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Not-always continent 8 yr old (sorry, long)

(20 Posts)
Lovage Mon 11-Aug-14 15:53:07

DS(8) has yet again pooed in his pants today. I despair.

It doesn't happen every day, or even every week in a good patch, although he has done so 4 or 5 times in the last fortnight. Sometimes he's fine for weeks or even months on end but I can't see rhyme or reason for when it is.

He used to have small pee accidents the whole time (like every day) but does seem to have outgrown that in the last year, although he still leaves peeing to the last possible moment and we often end up insisting he goes (it's patently obvious when he needs a pee)

He doesn't have any medical problems, apart from a mild tendency to constipation, which is well controlled with medication. He is otherwise happy, flourishing and a delightful child who is doing well at school and has plenty of friends.

I think what is going on is a combination of
1) he just wasn't ready to be potty trained, even though we left it until he was 3 and nearly-a-half, because we could see he wasn't ready. So he never got the hang of it early on (unlike DS2 who got it in 2 days) and since then it has been a constant source of aggro between us, so he tries to ignore it in the hope it will go away.
2) he is a person who gets very focused on what he is doing and really does not want to stop. He doesn't pay much attention to his body generally - rarely says he is hungry, thirsty, hot or cold. He is just ignoring his body's cues. On the (vast majority) of days when he doesn't soil himself, I don't think that's because he has paid attention to his body, it's just because we've got him into a good routine where he goes to the loo after breakfast and (with luck) poos then without having to notice (he usually plays on the Tablet at the time and if you ask him whether he has pood yet he says he doesn't know)
3) it has just become a horrible thing for all of us, so he doesn't want to think about it, so he ignores it. It's a horrible kind of power-struggle that neither of us wins.
4) I know we are not doing brilliantly in how we respond to him. He hates it when we get angry and I know it doesn't help.

I am particularly worried because it doesn't seem to be getting any better as he gets older and next school year he will be going on a school residential for 3 or 4 days. I am worried he will soil himself while he is away. I am teaching him to clear up after himself completely, including rinsing out the pants, which is something, but it is the other kids taunting him that I most worry about.

Things we have tried that have not helped:
-g.p. - prescribed medication to prevent constipation, which helps but not enough (but at least he is not now constipated).
-scans at hospital - everything appears to be biologically normal
- referral to specialist continence paediatric clinic - useless consultant just said 'some boys do this, we don't know why. They grow out of it eventually'. DS hated going there (only went twice and then we were discharged as 'fine now' which it wasn't).
- 'no more doing whatever it was he was doing at the time for X days' (usually playing on the computer)
- explaining about biological processes. He has an excellent understanding of these.
-stickers/rewards/charts
- getting angry, shouting, showing great displeasure
- talking calmly afterwards about it and asking him for suggestions about what's going on and how to fix it (he generally suggests rewards, we say we have tried that several times and it never works. He then has no ideas)
- making him clear up after himself

Suggestions and comments very welcome but please be gentle with me.

BranchingOut Mon 11-Aug-14 16:41:30

Not sure what to say, but standing with you.

My own lovely boy is nearly 5 and we are now seeing a paediatrician.

I think this is a lot more common than people realise.

Lovage Mon 11-Aug-14 20:03:45

Thank you, that's comforting! I hope it gets resolved for you quicker than it us for us and that your paediatrician is more useful!

nzmandy39 Tue 12-Aug-14 10:32:52

Poor poor you Lovage and your poor DS. Our DD is currently going through almost daily accidents (just wees) Have you googled 'sneaky poo'? The dulwichcentre has some very good literature for children (and adults) which explains what happens due to the previous constipation and resultant faecal impaction. It sounds like your DS may have this. The problem can take as long to fix as they have had it, so it may take years for the stretch receptors to return to normal. I think this is a lot more common than people think. We are also seeing a doctor and paediatrician and have been on medication constantly for the last 8 months. It is a very long slow and upsetting process. I hope things improve for you all.

insanityscratching Tue 12-Aug-14 11:20:28

Ds was much the same and I can think of three of his group of friends who were too. They are 24 now and none of them had any difficulties in secondary (was friends with their parents) it seemed to be something that they needed to mature into.
I was very dismissive told him to sort himself out and bought lots of pants so as to throw away stained pars.I think the lack of attention helped.
They all went on the residentials and none of them had accidents probably because they didn't want to embarrass themselves.

Lovage Tue 12-Aug-14 11:24:09

Thank you!

Yes, I've read up on faecal impaction and constipation, including this really useful book www.amazon.co.uk/Constipation-Withholding-Your-Child-Soiling/dp/1843104911 which has an excellent silly story for the child about Mr Poo and Miss Wee wanting to get out and play in the toilet. I'd definitely recommend this story for kids experiencing this - worth the price of the book alone!

But while that was definitely what was going on a year or so ago, I don't think that's the underlying problem because it's been going on so much longer than that and he wasn't constipated until about 18 months ago. I think it's more that he was holding on to poos because he didn't want to go, because of all the emotional horribleness around him soiling and wetting himself. Then that did turn into constipation (exacerbated by a bit of a tendency that way, I'm guessing, based on family history).

Writing this, I wonder whether the most helpful thing we could do is (somehow) change the emotional atmosphere about it - just accept the accidents matter-of-factly, help him clear up if necessary, but not show displeasure or anger. But I don't know whether I can do that. I mean, I can not show anger, but then I'd come across as cold and withdrawn instead, which I think would be as bad. I don't know that I can be neutral when I don't feel neutral, and he's a sensitive child who's good at reading my emotions. Clearly I need to change my mindset so I do genuinely feel neutral, but I'm not sure that's possible!

insanityscratching Tue 12-Aug-14 12:06:18

Yes, we used to rant between ourselves as parents but did our utmost to be emotionless around the boys. I do remember it driving us all potty but it stopped without any input from ourselves or professionals.

BranchingOut Tue 12-Aug-14 13:26:28

Potty! Lol grin

BranchingOut Tue 12-Aug-14 13:31:02

Good to hear it gets sorted out before secondary, at any rate!

I do wonder whether something else goes on around all this -after all, defacating in the loo is only a learned behaviour. It is not unknown for adults to soil or wet themselves....Does it ever really become fully 'natural'?

Sunshinenow Tue 12-Aug-14 13:33:16

have a check in Advanced search for 'encopresis'

there's loads of threads with empathy for your situation and practical tips.

I wish you luck -it is a hard situation.

Sunshinenow Tue 12-Aug-14 13:37:14

I looked up this thread for you - I remember it from years ago and it might help.

www.mumsnet.com/Talk/general_health/553228-please-help-me-with-my-seemingly-incontinent-8-year-old/AllOnOnePage

4boysxhappy Tue 12-Aug-14 14:03:58

Try fig syrup. Two spoons first day and then one every other day after that. Don't use any other laxative at the same time.

He can and can't help it at the same time. The poo leaks not his fault. However they get to a stage of giving up caring about wiping correctly and having soiled pants. So be matter of fact about it but strict.

Bucket with lid that he can put pants into. You need to pant and bum check every two hours until things improve. Wipe him yourself after he has wiped if need be. All this creates a starting point for the child to work on and teaches them that they may as well try to go properly and wipe correctly. After all it is easier than mum fussing them all the time. However like I say it is not totally their fault.

Don't let your child do any activities that means they stare at a screen for more than an hour.

Had this issue with child number three from six to eight years old. In the end the above is what worked for him. Once I found syrup of fig in sainsburys phamacy section it was much better within a week. Took a few weeks longer to stop completely.

OwnerOfAnInsanePuppy Tue 12-Aug-14 14:14:09

Omg are you me?? Exactly the same here but the wetting is a daily thing and the soiling every other day or so. We are gentle and point it out quietly but he gets quite angry. sad or denies it. Which is silly as we can smell both. Scans, X-ray, all normal. No constipation and no history of it. He slap still wets through night time pants completely every night. I change the sheets every morning, no fuss and font even mention it. The paed we have been seeing for three years now says get him to drink more. He drinks over 1.5 litres a day, no change. It is very very frustrating. Combine that with an asd trait older brother who has no problem pointing it out whether at home or outside or shops etc.... Sigh.

4boysxhappy Tue 12-Aug-14 17:03:06

If you want the wetting to stop you need to address the pressure built up in body from poo issue first.

Once they stop soiling dry beds follow instantly. Subject to any other medical problems and fluid intake of course.

OwnerOfAnInsanePuppy Tue 12-Aug-14 19:28:55

What if there is no constipation though? Nor has there been previously sad

Lovage Tue 12-Aug-14 20:15:57

Thanks Sunshinenow that is a useful thread which I hadn't found in my initial search.

Sympathy Owner you are not quite me, as we are mostly okay at night-time - he only stopped wearing pull-ups about 6 months ago, but has only had a few wet nights since. That sounds like an awful lot of laundry to be coping with!

OwnerOfAnInsanePuppy Tue 12-Aug-14 23:22:55

Thanks. It's not too bad, we are in a routine now and he strips it off the bed.

Oh and no idea what I wrote for it to autocorrect to slap!!!

nzmandy39 Wed 13-Aug-14 01:30:38

I can relate to laundry issue as DD has never been dry at night and normally wets pull ups, bedding and everything else. DS has also got in on the act recently so have had 3 weeks of washing everything on 2 beds every day- the joy. I invested in some brolley sheets yesterday so hope that will lessen the loads! DD had also never been constipated before so no idea how we got to where we are at this point. Will check out the constipation book on amazon to see if this can shed some light on the situation - thanks for that.

4boysxhappy Wed 13-Aug-14 17:17:45

Don't think it is always constipation as such. Sometimes they can also just need help becoming regular.

Sounds like something my gran would of said :-)

eddielizzard Wed 13-Aug-14 17:29:09

sounds like my dd. she has detrusitor overactivity. basically her bladder muscles are constantly working so she sort of leaks. very little notice for needing to go to the loo, but then needing it urgently with occasional accidents. plus inability to feel poos and constipation.

she's now on a generic form of detrusitol and a mild drug for her constipation.

different child. dry at night. no problems with poos. dry pants.

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