8 year old son anal skin tags and fear of pooing

[Happyhippy77]

Please can someone help? For two years now my son's fear of pooing has gotten worse. He was constipated when younger and passed such massive poos that they caused two anal skin tags. He now refuses to try for a poo due to fear, stating it hurts him. He only goes every 4ish days when he absolutely can not hold on anymore and sometimes doesn't make it in time. He has a pediatrician who has basically said its a psychological problem but there is no psychological support available for him. He's been referred to a constipation nurse but we are still waiting for that support. Every day he appears worried and preoccupied with the fear of pooing and pain of trying not to. He'd becoming more anxious and now wants us to stay in his room until he falls asleep. We feel we have tried everything, rewards, punishment (taking things off him which was obviously wrong but we were desperate), he used to sit on the toilet once a day when we asked but now refuses. It was leading to such distress and conflict that we are now letting him decide when he tries. As I said he can hold on for days and then rushes to the toilet when he has to. After a poo he I'd then inconsolable stating he is going to die. He is on Movicol so his poo is soft. I think it doesn't hurt as much as he says and it's more a psychological fear. Does anyone have any advice please? Are we doing the right thing by letting him decide when he tries? We can't force him and he gets so upset and angry when we tell him to sit on the toilet. Is he likely to grow out of this eventually? He has poo marks in his pants every day and we are terrified he will be bullied if he soils at school. He has done twice but luckily no one noticed. Please can anyone help?

[Nanoiu]

Sorry you’re going through such a hard time. I’ve been dealing with encopresis with my son (nearly 9 yrs), for about 5 years. At the beginning they said it’s a behavioural issue, it’ll sort itself out. Then they treated the constipation but not aggressive enough. We’ve been seeing a paediatrician for 3 years, several GPs, all pretty much useless. Now we see a paediatric surgeon and he seems to know more. He tells me by the time he gets to see the kids with long standing constipation, damage is too severe and it requires surgery.My kid also smears the undies every day but as far as I know, no one noticed. We change him after school, before other activities.

Poo has been soft for years, from Movicol. But recent xray showed he is impacted and soft poo goes around the hard poo. So id say if your kid cries that it hurts, maybe it’s true. Ask for an xray. And for a bunch of other tests to rule out other causes (Chron’s etc.)

Did you get a diagnosis of anal skin tag or do you assume it’s a skin tag?

crcaz.com/anal-skin-tags.html

I found the Clean Kid Manual by Collins, extremely useful in understanding constipation and all the possible treatments for it.

[Happyhippy77 in reply to Nanoiu]

Thank you for replying. The Paediatrician did an xray and said he wasn't that impacted. The Paediatrician diagnosed skin tags. He is going to be having a blood test for gluten intolerance. I think it's more a psychology fear of it hurting and the fact that it actually does hurt. Thanks for your suggestions.