HELP! Urgent Advice Needed re : Pooing ...

[Tillyboo]

My brother and sil are with us and have a little boy who will be 4 in Sept. They are having terrible problems with him not poo'ing on the toilet and now not even in a nappy.
It's got to the stage whereby he'll hang on for a week and then he gets in a real state (like this evening - they are staying with us).
He was up all night with tummy ache and screams and cries for hours on an off.

They are at their wits end and don't know what to do. The health visitor is no help at all and just say's he'll grow out of it.
Sil has resorted to giving him lactulose today in the hope he won't be able o hold it in - he's not constipated, just has amazing bum muscles. When he does finally 'let go', his poo's are enormous but don't give him any pain.

All three of them are currently in the loo at the moment trying to get a result.
My nephew is just crying and screaming saying he 'can't poo'. I don't know whether it's a mental block or what but if anyone has any advice I'd be very grateful.
Rewards have been tried, taking treats away also but nothing has worked

[eddiejo]

No negative stuff is vital. Only go with the flow.( parden the pun)

Does he want to go in a nappy? This is really common at this age and sometimes it becomes a habit of ignoring the need to go and so huge poos are formed which gradually de-sensitise the need to go.

Has he been checked out by GP?

[WigWamBam]

It sounds as if they are making too big an issue of it and putting too much pressure on him. I know it feels like the natural way to behave, but it isn't helpful.

My daughter was like this; wouldn't poo in the toilet for a good 18 months. She would poo in one place only, and at one time of the day - always in a nappy.

First thing I would say is to ease off - all three of them in the loo trying to get a result is too much. They get stressed, he gets stressed and it's no good for anyone. It often starts as a control thing - it's the only thing he can really control for himself at the moment. So we found that letting dd ask for a nappy and then letting her get on with it helped - she would take herself off in private once a day.

Tell him that he can ask for a nappy for a poo, or give him one when you think he needs one, but don't stay with him and keep on at him about it - let him take it away and deal with it himself. Don't force him to use the toilet if he doesn't want to.

Don't make a fuss, don't get hysterical, don't make him feel as if his poo is the be-all and end-all of everything, and definitely don't punish. Even bribery doesn't work when the fear of the toilet is as bad as this.

My experience is that lactulose won't help - it doesn't soften the poo enough to mean that he won't be able to hold it in. It can also take a couple of weeks before it starts to have any effect and needs to be taken long-term in most cases. Sometimes we resorted to Califig (a laxative) which always got us a result pretty quickly - like your nephew, dd wasn't constipated, but we needed to get her to the point where she just couldn't hold onto it, and Califig did that.

They need to take the pressure off - don't force him. Maybe see the GP for some Movicol, and consider Lactulose in the longer term. If they tell him that he can always ask for a nappy, and then leave it at that, it puts him back in charge (which, of course, is what it's all about).

[Tillyboo]

Hi, not checked out by a GP yet I don't think. He's been in the loo for an hour now - with a nappy on, but still won't go.
He knows he needs to go as he's got tummy ache but just won't or rather say's he can't.

I'll sensitively suggest the GP may help although I suspect all he'll do is give laxativ es.

Thanks so much for replying, the de-sensitising bit is interesting.

[Othersideofthechannel]

Chronic constipation

I didn't think DS was constipated because of the texture of his poos. But he was complaining of tummy ache and only going every three days at most. He got into the habit of holding it in because he didn't want to poo at school.

GP said to make sure he drank loads of fluid and to insist he sat on the toilet after every meal for five minutes. He loves prunes so we give him those daily.

A few months later he 'performs' about 4 times a week and no longer has stomach pains.

HTH

[mumdebump]

Have you checked the nappies/potty training message boards? They are usually full of sound advice. From what I have researched, it's quite a common thing in young children. It can be a mental block, fear or a control thing, or a physical problem such as constipation. If its a mental thing, which seems likely, then your brother and sil will have to try to relax about the whole pooing situation in front of your nephew, as their stress and anxiety can have an adverse effect on him. Easy to say, difficult to do.

[Othersideofthechannel]

An hour in the toilets! That's way too much pressure.

Desensitising thing is so true as far as DS is concerned.

(DD on the other hand is super sensitive. She goes about 3 times a day and they are miniscule!)

[3littlefrogs]

There is masses of information about encopresis and witholding on the internet.

There is a whole parents' forum on it with lots of good advice and explanation.

If you google encoprsis it is one of the first things that comes up.

HTH

[WigWamBam]

An hour in the toilets really is too much pressure. It's no wonder he doesn't want to go - they have made it into such an issue that he is either frightened of not performing, or is using it as a control issue.

Get them to leave him alone - they really need to relax and take the pressure off him. Let him go wherever he wants to to try for a poo in his nappy, let him take control of it.