Fear of pooing / with holding poo

[Cheesedog123]

my 4 year old son has been having problems with a fear of pooing for the last year now. We’ve tried various medications through the doctors and have found lactulose to be working the best at the moment. However when it comes to the time of him needing to poo he’s hysterical. He’s suspected to have sensory processing disorder and Autism. Have tried books, videos, all the hints and tips, health visitor etc but seem to have hit a wall at the actual pooing part. No longer constipated and formation of poo is now just right, no leakage or overflow either side. But still only pooing once a week (was previously only every 2 weeks ) which is obviously making the size of the poo huge. Hes still in nappies and has started having embarrassment around the jiggling around his does to hold in the poo around others which only makes him more upset. Any help would be much appreciated, can this problem be fixed or will it be something he will always be fearful from?

[BrumMum1]

I'm sorry for what your son is facing.

If he's only pooing once a week and it's a huge amount then he's technically constipated. The bowel is stretched which means even if he was pooing daily the bowel is transiting waste as quickly as it should any more.

The fear seems to be the issue and Interoception: it might just be too painful for him.

Could you contact your local occupational therapy team to support you with this? Or a Sensory Integration specialist? Kelly Mahler also has some useful information online that may help. Once the fear - or pain around pooing - is addressed then I'm hoping the he'll find it easier to poo.