bowel incontinence - reasons?

[hazeyjane]

Ds (nearly 6) isn't toilet trained, this is partly because he is very resistant, and partly because he doesn't seem to be aware when he has pooed of weed.

He is under a continence nurse, who said there is no point in starting toilet training (which school are keen to do) until he is regularly having one soft poo a day. We have been up and down with weeks without poos, a clearout with Movicol, thinking we are down to a good maintenance dose, because he starts to produce soft formed stools. Then he starts being dirty almost constantly, like he is just leaking little bits of poo constantly.

The thing is, are there underlying reasons that can cause this kind of bowel incontinence? He has low muscle tone, so could it just be that? I am just not sure whether we should be asking for further investigations into causes.

[FlouncyMcFlounceFace]

Are you sure that the movicol is fully clearing out before you adjust dosage because the leaky description does sound like blockage/constipation seepage.

My understanding from my parent understaning of issues with DS1 and my nephew is that the pressure from constipation puts pressure on the bladder and this sends mixed messages, so toilet training before the bowl issues are sorted is unlikely to be productive.

I cant remember what drugs DS had but it was just a liquid multiple times for many months. My nephew had liquid plus suposetorys(sp?). They helped with a fairly quick result and were useful regularly until he developed a more natural pattern. The volumes when he had a clearout could block a toilet.

DS1 has dyspraxia and muscle tone issues and has fortunately significantly grown out of bowl issues at 12. Nephew is getting there but a few years younger.

I believe there are many different drug combinations that can be used and maybe it would be worth going back to the GP to see if the routine and combination should be varried.

With DS1 he was a string bean and you could actually feel his lower abdomen was solid when he was backed up.Sorry if TMI

[Jasonandyawegunorts]

It does sound like constipation leakage, espesially if you are getting results from Movicol.

[BlackeyedSusan]

hypermobility syndrome can effect the bladder and bowels.

current leakage is proably due to leaking round the constipation.

[boobybum]

We started toilet training with DS at around 5. When he was in nappies he would poo between 4-6 times a day (always runny never firm) and I was convinced he had some sort of bowel issue. Toilet training took a while and there were lots of messy accidents but he did eventually start pooing less and they became firmer.
I think that when he was in nappies he wasn't properly aware of when he needed to poo and that's perhaps why he had so many runny poos - just leaking in bits and pieces (sorry TMI!).
He now tells us when he needs a poo and is down to one or sometimes two poos a day.

[claw12]

Ds was very late out of nappies and even once out of nappies had constant 'accidents'.

he is now 12, it's improved, in that he doesn't fully soil himself, it seems to be sensory, he doesn't get the sensation of wanting to go until 'it starts to pop out', then rushes to the toilet.

He still smears on occasion