has also soiled once today though too so I’m not under the impression we are totally there. And we have had ‘good’ish phases before and then regresses again. BUT it’s given me a bit more hope! And I do think he doesn’t need the movicol anymore. Has anyone any thoughts on senakot? Could this help get into a better routine and give more of an urge? I’m trying to get him to at least sit on the potty for a few minutes after meals.