4 year old soiling troubles.

[Kimipantz]

Hi my son has had soiling accidents for a while now he's currently in reception at school, my question is, he poos his pants constantly it can be once a day or like today we're already on our 4th pair of boxers. Each time he does it, it's like he knows he should have gone me toilet because we always ask him "oh you've done an oopsie daisy, where is the pop supposed to go" and he always replies with poo on the toilet. I think he's just not getting the connection between needing to go and actually going. When he comes.out of school sometimes he's got poo in his pants where he's not told the teachers and we can smell it 🤢 the teachers are great and do change his boxers ect. He's been on movicol but that's made it worse, I'm not even sure if it is constipation as it's not like a leakage in his pants it's always quite abit and it's stodgy so I'm really not sure! We're at the drs again on Tuesday but our Dr is useless 😤 he's been referred to an incontinence team but still waiting on them setting it up.

[Yaleamanda]

Hi, it definitely sounds like constipation. I think you need to disimpact him, have a look at the Eric website guide on how to do this.

[RuthRosetta]

Watch this about childhood constipation, it might be useful xxx

vimeo.com/179497116

[Sarah2104]

My son also 4 and in reception is exactly the same its stressing me out big time. His consultant says he isn't impacted (december) but does soft daily poos and little ones in pants daily too. I took him to a phycologist last week to try help and it did for a few days but now now back to doing it his pants, admittedly he does try to make it to toilet if at home but will always start in pants and if out it's a nightmare. At school he goes in pants too. I am going to see if I can take him off laxido and try something else like pico or senna to see if that changes things. I know I haven't helped but wanted to say u aren't alone and know how frustrating it is. I just want him to poo on toilet. Anyone else tried taking off laxido and replacing with something different?

[Hudson_can]

Sorry my 4 , nearer 5 year old’s the same, constantly poos in his pants. Don’t know what to do!

Only ever done it in the toilet once or twice, possibly just coincidental timing. But seems not bothered, will sit in it for ages, deny it when challenged and shows no evident self-consciousness/embarrassment, though school peers notice when he smells and school are annoyed and calling me in to change him the 2nd time it happens in a school day. (Every day, last week). Seems he doesn’t know when he needs to go or when it’s coming, or only at the very last minute, and says he doesn’t know how to try. But sometimes will run behind a curtain, into corner of his classroom etc - so seems to know when it is coming, just doesn’t go to the right place or let anyone know. And then wants you to wipe him, not do it himself. (And gets his way in that we try to tell him to do as much as he can but of course we always end up finishing off, if not doing more than half of it, as he can’t get off what’s crusted on due to having sat in it for ages). Not sure what to do!

GP previously just said that having no mobility issues he was unlikely to have nerve damage so it was just behavioural. And that they wouldn't do a referral to the continence team (apparently just one nurse in our city anyway), until he was 7. Going back to them next week to try to push for more help.

A couple of times at home naked he did rush to the potty and poo in it, but of course school say he needs to pull his pants down so after previously following advice to leave him naked on his bottom half, we’re now back to keeping him in pants or pants and jogging bottoms on his bottom half at home. Got rid of potties too so it’s clearly more difficult for him to run upstairs to our one toilet and pull his pants/bottoms down than go naked to a potty. But the point is he basically never seems to try. Having set an hourly alarm aiming to pre-empt accidents, he will jump up and go to the toilet (responds better to an alarm than us telling him). Will wee then (wees when on the toilet but not sure he’s ever gone to do it, just does it when he’s there). But still poo in his pants x minutes later and not tell you. (When asked he’s said that he doesn't want to tell us as we’ll be angry, but that’s not really an issue & we’ve repeatedly said that we might be disappointed, but would be pleased to have been told). Praise any effort/good wiping.

Quite often he seemed/still seems to leak a little poo, e.g. when naked at home he’d often have a smear/almond of poo that he’d not notice/acknowledge. Making me wonder if there is a physical issue. But the consistency of his poos always seems fine, he never seems to strain and says it doesn’t hurt, so doesn’t seem constipated. It’s just that he won’t go to the toilet?! Has claimed in the past to love the smell of poo and that it feels like a nice soft cushion in his pants! Hoped that the former might be a sign of embarrassment but not sure if it was. I heard that children can take a drug to make them regular - i guess the movicol referred to - but not sure if that would help, other than if we could manipulate things so that he never went at school. It wouldn’t be so bad if it was only once a day but sometimes it’s several. I’ll try and ask the GP about that, school also suggested bringing his dinner forward so hopefully he might poo before going to bed, and not giving him so much apple juice as that could be encouraging poo)?

[Kimipantz in reply to Hudson_can]

This sounds exactly like my son I could have written this! Although we have a downstairs toilet as well as an upstairs one so there shouldn't be an excuse haha! Currently writing this whilst he has just ran to the toilet for a poo but poo is already on his bum 🤔 we have a sticker chart with 3 separate columns for a sticker so he always gets one and there's no set back to try and have a positive outcome, one for sitting on toilet to try, one if he tells us and one for getting a poo in the loo!

[Kimipantz]

Seems were not the only ones then I just put it down to being too busy, he's Xbox mad 🙄 will just poo and sit it on playing Xbox and then il say to him I can smell poo and he shouts "i need a poo" and runs to the toilet but by this point he's already done it and been sat in it, it's never tiny amount either but it's also not huge, they always seem soft never hard, always comes out of school having an accident but the school are great and change him I did offer school that if he's ever in a mess to ring me as we live close by but they only done this once. It just seems like he's ALWAYS got poo there. Youl clean him up and send him on his way then even if he doesn't need a poo there's always some in his bum like a smear. I did think about disimpacting as this is why we're going to the drs to discuss it. He's been on movicol a few times and we been down to as little as half a sachet and even that makes his have really bad porridgy poo so it made me think it wasn't constipation. He has a good understanding when talking to him about where poo goes it's just that connection.

[Rosieabc]

It sounds like he disimpaction. Once they have been constipated for awhile they lose the sensation of needing to go. Watch the videos in the eric website. My son is 6 now, no longer impacted and on sennato help him regain sensation. He still hasno warning and we reply on routine. IT'S NOT HIS FAULT!! Your poor little lad probably has no sensation. The continence team should help but you are not alone in this, so many of us deal with the same. Goodluck out there xxx

[Kimipantz in reply to Rosieabc]

Yeah I've always said I can't really tell him off as if it is constipation he can't help it. Yeah il be asking the Dr if we should do a disimpactation and see where we go from there, I think he will be needing time off school to do it though as can't think of anything worse for him bless him

[Staceyronnie]

Hey kimipantz, I'm sorry to hear you guys are struggling with this too! We had an almost identical problem but thankfully the continence team in our town are fantastic and worked with my little boy from when he was 3, we were discharged from the service jsut last week after what seemed like a miracle happened just before Christmas, he is almost 5 now. Chronic constipation and withholding was our issue, he was prescribed movicol a couple of years ago and we regularly had to manage disimpaction routines at home. They aren't pleasant but the relief from the constant soiling afterwards was definitely worth it, he was so much happier and more energetic when he had cleared out too. Once we got the stage of managing his dosage ourselves and knowing the signs of when to disimpact it became much easier for us to start working on the psychological refusal to use a toilet for no. 2 (would ask for a nappy everytime he needed to go except at school) I started with short trips to the bathroom with him 30 mins after every meal and frequently through the day too (on weekends and evenings as I work full time, he is in reception class at school and his first school was extremely unsupportive so I moved him within 5 weeks of starting) firstly just sitting with him in the bathroom for 1 minute at a time explaining that this is where we go to poo. Gradually over a few months we graduated to practicing a poo actually on the toilet but with clothes/nappy on, then without! then I increased the time we spent in there by a minute each day until the final week where we would sit on the toilet for 5 minutes at a time, multiple times a day and sing songs, practice counting, etc. Any kind of distraction until we timed it perfectly for him to need a poo as we were singing and chatting with him on the toilet. He said mummy mummy I'm doing it look I'm doing it! And that was that. No more nappies, no more soiling and within 2 weeks no more movicol as he was regular and we kept him very hydrated. Sorry for the long post but just wanted to share a few of things that worked for us and to reassure you, you are not alone in this and I promise it does get better. Good luck to you guys and I keep everything crossed that it turns around for you very soon xx

[Kimipantz in reply to Staceyronnie]

Thanks for the reply we went to the drs this morning and he gave him a check with his pinky 🤢 but said he's not impacted, he said that it should have been quite tight but Charlies was very much open and lose so he said it's the fact he's lost his muscle feeling in his bum so it's always open which is what's causing the constant accidents ect so we have been prescribed lactulose 10ml every night before bed then to sit on toilet every morning after breakfast and also he's got to do bum excersises (squeeze his bumcheeks together) to try and get that sensation back! Got to go back in 2 weeks see how we get on xx