Fecal incontinence in 4 yr old, driving me crazy.

[Pettywoman]

He's soiling himself several times a day, sometimes just a skiddy, sometimes more but never a big poo. He's got Movicol from the doc but still seems to be unable to pass a proper poo on the loo. He just sits, nothing happens. I've taken to giving him a pull up, successful once only. He doesn't seem to feel the need to poo and doesn't care if he soils himself.

I don't know what I'm asking really, just my washing machine and I would really like to hear that this problem will pass (no pun intended).

[IwillrunIwillfly]

Could he be impacted? (Very constipated so there's a big blockage of poo?) That some times results in overflow where some watery stuff comes out round the side and it can mean the bowel gets stretched so kids can't necessarily get the sensation to push. When he does poo something out is it soft or more like hard lumps? The ERIC website has good information but it might be worth going back to the gp to see if you need to up the movicol to get him cleared out. Hope you find a solution soon!

[StillRabbit]

This happened with my son. Took me ages (and a trip to a private paediatrician - best £200 ever spent) to convince my GP that there was done thing wrong. Paediatrician discovered that he was hugely compacted with this leakage coming around the blockage (GP had absolutely insisted that this was impossible and if he was blocked NOTHING would come out). He was put on an increasing dies of movicol to clear him out. I was warned that I would not be able to leave the house for a week, he had to drink more and more of the movicol until he was cleared out. It didn't hurt him but was distressing as he was exploding and he and his bed had to be stripped and cleaned every few hours. But it worked! He was on a 'maintenance' dose for quite some time until the expanded section of bowel shrunk back to the correct size.

He was diagnosed at three and a half and came totally off the movicol at between six and seven years old.

Look up encoperesis and be assured that it WILL get better.

[Thesunrising]

I feel your pain. Getting the dosage of Movicol right is like a dark art. If your child is impacted then the disimpaction routine may solve lots of issues, but even after that getting the maintenance dose can be tricky if your child is still withholding. The bowel needs retraining to function normally again and this can take time. Sitting your child on a potty 20 mins after they've eaten is a good routine (it's when the gut is most likely to start moving and squeezing stuff through). If you go back to your GP you could also ask about combining movicol with a small dose of sodium picosulfate which acts to make the squeezing movement happen (peristalsis). While you're waiting for a GP appt, phone or email ERIC helpline for support and information about what else you might do. Good luck - I know it's exhausting!

[StillRabbit]

A tip for when your child is sitting on the toilet/potty is to use something to put his feet on to raise the knees above the hips, this helps the angle of the rectum.

[Pettywoman]

All really good tips. I had no idea it could take so long to solve. At least I know what I'm dealing with now, thank you.