To think this poo situation is just ridiculous now?

[Alittlebitwary]

Posting here for traffic to see if anyone else has any experience of the same, as I'm at the end of my tether with this and literally don't know what else I can do.

My 4yo just will do anything to avoid doing a poo.
Potty training was fine, this started sometime between age 2 and 3. She holds it to the point it starts to come out, so gets poo in her knickers, but won't go to the toilet. She will cross her legs, crouch on the floor, and though clearly desperately holding it in she flatly denies needing a poo.
We sit her on the toilet and she screams her head off saying she doesn't need one, despite the repeated pooey knickers. She'll then go off and play, then repeat. More pooey knickers and toilet refusal. I'm absolutely sick to death of it now.

We've tried everything.
Poo apps recommended by HV.
Ignoring and letting her lead (she then holds so long - days - that it's eventually painful when she finally does do one then is even more avoidant).
Forcing her to the loo (she refuses)
putting games and toys in the loo to keep her there / make it relaxed (she just plays and no poo comes out)
Positive reinforcement, sticker charts, rewards. Huge praise for every poo.
Also tried not making a fuss so she didn't stop doing it just because she wasn't getting a fuss.
Increased fluids and fruit.
We make doing a poo part of bedtime routine and sit her on the toilet every night before bed.
We often have to spend 15 mins making her laugh to get her to relax enough to poo.
She ALWAYS denies needing to go, even while she's doing one!
However, occasionally she takes herself off to do one, and gets on with it no problem. I have no idea why sometimes she can and sometimes she can't.

We saw GP when she was 2 or 3 and she's been on laxido daily ever since and the poos are always soft now. It's possible she was constipated at one point and had a painful poo.

The thing is, we'll go round in circles having a period where she's going on her own no problem, every day with no issues!! and then suddenly there'll be another period where she is constantly holding and it's a constant battle to get her to be regular.

I am absolutely sick to death of the pooey knickers and her little sister is starting to copy this behaviour and I just can't!

She's at school now and comes home with poo knickers on the regular and she gets a sore bum.

Help me Mumsnet!!

I really, really suggest you need to take a "holiday" from the stress of this. Your dd likely can't change, so you need to make the shift in how you are seeing things.

So, buy plenty of cheap pants, have an easy place in the bathroom to put pooey things (e.g. lidded bucket) and accept you will, for the foreseeable future, be doing a wash of pooey stuff each day. It's the dissonance between your thoughts about "I shouldn't have to be doing this" and the reality that makes it feel worse.

Your dd is going to need a good period with absolutely no stress about pooing to start her feelings. You need time together when you aren't fighting about going to the toilet to feel like you are on the same page supporting her to deal with a medical problem.

I think you have to be realistic about a 4yo's capacity to choose to do something willingly that they associate with pain and discomfort. It's a lot to ask if a child of that age. It's absolutely understandable that kids withhold poo when they have had a previous bad experience.

@TheFormidableMrsC really interesting video, never heard of interoception before

I'm surprised there aren't more comments about sensory processing disorder/interoception disorder/ADHD etc... its not an uncommon problem to have toileting issues with them.

It may be worth considering OT input. They were amazing with us and started the diagnosis ball rolling.

Ffs not everyone has ADHD! Clearly by all these comments poo anxiety is a thing

I had terrible constipation as a child.

Has she got a step so her feet are on something solid? Much easier to go when your feet are slightly higher.

Also try gently pushing her hips together.

I could have written every word of your post OP! DS is 5 and I'm at my wits' end with this. School are also on my back about it saying it's not normal and they don't have the resources to clean him up when he has accidents there. Just want to cry and scream and hide in a hole.

Hello,

I feel you paint we had the same issue with my daughter who has grown out of it.

GP and heath visitor was rubbish basically blamed me for a poor diet. Kept food diaries and her diet was better than average (gps words)

I second blowing bubbles or blowing up balloons on the potty/toilet.

Definitely have a chat with this two charities I found both helpful and supportive

https://eric.org.uk/childrens-bowels

https://www.bbuk.org.uk/

My son was exactly like this. We tried everything as you have but then eventually got a referral to the bladder and bowl team which was what made the difference. They suggested doing a full disempaction with high doses of Movicol for a period of about 2 weeks which we then gradually reduced. We made a big thing of this with him and how it was going to help him poo on the toilet like a big boy now and we didn't have any accidents at all from the very first day. He had been completely backed up and it had been going on for so long that he had lost bowel control. After a few weeks we continued with lower doses of Movicol but wereprescribed pico sulfate alongside to help him understand his blowel impulses. He was able to come off all medicated about 9 months after we first started this process and he has never had a single issue since. This felt like a miracle to us after so long with him having accident after accident. I'd definitely push for a referral with your gp as the waiting list could be long.

I’m going to admit something weird here, that I’ve since found out is quite normal.
Around the same age, I got a weird thrill out of stopping myself going. So I’d need to go and I’d feel it moving and I’d crouch and sort of stick my heel in my bum. I liked the sensation of stopping it and being able to control it and I’d put off going, not for any real reason, but because I preferred the feeling of stopping it. It felt weirdly good.
I was fortunate to never soil my pants, but looking back it was a big deal for me. My mum would ask if I needed the toilet and I would say no.
I eventually grew out of it.

Look up Freuds anal stage. It was only when I learnt about this that I realised that’s exactly what I was doing and the feelings I got were weirdly pleasurable.

I have no advice buy I'm right here with you. I am lost. We've tried everything. Literally everything. ERIC, laxatives (which weren't necessary but GP said they were which caused 'cosmocol-gate' where she exploded poo everywhere for days and days even on only one sachet and got even more worried about going because she couldn't control it). We've spoken to everyone. She's not constipated. She just won't go on the toilet or potty. I could cry.

DS's continence issues aren't caused by withholding so I have no suggestions there. However, as well as Eric, Bowel and Bladder UK also have a helpline - and they actually have a separate team for pediatric issues. I also struggled with getting through with Eric, and I didn't find the online form and advice I got in response that helpful because there just wasn't enough space on it to put enough of the relevant details in. Bowel and bladder I called and left a voicemail and after about 5 days a pediatric continence nurse called me back, and spent something like 30 minutes talking things through with me. It was incredibly helpful.

If you are on Facebook, the group Movicol Mummies is UK based. Even if you don't want to post, searching for past posts on withholding would give you a lot of information from people who were in a similar position.

That was kind of you to post that. It’s clearly been quite a traumatic issue for you and good of you to want to confront it to offer solidarity. If I can offer a tiny bit myself, I have also posted about my cousin who also had this in the mid 80’s and despite his parents really trying hard, in retrospect it was completely mishandled. The “ advice” was that it was a behavioural thing which meant my uncle got cross and thought it was a disciplining thing, my aunt would plead and thought it was a stubbornness thing, and the rest of us ( who witnessed a fair amount of the drama) lurched between shock and toilet-humour hilarity. He still gets teased by his siblings today if things like figgy pudding or prune are served . So I think you were not alone in it being clumsily handled. I also know my aunt and uncle were doing their ( misguided) best.

I actually think there have been lots of comments about that. I’m not disagreeing that it could be behaviour fitting those profiles; but I also think it’s a “ thing” in itself. It is likely sensory in nature in the sense that it involves physical sensations and visual aspects and smell aspects that probably play a part. But I’m pretty sure it can exist as “thing” without a corollary diagnosis and that some children can have an issue with it but not display other behaviours warranting a diagnosis.

Thank you @Calliopespa for your kind post. Yes, the whole episode did cause some significant psychological damage which persists in some ways into adulthood. Some years ago while having counselling, the topic came up. It’s certainly had an impact on some of my behaviour. Talking about it all 40 years on is still embarrassing and difficult, even though I would have lots of sympathy for a child going through it now and would know they were not deliberately trying to be difficult. But it is hard to find that same sympathy for myself as a child- because the sense of shame is so firmly wedded to the whole thing. I know it wasn’t my fault but still sort of think it was, if that makes sense.

I read with interest your post about your cousin and a lot of it resonated with me! It was a very 80s approach to the problem that your aunt and uncle had, and my mum too! (My dad managed to stay out of most of it as he was at work so much of the time and otherwise I think just let my mum deal with it because she was a primary teacher and he probably thought she was better equipped to sort it out).

I hope your cousin hasn’t been left with any lasting MH impacts. By the sounds of it, he doesn’t mind the teasing, which is good. I would be mortified if anyone brought my issues up in conversation now- even if it was meant with kindness and humour. It might be that your cousin is more resilient than me!

Thank you again for your kind words.

And to add- yes, I’m sure your aunt and uncle and my mum were doing their best. They weren’t deliberately cruel but were likely following the advice of the time from health care professionals who clearly at that time didn’t know the best way to approach the problem.

I think the suggestion people have made about ignoring it for a period of time seems like a really good one. As a child, I hated the fact that every single day involved discussion about poo and bowels. Constant questions: ‘have you been?’ ‘Do you need to go?’ ‘Can you sit on the loo for ten minutes now please?’ It all just repeatedly highlighted the fact that I wasn’t normal and wasn’t like other children. Perhaps if everyone had relaxed about it a bit, it might have taken the pressure off and helped the problem resolve more quickly. 🤷🏼‍♀️

Yes, absolutely a thing in itself.

I just wanted the OP to possibly bear it in mind as it was our route to diagnosis when there were no other issues apparent.

It’s been interesting for me personally to read the references to ASC and ADHD.

As detailed in previous posts, I had this same experience in childhood with bowel issues. As an adult, I have long suspected I am not completely NT and am now awaiting assessment for ADHD. Never would have occurred to me that there could be a link between the two.

Yes I think a bit of ignoring is probably extremely helpful ( perhaps with a sneaky slop of lactulose or similar in some juice just to keep things slippery).
I think my cousin seems to have weathered it ok; he’s a fairly forceful character and probably having his own Achilles Heel has not been the worst thing in terms of promoting some understanding of other’s frailties. He takes it in good humour but I can still see that aporoach was a gamble, and it could have been very damaging.

I havent read all the comments posted, but please take a look at a website called Eric. They are a charity and there will be lots of advice and tips on toileting issues with your child and what you can do to help and support them. You can also talk to school and ask for support from the school nurse team who can refer you.

My daughter ended up with faeces impaction. She ended up needing daily movicol and we were advised fruit juices and lactose also. Unfortunately the acids and sugars affected her teeth and she needed 13 out at the age of 7! Was a very traumatic time. One day I mixed up an extra sachet and all of a sudden it just disappeared! But yes she used to hide behind settees. Refused to go. Read 10 books every time she went. She's 20 now with great teeth and good bowels. No food issues. We had no reason for it to happen. It just did. My first stop was the GP at the time. Good luck with it all

No real advice just empathy! My daughter started toilet training at about 2.5. Didn’t crack poos until 3.5. We thought she’d FOREVER Poo her pants! Usually hide under tables. We had to go down the movicol route. You can control the dose, originally had to keep upping the dose quite a lot. She’s just about to turn 4 and is off the movicol and no accidents. She sometimes struggles but it’s usually good. I know you’ve said you have tried similar so not sure it would help you. We had mini successes before the movicol with bribery but would only last a few hours 🤦🏼‍♀️

One of my sons always had soiled underwear, and trouble going to the toilet. The hospital put him on several stool softners and diagnosed it as extreme constipation. They explained it by saying , that the solid poo blocks up ,then runny stuff behind it, dribbles around it and comes out, causing the constant soiling. It's completely involuntary.

It took several years of checking his diet, eliminating different items from his diet for periods of time, making sure he ate regularly as he had intense pain if he didn't eat often, and had to go to hospital several times for suspected appendicitis.

The stool softeners helped make it easier to go to the toilet. It was a powder that got mixed with water, which he hated, so that was a struggle. Plus making sure he drunk plenty of water throughout the day.
He was given a toilet pass at school , as he had several accidents that required me to go in and clean him up and bring in fresh clothes.
This all started when he went to infant school and he grew out of it almost completely by secondary school.
So it's worth going to the gp to check.

sorry to everyone going through this.

i joined Movicol Mummies on Facebook which helped me a lot. However lots of movicol did not solve my daughter’s problem. She was a BRILLIANT withholder, like could have won the Olympics for holding in even runny Movicol poo.

i didn’t know what to do so I googled world expert on withholding. And I found Jamie Glowacki who wrote the Oh crap potty training books.

i had two zoom calls with her and she told me that the issue is not hard poo. The issue is that my daughter’s anal sphincter has locked closed due to anxiety of pooing, or not wanting to poo because she’s playing, or control…who knows? So the thing was to make her relax that muscle.

only way to do that is via a mini enema called Microlax. So we had to come from 8 sachets of Movicol per day to mini 2 sachets plus the mini enemas. It was fixed in a week.

@Nofilteritwonthelp this is MN - EVERYONE has to have ADHD/ASD/ something wrong with them. Kids can’t just be bloody awkward.

I know exactly how you feel! My son withheld his poo for years and it didn’t resolve itself until he was 12 during lockdown. I literally tried everything. He had to go to hospital several times for an enema as he was so impacted. He was on movicol for years, but it didn’t work and he ended up refusing to drink it. I think it was more of a mental thing that developed because he had a painful poo one time and literally refused to go to the toilet. We had support from our gp, the urologist and all manner of ‘experts’ but in the end I just accepted that this was how it was going to be. He even had to wear pull ups under his boxers at primary school until Y6. In lockdown we had time to encourage him and he finally went on the toilet and pooed. And that was it. Once he realised it wasn’t that bad he just got on with it from then on and no problems since.