Treating constipation hasn't affected the wetting accidents

[Chinchichip]

My son is 8 and has never been dry, day or night. I began toilet training him after his third birthday and I thought at first that I must have done it wrong as he could never keep dry. He would have the occasional poo accident too, but his real problem was wees. I took him to GPs and HVs and was either told that I began toilet training too late or that he would grow out of it. Either way, that left me feeling defeated. At the age of 7, he was finally referred to a urologist who put him on meds for an overactive bladder. The accident frequency lessened as my son ended up holding his wee all day till the evening when he would have a huge accident. I quickly stopped his meds and the urologist scanned his tummy and found he was severely impacted. He went through disimpaction twice 8 months ago using movicol and I reduced him down to a maintenance dose of between 1 and 2 sachets. He was also on 5ml of sodium picosulphate but he same off that a few weeks ago as he was getting a very sore bottom. Since being on movicol, he has more poo accidents than he ever had and his wee accidents are just the same, so it's like he is doubly incontinent now. He can never clean himself up as the poo is such a mess and because it's made no difference to his wee accidents, we both feel that he's worse off now. He is now waiting to see a gastro specialist later on this month but I am at a loss as to how I can help him in the meantime. Has anyone else experienced this? I had hoped that when his blockage was cleared he wouldn't wet himself as much, but this hasn't been the case at all.

[Yaleamanda]

Did you fully disimpact and reach watery stools with no lumps consistently for a few days? How quickly did you reduce down the doses? An over stretched bowel takes time to shrink back and will still put pressure on the Bladder hence the accidents. How much is he drinking during the day. He is fully emptying when he goes to the toilet?

[Chinchichip in reply to Yaleamanda]

hi, thanks for your reply. We got down to brown water for three days before we slowly decreased down to his maintenance dose over a period of a week or more, going down by a sachet every few days. He then had a scan to confirm the blockage had gone. His bowel did measure almost twice as wide as it should be. He has never drunk much at all and that’s the problem so it’s still hard to get him to drink during the day. He’s at the age where he doesn’t want me in the bathroom unless he really needs help cleaning up, so it’s impossible to say whether he empties fully. He had a test at hospital though to measure urgency and whether he was emptying properly and he was, without urgency.

[Yaleamanda in reply to Chinchichip]

Sounds like you have found the problem, he isn't drinking enough and if you can't be sure he is voiding completely that's contributing towards the problem.

[Chinchichip]

After reading alot of other peoples' posts, I'm fairly certain my son is impacted again. His poo is sticky, smelly and difficult to clean up and his wee accidents haven't lessened at all so I think it's time for another clear out. I'd like to minimise his time off school so can I start building up his movicol doses over the next few days or is it possible to jump straight to a higher dose? He is currently taking 3 sachets and as of tonight, I've started him back on 2.5ml pico.