11yr old Pooing pants

[HeartySwan]

Apologies in advance for tmi and length.

Hes always had regular accidents since potty training but started to get a lot worse when he was around 9 with both soiling and wetting daily. He was straight away diagnosed with constipation and put on Laxido and we were told he need full disimpacation. It took a few weeks of hard work until he was fully cleared and doing regular soft pooes. He was then moved onto a maintenance dose of 2 sachets which he takes daily.
It got better for the most part but we still had accidents here and there which I was told is completely normal as his bowel adjust following the process, and may take time to fully recover.

However theres since been no improvement and recently started to get worse. I initially suspected he could be backed up again, but he is doing normal pooes (mostly type 4) at least once a day and he does have the sensation of needing to go in bowels. When it happens now it isn’t like the frequent water smears he was getting before the disampaction but normal whole poo and quite a bit of it.

We saw the GP again with a recent tracker diary and after some tests have been told he doesn’t have any evidence of impaction anymore but they have increased his maintenance laxido dose to help his bowels regulate themselves, which has done nothing. We have now been referred to the local continence service, which I found out today takes 3 months minimum of waiting!

It happens out and about and I’ve noticed it happens a lot when he is preoccupied in something so I do limit his screen time and gaming. But there are time where he will carry on with whatever’s he’s doing after an accident with damp or soiled underwear despite me not being angry with him about it.
We were at my mother’s house last week and he went off to play outside in the garden for of couple hours. When I called him inside for dinnner he absolutely reeked and after checking him, I could not believe the mess inside his underwear, and that he just carried on playing for gods know how long like nothing had happened making him an absolute nightmare to clean!
He will say he is sorry and he just didn’t get to the bathroom in time or he felt the need to go too late. I try to be calm with him as I don’t want to make him feel even worse about it but I really am at the end of my tether with it and don’t know what to do next.

if anyone has experienced anything similar or have any advice would be a godsend

Gosh this sounds so so hard. I would definitely be on at the GP for as much info as possible because this seems very unusual to me given his age. I’ve had no experience of a child in this situation but didn’t want to read and run. I’d be wondering what else is going on here- a medical issue or is it laziness or lack of noticing he needs to go? What’s happening when he’s at school- is he managing it better there? What do you think is the underlying reason- could it be diet related? I wondered what the initial cause of the constipation was. lots of luck to you x

You say he’ll just carry on ‘without you being angry’ about it - what happens if you are angry with him about it? I think at 11 that’s justified unless there’s a medial issue.. I can’t tell whether you think there is or not from your post. At 11 I’d be making him clean himself up and his clothes!

My DD had a spell of this aged 9 and is now on the maintenance dose a year later. After she had so much impaction I think she got immune to the smell/feeling so it may be that - we are I think just keeping a closer eye and not letting her go too long without checking her.

There was a poster about a year ago whose similar age child was doing the same thing. It was very backed up - yet it seems like you'd know this as you're on it with ths constipation?

Best of luck and hope you get to the cause of the issue.

What about making him go to the toilet to ‘try’ every hour or so. Done with you reminding or through an alarm on his watch/ phone?

is he ND as that could affect things?

I was under the continence and colorectal team after I gave birth so I thought I’d give you a bit of information around the experience I had with them.

The first things they’ll suggest is his diet, is he exercising, does he go and relax on the toilet, they’ll probably suggest he uses a small stool to put his feet on to open up his bowel when he does go. Having a diary will help.

I then wondered if he has stretched and damaged his bowel or if he has problems with his sphincter. The colorectal team can do further testing to check his muscles or to see how much or little his rectum can hold, how sensitive he is to feeling the urge etc.

It’s alarming that he happily plays in soiled clothes at 11. Does he know he’s had an accident? Does it not bother him? How much is laziness?

I should have clarified that I was angry with him after he ignores but will not be angry if he’s honest and transparent with me, hence I find his behaviour really frustrating! I am working with him so he is independent when changing but sometimes depending on the situation he may need some assistance. As I explained he does have a previous medical issue which still effects his bowels.

How is his bladder?
Does he pee regularly or is he able to hold vast amounts?
I believe an 11 year olds bladder should hold about 360ml ish and no more without is being painful.

My DS has kidney and bladder issues, he would smear/just poo completely before the bladder issues were fully found out. His bladder was holding too much and it was compressing his bowel.

My DN was just too busy to go to the toilet. No issues but he is ADHD, it took him a long time to "click". One day he did and then at age 10ish he stopped doing it. Hed been through the movicol treatment etc but it didnt make any difference really as it wasnt medical.

My DS once his bladder issues were fixed also wouldn't go in the toilet until he was 10.5. He was afraid of it. Took quite a lot of input from psychological services. It was all trauma from surgery and treatment on his private parts. Would any of your sons previous illness have affected him in this way?

Its a difficult place to be in, but not fully unusual. People just dont talk about it

Does this ever happen at school. Is he in Y6 or Y7? I can't imagine he'd get away without being teased if he's moved up into Y7. Secondary students can be brutal.

Is there any other special needs?

The soiling is one issue but it’s not normal for an 11 to just continue to play covered in poo and I would expect an 11 year old to clear up after themselves immediately.
what does he do at school or around friends?

But if you know he has problems why are you letting him play for hours unchecked?

surely you would make him go to the toilet before he leaves the house? Then call him back after at most an hour? And the repeat all day until you catch every toilet? And then build?

why, when you know he has a problem, let him soil himself and then get angry?

At 11 you shouldn't be having to check his undies and clean him up. The fact he doesn't feel extreme embarrassment and doesn't know how/refuses to clean himself up without your involvement is a worry I think.
I think it needs to become his own responsibility at that age. I don't suppose he might have SEN or another type of difference?
I hope things improve for him and you.

My DS is younger, but after disimpaction needed senna as well as laxido to help with sensation and fully emptying the bowel as everything had got stretched by the constipation/impaction. GP was not keen to prescribe until the continence team got in touch with them though, as senna is not licensed for under-12s.

I was literally coming on here to write a similar post. My DS is 11 and having these exact problems. Wetting himself so much that he has got a rash, constantly pooing himself. We have got flushable wet wipes and tell him everytime he goes to the loo to wipe his bum and he doesn't. I ask if he's wet or had an accident and he says no, but then I smell it and check and and its an absolute mess. I cry most days over it. Same as you, no constipation although the doctors said it was at first, but laxatives just mean't when he had an accident, it was looser and messier. We perservered for a long time, but they were stopped in the end. I'm the same also in the sense I don't get angry - I just promote honestly about accidents but he still isn't. I've tried reasoning, rewards, making sit on the toilet on a regular basis for 5 minutes (which DS sees as punishment). I have no answers, but my inbox is open. Please do message me, even if to know you are not alone

We’re similar with DD(8). There’s a complete lack of embarrassment and unwillingness to engage in solving the issue.
Every day I deal with pooey pants.
We’re under the paediatrician who just says ‘she’ll get it when she’s ready’.

She’s been on movicol since 4 years old and no one seems to want to engage with the idea that perhaps it’s not the correct medicine - just feel like I don’t know where to turn which I imagine is similar to you.

It’s a postcode lottery but if you are under a hospital consultant ask for a referral to paediatric psychology. You also probably know about the website ERIC but worth checking that out as well.
As PP has suggested, your son may have become accustomed or desensitised to the physical act of pooing and the feeling afterwards.
Another possibility-Even in the absence of ND stuff, psychological trauma perhaps from medical investigations or pain from his condition may have caused the sensation of being soiled to feel familiar or even ‘safe’ for him.
sending you and your son good luck with getting a resolution

I would question if all the laxatives they give children is the wrong answer. It’s difficult to manage your bowels when taking them never mind a childs. They’ll be causing the urgency and making the clean up far worse.

Actually laxatives are completely vital in reversing the chronic changes in the rectum from long term constipation, in order to regain normal function.

OP can you try and build a routine around when he goes for a poo. Most people feel the urge a little after eating a meal, can you send him to sit after dinner in the evening, let him watch a tablet or something if that helps him relax a bit, and try and build it as a daily habit?

My eight year old son has started pooing and wetting his pants after six years of being exclusively dry and clean apart from a few night time wettings related I think to alteration of routine. I'm worried sick, I think deep down it's just one of those things, most importantly he seems in rude health. My friends who have kids around the same age say they go through phases where they're lazy, distracted etc and they grow out of them. Is this true? I don't have siblings to compare him to, but is it unheard of for 8 year olds to wet and/or poo themselves occasionally. I'm worried my friends are just being kind.

I wondered this.

Sounds like he has more than 1 issue as even tiny kids don’t like Poppy pants, by not giving consequences you are telling him that his behaviour is ok.

Does he eat a healthy balanced diet and only drink water and plenty of it often constipation is linked to poor diet and lifestyle.

I would agree that it’s really odd for a child of this age not to feel ashamed or embarrassed by this. To keep playing knowing they’ve shit themselves. Are there any other issues at play here? I really sympathise as my eldest suffered with impacted bowels and often had poo in his pants but it was just smears not full on poos and even by the age of 6 or 7 he knew to tell me.

I have no medical advice but I think you need to follow this up further as it will be a nightmare for him if it happens at seniors.

Speaking to the teacher these problems are much much more prevalent. She thinks it's related to lock downs, and kids not getting properly toilet trained. The GP thinks it's a definitely increasing problem, but he thinks it's down to using pull-ups, poor diet, society and parental attitudes to kids disappearing into the bushes when caught short.