9 year olds concerned about soiling himself at school

[Sprogzmama]

My son has been constipated for 6 weeks now he was supposed to go back to school today but was so anxious about himself soiling and not feeling it he just broke down he doesn't feel when he doesn't it he's having problems knowing when he needs a wee and poo he's on senna and laxido sachets (8 a day at the moment) but he's getting sick of it he won't even sit on the loo now to try and poo coz it hurts his butt hole he gets tummy pains as well I just don't no what to do I'm so stressed and feel so alone really could do with some advice please

[SallyandPaul]

Bless your hearts,really feel for you both. Has he done a full disimpaction. I presume so. Treat his sore bottom as you would with nappy rash ie something soothing. Is it worth trying pullups ,just to take the pressure off him,until everything settles down. We did use childrens suppositories sometimes too. My daughter has used peristeen for the last year with one sachet of movicol a day. Peristeen is a colonic irrigation system which has helped enormously. Take care xx

[14crosstitch14]

Is he drinking plenty? To soften himself, over than sugery drinks. Plenty water is needed. Maybe he can write himselfa poo diary so he can see his own toilet habits and he'll know when te best time to go durin school times and breaks or after school.

[Sprogzmama]

Morning all the doctor has prescribed him an enema that I have to do at home!Which he won't let me do (very stubborn 9 year old boy!)

He's been hard work anything I suggest is a no!

I've wrote a letter to his school until he has control over his condition he can't go in.

the doc is sending me his medical records over the last few months to back me up he can't do a sick note which is really silly hopefully the laxido and senna flush him out so he can go back to school soon.

He's getting sick of the laxido so any tips I'd be grateful for 💜

[Frogstar13]

Hi I feel your pain... also have a 9 yo with constipation/ soiling issues & it rules our life 😐 When you say he has been constipated for 6 weeks- have you tried disimpaction for a full clear out? We did it over hols & it seems to have helped. Still has little accidents but usually ok if he does a poo b4 school in morning, though bit can still leak out & he often doesn't feel it. Constantly have to get him to sit on loo after meals & plan everything around him having time to sit on loo or he'll have an accident. Now on one sachet Laxido a day & trying to have plenty of fibre as that seems to help him do actual poos rather than mush. He has peed himself too when too much poo in there... I find it all so exhausting & my son gets upset and keeps asking why he has this problem 😢 the Eric website is helpful & there's a fb group called Encopresis- Soiling Solutions Clean kid Manual .. it's US based but lots of folk on there swear the method has worked for them. It involves buying a manual & following a regime. Am still thinking about trying it, maybe over summer if possible. Best wishes x

[Dogpurple12]

You are not the only one my 13 year old son poop his pants everyday sometimes 3 times a day and it's disgusting when he does it as it is full pant loads like what a baby would do in a nappy

[Sprogzmama in reply to Dogpurple12]

Oh gosh poor u having to deal with that feel for u both it's just so, horrible isn't it

[14crosstitch14 in reply to Dogpurple12]

Hi i'v just been looking up some exercises you and child can do too tighten up if he needs too. May help stop haveing accidents. A little bit of physio may help.

[Dogpurple12 in reply to 14crosstitch14]

That would be great as he is soiling up to 3 pairs of pants a day now

[Nanoiu]

Hi everyone. I’m reposting because you may find this useful.

I am in NZ and my son is almost 9 years old. He’s soiled since he was 4. We’ve done many kinds of disimpactions and found the one using Movicol to be the most disruptive one as it takes so long and the child is house-bound.

Are you under the care if a paediatrician or better?

It seems there are multiple stages of treatment and if one doesn’t demand to try something else (because the current treatment doesn’t work) you struggle with a few oral medications and have little control over the process.

So beside disimpaction with Movicol, there is PicoPrep, takes only 3 days or so. A couple of sachets per day (not 10 or 12). There is nasogastric drip with Kleenprep, you get admitted in the hospital and stay there 4-5 days - this one is the surest way to melt the poop, they’ll do an xray before and after and make sure the blockage is cleared. It’s unpleasant but gives the best result. Because sometimes to reach the clear water stage with Movicol and guess what, there’s a blockage somewhere and it’s not melted, you wouldn’t know unless an cray is done before and after the disimpaction.

Now, we’ve done the Kleenprep disimpaction after struggling for 3 years with oral meds, but then the kid got blocked again, and quick after, because there is damage to the colon, the nerve endings etc. The oral meds (movicol and Senna) we took after the disimpaction weren’t enough to keep the poop going!! So we were back at it, struggling to move the poop along and out.

We concentrated on keeping the rectum clear if poop - with enemas and such. But guess what, xray shows the rectum is clear but the blockage is on the ascending colon!

It’s a very tricky condition.

After 5 years, I feel we finally have all the ‘tools’ needed to treat this.

We’re going back to hospital for a proper disimpaction with Kleenprep. Afterwards, we use oral meds (movicol and Senna) as we’ve been doing for years, to keep poop soft and moving along. Then keep the rectum clear - this can be done with enemas, we’re past using the mini ones or Fleet, we now use bag enemas with catheter (to prevent flow back), system is called Peristeen, by prescription from paediatric surgeon.

In conclusion, you must disimpact but also keep the poop going afterwards.

Oral meds alone sometimes are not sufficient. Keep that in mind if you still struggle to get the poop out after disimpaction. Push the doctor to move you to the next stage of treatment, if needed.

There is always more they can do.

This condition gets worse if not treated properly.

The most useful info on treating enco, with all the possible meds involved is in The Clean Kid Manual by Robert Collins, best $200 I’ve ever spent.

All the best, hopefully your kid gets well soon.

[Nanoiu]

This condition will not get better if left untreated. Your son NEEDS to be disimpacted properly. And then keep the poop moving.

Easy to say, hard to achieve.

He has been constipated for longer than 6 weeks, it just became apparent 6 weeks ago.

More water and more fibre won’t fix it at this point. This is 1st recommendation, we wasted half a year on eating better and drinking more water, while the poop inside got bigger and damage got worse.

Family doctors are rubbish at treating this!! I’ve changed 4 in the past few years, none has a clue about encopresis, their advice is bad, get past these people and to someone who’s fixed this condition in some patients.

Oral meds help but may not be sufficient in treating this, keep that in mind. Movicol will keep liquid in the colon (doesn’t get absorbed, what goes in, goes out). The colon extracts water from the stool as it passes along, the longer stuff sits in there the drier it gets!! Movicol adds liquid to keep stuff soft in the colon! Now if colon gets stretched because stool is stuck in there and more stool arrives and it becomes bigger and bigger, you get a distended colon and it can’t contract to move the stool along. So you get prescibed something like Senna which is a stimulant, it causes the colon to contract to move the poop along. If you got a blockage, Senna can only do so much, the poop must be soft to be movrd along.

Then poop arrives in the rectum, hopefully. The rectum is stretched, distended, nerves damaged, kid can’t poop, it’s hard and it gets harder each day as more liquid is absorbed.

It cannot be fixed by drinking more water and eating fibre!!

1. Disimpaction with xray before and after

2. Oral meds daily like Movicol to keep new stool soft

3. Oral meds daily like Senna to keep soft poo moving along in the colon (peristalsis) and to push it out (expect a poo after 8 hours or so)

4. Keep the rectum clear daily with the use of enemas, mini enemas or Fleet or better bag enemas which fill the rectum and suck it all out!

[14crosstitch14 in reply to Nanoiu]

Wow thats great advice, we haven't gotten that far. I wouldn't of known all that. Child lives between hones so she's rarely been cinstapated at ours. She usually comes to us like that after a week at her mum's and we sort her out.

[Nanoiu]

Enemas may not work if the poo in the rectum is too hard. What enema were you prescribed?

The enemas only work on the rectum, causing contractions and drawing water in from surrounding tissues.

If the poo in the rectum is super hard, what can result by administering one is a kid screaming in pain because the contractions are strong but the poop is too hard to be pushed through!!

Poop needs to be softened!! Hence the need for oral meds.

And keep in mind, for each day poop stays in, it gets drier and harder.

If your boy refuses oral meds, i would really try to get him to the hospital to do a disimpaction, manual or/and Kleenprep. Take him to Emergency, say he was at home screaming in pain, hiding under the table, and hasn’t pooped in () many days. He has encopresis, refuses medication. They can’t refuse treatment!

I don’t have experience with manual disimpaxtion at hospital but some people on the forum mentioned it, having been done at Emergency department.

For Kleenprep, they insert a tube through the nose, unpleasant, but after that he doesn’t need to drink anything, the meds drip through the tube and melt the poop. Takes a few days.

That’s what I would do if I had no other way to convince a doctor that the treatment cannot be done at home!

If he gets disimpacted in hospital, he wouldn’t hurt to poo, he would see some improvement and would be more inclined to follow doctor’s advice on taking oral and rectal meds afterwards. There is no way around it and there’s no magical, one time fix. But your boy needs to see some results to become motivated to try!

[Nanoiu]

At Emergency mention major abdominal pain and you being fearful of an Appendix rupture.

[Nanoiu]

The other option is to struggle at home and somehow manage to do a botched disimpaction in the next month and so, using oral meds, about 1 L a day for 10 days. Likely for your boy to follow such treatment? The quicker this is dealt with, the better, I say. Best of luck!

[Nanoiu]

What enema were you prescribed? A mineral oil one? One containing glycerin perhaps? They lubricate the stool.

Laxido is Movicol.

[Nanoiu]

Bribe the child. Anything you can offer, which would get him to agree to treatment, hospital or at home. Pay him per poop, device time, video games, whatever works. If he agrees to treatment, it makes a world of difference.

Are there continence community nurses where you are? They can be of help, after disimpaction.

[Sprogzmama in reply to Nanoiu]

I've tried that not even that works now he freaked out yesterday having blood tests done and didn't go through with it. so we have to go to the main hospital now to get it done.

I'll ask the doc about the xray

[Nanoiu]

Do not accept anything less than an xray, as a physical examination is meaningless. My son has always had a flat tummy, non-tympanic, no gas, no palpable fecal mass, but he was full of blocked poo.

[Sprogzmama]

I got him in to the school grounds but he wouldn't go in the school the school are going to get the school nurse to help and family support worker to help they can't authorise the time off He's had this week so could be fined for him being off. help! 😭

[Tom012]

I totally understand why he feels so concerned. I think he should be checked out for sure. The school should class it for medial absence

[Jbfs]

How are things going? Poor little boy what a horrible thing to go through for you both.

It’s hard to get my son to cooperate too. We resort to bribery . We attempted a disimpaction but he couldn’t stick at it for more than 8 days. I got really creative and put the movicol on cereal, in soup, in super noodles, made milkshakes with ice cream and sneaked some flaxseed in them too, hot chocolate, Fanta orange. We are still on our journey. I wish you and your son all the best and I hope you get some support from the school and medical care

[Sprogzmama in reply to Jbfs]

Hi jbfsHe's back to school each day is different hours at the moment but he's getting there he's not soiling himself this week he's taking 6 laxido a day I'm so scared to put it down atm he takes senna in the morning as well

I feel like the happy dance is a long way off yet he's still doing bunny poops but at least it's coming out ill have to give it ago hiding it in different things he's so stubborn

[Jbfs]

It’s so hard isn’t it! I was excited this week as we finally got referral to a consultant but my son refuses to go. He’s 13, not a child anymore . I have to stop myself from getting annoyed at him but it is so frustrating when he won’t help himself and I’m constantly washing clothes and cleaning up after him everyday. Anyway I hope things begin to improve for you and your son x

[Hidden]

Sorry to hear about your issues. I had similar when young. Wonderful thing that helped me was my step mom gave me a series of enemas. It did clean me out and relieved my worries. I would wear a nappie still just in case. How are things going now. I see this post is a few months old.