Almost 4 year old pooing in pants

[Hannah1589]

My son who is nearly 4 and starts school in September has gone back to pooing in his pants. We have had a lot of difficulties and he has been on movicol daily for over a year as after speaking to ERIC we identified that constipation was causing him to not know when he needed to wee. Now wees are absolutely fine and a few months ago 90% of the time his poos would go in the toilet but recently we are getting poos in his pants every day. My question is how do I know what the appropriate dose of movicol is? I am wondering whether the dose is wrong. We were having normal poos a few months ago when he was doing them in the toilet but now they are either large round and hard, or runny and explosive. He often knows he needs to poo but he can't get to the toilet quick enough. Anyone have any suggestions? I'm worried as he starts school in a few weeks and it's frustrating as a month or so ago I thought we had this sorted but it's gone backwards again.

[Yaleamanda]

Have you disimpacted him?

[BeeBeeBuzzyBee]

Hi.

My son has just turned 4 and is starting school soon too.

We too are trying to find the right maintenance dose of Movicol. We are currently on 1 every other day. Our son's problem is that he withholds and then it hurts him. He currently poos in his pants, but I'd rather that than him getting constipated. 1 every other days seems to be working for us to get the poos out, but getting him to use the loo is another story.

Why was your son originally put on Movicol?

I'm not sure I can suggest what dose would suit as hard poo would imply more Movicol is needed, but runny would imply less Movicol. If it helps, a GP once said to me that you can give a dose every other day or just half a dose if that's better.

Has anything changed in the last few months? Perhaps the summer holidays have affected him and getting back into a routine will help him back to using the toilet.

Just thinking about it, since he knows he needs to go but can't get to the loo quickly enough I would suggest reducing the dose a little. If you're worried about hard poos, perhaps extra water and fibre will be a way of keeping them soft but reduce the Movicol to allow him time to get to the loo.

If you haven't already, perhaps ask the school to get a Personal Care Plan in place. It's at least put our minds at rest that someone will clean him up when he's at school.

Fingers crossed this phase will pass soon for both our sons.

Good luck.

[Hannah1589 in reply to BeeBeeBuzzyBee]

He was put on movicol originally after speaking to ERIC when he was around 3, we had toilet trained and he understood it all but he never knew when he needed to wee so he had lots of accidents. As soon as he was on movicol he started to know when he needs to go and has stayed on it ever since. I do feel that the runny poos are more of an issue now than the more occasional hard poos at the moment so perhaps the dose is too high. Maybe I'll try halving it or every other day then. I did wonder whether he even should be on movicol at all but I'm worried about changing too much ahead of him starting school incase it makes things worse.

What does a personal care plan do? Not familiar with this. He has been at the nursery at the school where he will go and they have always been very helpful but I do worry a little that school will be different to the nursery class.

I've been trying to get through to the ERIC helpline all morning but it's impossible. Really wanted to speak to someone.

[BeeBeeBuzzyBee]

I don't know that much about Personal Care Plans but our nursery (not attached to the school) had meetings with the school and discussed our son's toileting issues with the school's SENCO officer. That lead to the school liaising with the School Nurses to get a Personal Care Plan (PCP) in place. I've recently heard back from both the school and the School Nurses to say the PCP is in place for our son so they should be able to clean him up and change his clothes if/when needed. I've heard of stories where parents are called into school to change their child and that kinda situation badly affects parents who are at work.

Sometimes PCP's are called something different. Our nursery said all the schools give them slightly different names.

Perhaps speak to school or your health visitor to get some more advice? If your son was alright at using the loo before the summer holidays, the nursery/school may not be aware that he's not so good now (they'll understand that things can change).

What kind of dose is he on right now? We are always assessing whether to increase or decrease, but trying to give the 1 every other day long enough time to see if it suits our son.

I've not heard about being prescribed Movicol because of not knowing when to go wee. Sometimes it can seem ERIC promote Movicol a little too enthusiastically, but I suppose the worse it will do is give lots of runny poos.

Our son was prescribed it because he was constipated, but now he withholds and speaks about not wanting to go poo. I can't think why. When he does 'go' he's fine about it, quite happy sometimes. A mystery!

Good luck.

[Hannah1589]

I was told by the ERIC nurse to give him movicol because he was constipated, but that the reason he didn’t know he needed to wee was probably as a result of being constipated. So the movicol was for constipation really.

Do you know if I half the dose do I still mix with the same amount of water or should I half the water too?