In being at the end of my tether with ds? (Toilet issues.)

[bigflowerdog]

Name changed for this as people on here know me irl but I've been around for ages and promise I'm not a weird poo perve.

DS is nearly 6 and just started school this September. He's been fully potty trained since he was about 2.5 (I think, around then anyway) with no issues.

He's just started pooing himself everyday! Sometimes twice a day. It's been about 2 weeks now. We've been very gentle and understanding but yesterday it ashamed to say I got pretty angry with him. I realised he had poo all over his hands and clothes and was just carrying on as normal! He got really upset and obviously I felt like a very shitty parent.

He's also been hiding his pooey pants in places.

Today I got a call from his teacher, he's done it at school. Is this something I should take him to a doctor about? Could it be a physical thing? I yet can't see how or why it would be psychological.

The other kids are going to start to notice, it's a small community, people remember things kids did 30 years ago. He'll forever be the kid that used to shit himself.

Anyone ever experienced this? Ugh. My patience is wearing really thin with it but I want to be as gentle as possible, going in full steam clearly won't help, especially if it isn't a medical thing.

Children crap themselves for many reasons after being toilet trained.
Sometimes it's a sign of stress from an abusive situation that they have been unable to verbalize.
Other times it's because they aren't encouraged to drink enough fluid (6-8 cups a day) which then causes dehydration and constipation.
You need to find the root cause and not take the symptoms of what ever is going out on your small child.

kidshealth.org/en/parents/encopresis.html

Read this OP, and take him to the GP.

To answer some questions, the bugs have all been diarrhoea. After the last one I thought it was odd he was the only one.

His diet is awful. Mostly beige food. I've worked with kids for over 20 years and he's by far the fussiest. I've switched rice to brown rice and am switching pasta to whole meal.

He also doesn't drink nearly enough. This is worse as he's started school and they don't encourage him like I had to.

Thanks all so much for the comments, it's a walk in doctor surgery tomorrow so I'll see what they have to say but I expect they'll refer me to a paediatric doctor or gastro.

I just spoke with his teacher. She cleaned him up (and was a little freaked out as they're not meant to but she knew I wouldn't mind as she's known him since he was a day old, we were pregnant at the same time.) She's going to talk to all of his specials teachers and make them aware that he needs to be told he is welcome to use the toilet at any time. She was really sweet about it, she said she got someone to take the other kids to do something else so nobody knew.

That article is him to a t! I feel so so fucking awful for losing it yesterday.

And I remember clearly setting myself a lot at school until I was probably about 6 or 7.

some tips on modifying beige diet. Ds2 ate raw carrots in sticks, and cauliflower raw in florets, and raw red and green and orange peppers if they were arranged like traffic lights on a cocktail stick! Also potato wedges can have skins left on and masquerade as oven chips (ds liked his with smoked paprika sprinkled on before baking) He also liked humus with bread sticks and that can have fibre in it obv...or even liquidized red peppers. And raw green cabbage shredded. Anything crunchy rather than cooked. It helps if you put these things in front of them when they are watching telly, rather than at mealtimes proper...

@Nettleskeins thank you!

He will actually eat raw carrots and raw veg if it's very fresh and in season. We live very remotely in a cold climate so we don't get the lovely veg the UK does.

He won't touch humus unfortunately.

Much to my initial disgust we do sometimes feed him in front of the tv. Our paediatrician actually suggested it. DS didn't even chart until he was 4, and then he was only 3% for weight.

Another big accident. Everywhere. Over an hour to clean it up. And not remotely hard so I'm erring against constipation. He says he doesn't know it's coming bless him.

On the way to the doctors and I'm struggling to fight back the tears. I have a constant smell of shit up my nose. I feel like I can't even send him to school whilst this is going on can I? It's not their job to be cleaning him up and I don't want the other kids to find out.

If it is overflow then it won't be hard. It's the soft stuff that is getting around the blockage. Hope the doctor can help.

That’s exactly what constipation overflow is like! He’ll be so impacted that it’s stretched his bowel and damaged the nerves so he’s right, he has no idea when it’s coming.

Hang in there, it will get sorted.

OP, with constipation, you get cycles of diarrhea as well. Basically the hard stool backs up but can't get out, so what manages to leak out is usually very liquid. So I wouldn't rule constipation out yet. See what the doctor says. He should be able to tell if your son is constipated by feeling his belly and possibly taking an x-ray to look for impaction.

Start with the medical side, but regarding school, could you not have him wear pull-up style absorbent pants for a few days so that he could be more independent in cleaning himself up after an accident? It would be less embarrassing to him, I bet, because no one would see his pants, and he could simply go change into fresh ones without having soiled his clothes. If the doctor starts him on medications for constipation, definitely get some for him to wear around the house over the weekend because the poos will be massive and uncontrollable and it will save you some of the mess you've been cleaning up.

Okay. Chronic constipation with overflow diarrhoea and soiling.

The last part of the gut (the rectum) is effectively a stretchy squeezy hosepipe, held closed by a doughnut (the anus/bumhole) at the end. This usually sits empty, then some poo is pushed down into it by the natural internal pushing of the gut. You then get the sensation of needing to go for a poo. When a child is constipated for a long time, the hard poo in the rectum stretches it out. As the rectum is stretched up, a number of things happen. The muscle fibres stretch out, so they can't push poo out as well. The walls of the gut keep sucking water out of the poo, making it harder and rockier. The sensation of when you need a poo goes away, as it is always there, so the brain subconsciously ignores it. The stretched up rectum makes a baggy reservoir for unpassed poo. And the pressure of the hard poo on the anus starts to stretch that, like the head of a baby on the cervix, so you can't hang on to poo well.

All the time that this is going on, more food and drink is going in the top end, and all the digestive juices are going into the gut, so liquid poo is still being formed. This liquid poo, that hasn't yet had all the water sucked back out of it, hits the top end of the mass of hard unpassed poo. This may give tummy ache. But there is still natural waves of pushing from higher up. So the liquid poo starts to move, under that pressure. It finds the gaps, and crevices, and sneaks around the edge of the solid poo. So there is liquid poo heading rapidly for the bum hole, under all that pressure. But the child can't feel it coming, because the signals are all screwed up by the mass of hard poo. So they don't know they need to go to the toilet. And then the liquid poo hits the anus. But that is stretched up too, so even if they have enough sensation left to know that they need to hold on, they can't. So you have an accident of liquid poo. Sometimes in small amounts, sometimes everywhere. Quite a lot of children have such screwed up sensation that they can't feel that they've had an accident.

The good news is that this is extremely treatable. The way that this is properly managed is to first get rid of all the old hard rocks of poo. And then to make sure no more hard rocks form whilst the rectum and anus slowly shrink back down to normal, and get back their normal function. The way that this is done is using a macrogol - this is a powder, mixed into any non boiling liquid, and drunk (makes include movicol and laxido). The powder hangs onto the water in the liquid, and keeps it in the gut. In low doses this softens new poo. In high doses it works into the old poo and gradually erodes it away. So the proper treatment is initially to go on high doses until they poo like crazy (I usually say at least 3 days of multiple episodes each day of watery gravy like poo) and then on a low dose for months, aiming for about scrambled egg consistency poo.

Obviously we can't be 100% sure of the diagnosis over the internet, but I'd pretty much bet the house. In the last 10 years, there's only been one child I've seen where that wasn't the explanation for the type of story you've given.

Read the eric website and take your child to the doctor. Please. The longer this goes on, the longer it takes to get better.

Nowhere to put soiled pull-ups at school.

The doctor didn't really know. She's referring us to a paediatric gastro which is all I really expected of her to be honest.

Op we had regressions with ds sounding very similar to yours (except henever covered himself in poo like your ds) and I was at the end of my tether with him. There was absolutely nothing medically going on with him, though I did realise that he was holding it in for a few days and then sometimes became afraid to go in case it hurt after withholding for so long.

Our regressions always happened around a time when something was changing in his life, like going back to preschool after summer or having building work done in the house. I did also notice that if he was ill with a tummy bug, he used to sometimes regress for a short period of time afterwards.

The only thing that worked for us was trying to be patient (easier said than done, and I did lose it a few times which I am not proud of), and setting a regular toilet routine for him. So every day after preschool, the first thing he had to do was go to the toilet and try to poo. If he didn't succeed, he'd have to try again after dinner. Sometimes this took a lot of nagging and tears, but after a few weeks and lots of positive enforcement, he was going regularly and didn't need to be reminded or nagged.

He's almost 6 now and hasn't had a regression in 8-9 months. He started school in sept and I was dreading it but thankfully, he didn't regress.

She suggested pull ups but I don't see how they would work any better. He just isn't that bothered. I'd say about half the time he doesn't realise he's done it! That's why I'm getting so upset about the whole thing, by the time he's realised it's everywhere.

Thank you so much to everyone that's posted. This is really getting me down, I burst in to tears at the doctors (great help I know ).

I'm just so worried about this becoming something that affects his confidence or mental health. He seems very matter of fact about it but a couple of cruel words from kids and that could change. I do also realise I need to get a grip though.

He's mentioned not being allowed to go to the toilet when he's asked and his teacher admitted that and I've told her this absolutely needs to stop. He told the doctor he feels scared to use the toilet at school.

I'm having dinner with the school guidance councillor tonight (like a welfare officer for the little ones) and will also tell her that all staff need to be aware he needs immediate access to a toilet. Although any bloody 5 year old does surely.

Are you in the Uk?

Sorry, just read back and you’re not.

Have a look at the website below. It’s the one we get referred to here in the uk. Lots of good advice.

www.eric.org.uk/

The eric website is great.
Also, google The Poo Nurses and watch the whole video, right to the end.
This is a whole family and school physical and psychological issue and will take time and effort from everyone.
It can be solved though. The sooner you start, the better.

I'll look now thank you. DH just texted me. He'd taken him to the playground and it happened there. Liquid, everywhere. I can't even send him to school like this, what the hell do I do?! I'm going to ask the doctor to refer him as a matter of urgency on Monday.

I had very similar with my DS - soiling & wetting. I know everyone is quick to say constipation & overflow, but for my DS it wasn't this at all. He has a lot of other health issues, and so we were lucky to be under paeds in lots of specialities.

With DS he was initially diagnosed with a form of colitis - he tried sulfasalzine, to no avail. We tried meds for his enuresis too, which didn't help either.

Upshot of it was they believed it was him not getting the signals that he needed the toilet - he has collagen & muscle issues, and they linked it to that. He had ultrasounds on his bladder & wasn't emptying it fully - this was another factor with enuresis.

I'm afraid we didn't find much that helped, apart from me constantly checking if he needed to go, trying to make times for him to sit on the toilet. This was all info given from enuresis & encopresis specialist. I got really upset about it too - I was terrified he'd be bullied over it. He was upset, but he honestly couldn't control it. At first I was really angry, and I did shout in exasperation - I think that's completely understandable when they have been able to cope, then seemingly regress. Definitely get some help & hope things resolve soon.

FYI - encopresis doesn't refer only to constipation with overflow - retentive encopresis does - but there is also nonretentive encopresis, which my son had.

I should have mentioned that he's always suffered from what we thought was CVS. They may be unrelated completely but I'll definitely be mentioning it to the doctor as it's a gut issue too. If it even is that.

Obviously we are going to do absolutely everything recommended to sort this as quickly as possible but not having health insurance the potential bills are making me feel bloody sick too.

bigflower as regards to school, I would keep him off until you have taken all this new information in. If you are worried about explaining, just say he has d & v.
I am shocked that teacher admitted they weren't allowed to access at all times to the toilet.

In the long term missing a week or two of school is not the most important thing, sorting out this problem in the long term (and it could continue for many years on and off, those of us whose children have had soiling issues will confirm that, sadly) IS the most important thing and will save you hours and days and weeks further down the line. Fwiw you shouldn't need to pay anything surely - NHS should do referrals???

@Nettleskeins I'm in the states.

Keeping him off school will be fine. I'd rather do that than have this turn in to something that he gets bullied or shamed for. They're a lot less lax about attendance here. And seeing as this seems to be partly fucking caused by them they wouldn't have a leg to stand on if they did have a problem.