AIBU to think there must be something we can do about my 5yo's poo accidents?

[Dalrymps]

My 5.5yo ds has been having frequent pop accidents since he started Reception. Both at home and at school.
It seemed to start around the time he went in to Reception and we stopped him using his potty. He was really attached to it and not sure about going on a toilet at all. But we thought best to phase it out as they have toilets at school and he can’t go on the potty forever.
Anyway, he can have several accidents a day sometimes. Sometimes it’s several a week. I get called in to school to clean him up. I just feel so bad for him.
We don’t get annoyed at him, we just clean him up and remind him to try and sit on the toilet next time.
He does sometimes start to poo at home and just have a shart, so we’ll put him on the loo and he manages a poo. But we really have to insist he goes on the loo as he’s reluctant. He has his own special seat and it’s nice and sturdy.
I read on the internet it can happen if they have been withholding and stretched their bowels, resulting in loss of sensation and signals when they need to go. The advice was to give him lactulose for this to make him regular and that hopefully he would start to get the correct signals again.
I took him to the dr and asked for lactulose. She felt his tummy and said there were no lumps or blockages but agreed to give it a try anyway.
There has been a small improvement but it’s still happening quite a lot. I don’t think he’s ever managed to poo on the loo at school :(
I rang the school nurse on advice of the dr weeks ago and heard nothing back. I just left her another message.

I worry he’ll start getting picked on. I don’t really know what else to try. We’ve had sticker charts, but I really don’t think he can help it.

Poo* accidents

Look up Steve Hodges work on constipation and ask school nurse to support with a referral to paediatrician

Ok thank you! He saw the paediatrician when he was little for slow weight gain. I’m sure they’d see him again..

If I ever hear back from the school nurse that is

We had to retrain during reception as well. We bought a watch with multiple timers set on it to remind mine to use the toilet. He was asked to try for a poo each time. Looking back now, I never imagined he'd e clean. But it worked. He needs to learn the sensations and not to wait until he's desperate. I also poo very quickly, as my child does. Whereas my other child likes to really take his time on the toilet and is completely clean and in control.

I would chase the school nurse appointment- maybe by email and leave it 2 days and phone again in case something has got lost. We got a response very quickly from ours a year ago when we self-referred to say they would contact us fully by x date as they were busy, but we were in the queue.

Have you taken him to your GP.
My dd was the same. I was out of my mind. It turns out she had a blockage in her stomach. It may sound stupid but the relief when something was wrong.
She was put on Movicol. She's 18 now and thankfully up to know she's fine.

Encopresis is very common but rarely talked about. You can’t always ‘feel’ a blockage. Referral to paediatrician and onto specialist as required. It can take around six months for the blockage/ seepage to resolve and for sensations to be relearned.
We were essentially dealing with this for about six years in total (and four washing machines). For ds we had to use a product similar to lactulose, but also suppositories (three in a row every time he soiled) to clear properly.

Ask for a referral to the continence team . My son has sn and they are constantly on to me with lots of ideas .: some I hadn't thought of . Sn aside he should be toilet trained by 5 so it's worth asking for some help .

We had a good few months of poo withholding after a big house move. We started using xylitol on his cereal instead of sugar, which makes the poo softer and easier to come out. Our most effective weapon was engaging the small boy's love of disgusting things, and asking him to see if he could do a poo so big that we could hear the splash from the hall and, if he did achieve something, calling his big sister in to have a look and she would do a fine line in teenage "eeeeeewwwwwww" which made him laugh.

I think you need to ask your GP for a paediatric continence/gastroenterology referral.

There's practically no chance he's comfortable with this and I would want to rule out anything physical before managing his bowels with laxatives as the final solution. Nothing wrong with doing that btw, needs must and all that, but there's a chance there's something else going on.

School nurse continence service and GP for this.
He is very unlikely to need or be benefitted by a paediatrician.

We used the school nurse service for nighttime wetting last year and they were really good, they cover bowel continence issues too I believe so it’s a good starting point, particularly as it is causing issues at school.

You need movicol not lactulose. Also chase the school nursing team for help. We ended up being under the bladder and bowel nurse for a year after going through the school nurse.It will get better eventually.

Thank you for all the support, I feel a lot less alone now. I will keep trying for the school nurse. I either keep getting an answer phone or someone takes a message then they don’t call back.
He has said several times that he ‘can’t stop it coming out’. He also has wee accidents but they are less frequent and he’s mostly happy to pee in the toilet.

OP I sympathise. Poo issues seemed to dominate everything for a while when one of our dc had similar. In the end he was prescribed movicol which, in conjunction with star charts and encouragement, absolutely turned things around. It works much better than lactulose for some children. We were very lucky to go to a GP who had seen this before. In the end ds was on movicol for a couple of years - we weaned him off gradually and he is completely over it now.

He probably can't stop it. The nerves get damaged and the child can't tell they need a poo until it is coming out. The weeing is also normal, the blockade bowel presses on the bladder.

We actually sought advice for day wetting that turned out to be chronic constipation.

Ah I see, really interesting.. I thought the wee accidents might be related

Will ask about movicol

Hi. My son had exactly the same problem. Got him referred to the paedatrition, turns out he was extremely constipated. Had movicol prescribed to clear him out. (High dose..(think 2 pkts 3 times a day) once the constipation was relieved the accidents stopped. Good luck. X

DD developed chronic constipation at that age, was always difficult with poos but a stressful time at home really triggered it.

Movicol didn’t help at all, a nightmare and we ended up seeing a paediatrician specialist for Gastro problems, luckily we were covered with my private health insurance from work so we saw him pretty fast.

He put DD on liquid paraffin and senecot. Plus lots of liquids and anything non constipation-causing food. We went through tons of knickers but after a short while she started going regular. But it took a year to get away from the senecot tablets.

Most GPS go the movicol route but it doesn’t work all the time. I would stress for a referral.

Have you asked him why he does it? Ie is it that it happened unexpectedly or is he holding it in? A lot of children go through a phase of holding it in (most) - I know it sounds bizarre but when I did my mum told me this and explained that Freud had studied it and it’s called being anally retentive. She said if I didn’t stop holding it in I’d get a a bit round ball of pop stuck in my bottom and have to go to hospital.

Sometimes explaining things to children takes them outside of their thinking and gets them past a rut,

Has he a fear of toilets? Or are the school ones really dirty so he wants to avoid them?

It sounds like stool withholding to me. Read Dr Anthony’s Cohn book “Constipation, withholding and your child”. We’re just emerging from a three year nightmare with this. Movicol and a lot of patience worked for us. Eventually! Good luck.

Have you contacted ERIC, the children's continence charity? They are excellent. They will give you a detailed plan of action, either over the phone or by email. Good luck. We went through something similar, and they very much put it right for us.