Please help - child constantly having accidents

[PinkGardenParty]

Have a seven year old son. He's always had poo accidents but recently it's getting worse. He's had several today and is getting absolutely frantic when I ask him if he's had an accident to the point of being like a two year old having a tantrum.

Despite me asking him repeatedly to put his soiled underwear in a lidded bucket in the downstairs loo, he leaves them on the floor all over. I've just been to the upstairs bathroom and stepped on a pair of soiled pants he'd dropped next to the loo. I asked him to move them and he got incredibly upset - sobbing, yelling, slammed a door.

We have an appointment with the child continence team next month and have seen them before where they felt his was constipated and prescribed movicol and picolax which haven't really helped. He's soiling several times a day still, even after following the disimpaction protocol and sticking to the matainance regime.

I'm genuinely, genuinely at the end of my rope with it. I'm single parent and have another son. It's costing me a fortune each month in bedtime pants and normal underwear because despite being washed with bio liquid, I can't get the poo smell out of them. I can't cope with the constant tantrums (I hate that word but don't know how else to describe it - meltdowns maybe?) I'm paranoid that my house stinks of shit.

Can anyone help? What can I do next?

It might be worth contacting the ERIC helpline when they open on Monday. They specialise in this, and will be able to offer you advice as to what to do next Home - ERIC. Does he have any additional needs at all?

It’s good that you’ve been referred to the right medical team. Continence nurses are also great if you have the service in your area.

On how to clean this: rinse the solids out (in the loo) 60 wash with a capful of zoflora instead of fabric conditioner.

Have you trialled any food eliminations? If you haven't then I'd be removing dairy and soya as a priority.

I hear you, I have an almost 6 year old that has phases of this. We’ve exhausted medical causes.

My only advice is on the laundry, rinse in machine before washing cycle, bio powder on long wash, extra rinse in machine, dry in sunlight.

The shit is shit.

You said ‘felt’ which stood out to me, Have they actually confirmed if he was constipated, or was it an assumption based on his symptoms?
Because if he wasn’t and he’s taking doses of laxatives it will get worse.

I'm already doing that ☹️

Getting frustrated won't help the situation, I know that is easier said than done but the meltdowns are likely to be because of the shame he feels and that shame may also lead to him trying to hold for longer and/or being anxious about going. Just quietly clear away the pants for him. A typical 7 yo should be able to do this this independently but he's clearly not at the same developmental stage as a typical 7 year old.
Make a claim for DLA, covering the extra costs with a child's health conditions is exactly what it is there for.

The nurse felt his stomach and said he was constipated then prescribed the movicol and picolax.

That was probably a year ago and he hasn't had a clean day since. My life is just a relentless deluge of poo and I know it's starting to embarrass/upset him too.

We had this with my daughter when she was 7. Constant poo accidents. We also went down the constipation route, made sure she drank 1.2 litres of water a day minimum (or squash, not milk), and made sure her diet had plenty of fresh fruit/veg and minimal processed foods. We then had to make sure she sat on the toilet an hour after her evening meal for a considerable time to try and empty her bowels. It did work eventually but took about 12 months to be mostly accident free. She is now 9.5 and does still have the occasional accident, but sorts herself out.

I would ring ERIC and ask for some advice. I would expect them to say do the disimpaction again and then help you work out a maintenance routine. That is harder than the disimpaction stage. We ended up with sodium picosulfate only for the maintenance stage. It took 9 months ish for us to get sorted from first disimpaction.

I wish you luck op. GP’s are so cr*p with this kind of thing. Continence nurse we saw changed our lives - literally.

also at 7 I’m not surprised your ds isn’t brilliant with sorting out his pants. Deep breaths & patience and lots of encouragement

it could be that he’s not taking himself to the toilet when he first feels the need to go so you might need to set him a routine of toilet sits with feet on a little step or stool & they sometimes recommend rocking forward & back with a soft (big ish) ball on their knee. Our nurse called it ‘rock and poo’ - once for each year of their age

obviously food makes a difference but that’s probably tricky - drinking water is really important though

have you tried the dettol laundry cleanser? I found it helpful x

I do help him and have never told him off or made him feel it's something he should be embarrassed about but his reactions to being asked if he's an an accident is getting more and more extreme.

I would use napisan for cleaning his clothes. It's used to baby poop explosions so should be able to handle the smell and stains.
I would stop the laxatives. Or at least try and reduce how much he's having, he definitely shouldn't be going multiple times a day. Maybe try a laxative every other day and see if his need to go reduces? He doesn't sound constipated anymore!

It’s good that you’ve been referred to the right medical team. Continence nurses are also great if you have the service in your area.

On how to clean this: rinse the solids out (in the loo) 60 wash with a capful of zoflora instead of fabric conditioner.

I was also going to suggest the ERIC helping but another resource I was given by my health visitors was The poo nurses https://www.thepoonurses.uk/

Their website has some good advice on it and there's an email address you can email them on too. Wishing you the best of luck.

I feel for both of you.

Even if you've never told him off he's going to feel your frustration. He's old enough to feel ashamed and that is likely why is reacting so badly. He may also have pain if he's trying to hold it back and then again when it leaks out.

Most soiling is a combination of physical and mental/behavioural issues.

Absolutely agree with the ERIC helpline.

Also contact your GP on Monday. I know you've got an appointment in a month with the continence team but it sounds like you need help now - they might be able to send a message asking for advice.

Have school mentioned anything? Is the soiling happening at school or is he holding on there? Do they have any other concerns about him, his behaviour or development?

Have you done a diary looking at when this happens, what is happening beforehand - do you see any signs of discomfort first? How far away from a meal is it? Any clues might be helpful.

Would he talk to you about it, how it's making him feel and reassure him that you know it's difficult and you're going to try and get him help? Ask if he thinks there is anything that makes it better/worse - he might have some ideas to explore or at least listen to. He might have ideas that are wrong - that it's his fault/ he's dirty that you need to let him know are not the case.

Is your son doing "full" poos in his pants or is it more like "fart with follow through"? If it's only a small amount, could you put small panty liners in the back of the pants to collect the worst? Obviously that might not help if it's a full poo.

My daughter had issues which were not due to ongoing constipation, though may have been caused by that initially when a baby - resulting in a stretched bowel and huge poos, meaning she would not always feel when it was coming and a bit of soft (healthy) poo would come out first. She was on the laxatives for ages which I think made things worse sometimes, and I got the impression that the continence nurse (as lovely as she was) was only really focused on constipation.

However, now at age 8 it is mostly under control except occasionally when she eats badly if we're away from home - other than her body growing up to catch up with the size of her poos, the thing that has made the most difference is being allowed to have her water bottle on her desk at school so she will drink enough on school days (only kids with medical issues are allowed that, the others have to leave them on the side). Also getting her to drink weak squash at home as she'll drink more of that than she would water.

We put a Natracare Mini pantyliner in her pants on school days (we buy multi-packs on line), just to be on the safe side - they're small and not full of the scented stuff in some of the mainstream brands that might cause irritation.

It's somewhere in between.

We're doing all the stuff - meds, water, decent diet (not perfect, but it's not terrible either- we eat plenty of fruit/veg and not a load of processed stuff).

I feel like it's more than constipation but I'm genuinely at a loss what to try next.

Is he sitting on the loo regularly for 20 minutes to poo properly? With a footstool for support? We had to bribe DD with iPad games to sit on the loo but it made a difference.

and keep up the movicol. You may need to do another big disimpaction and then keep going with a maintenance dose for a long time (years) to fully retrain the bowels.

Are children never referred for a colonoscopy?

Yes, the specialist nurse said to get him to sit on the loo for five minutes twenty minutes after each meal. He has a stool and gets tablet time.

But he's started refusing to the point of screaming and sobbing so hard he chokes. I can't physically make him use the loo so it turns into a battle every single time. I mostly win (in that he uses the loo) but it's exhausting for both of us!

If he is crying when sitting on the loo, it could be that pooing is v painful. Might he have an anal fissue? They are v v painful and can cause a child to become afraid of pooing and then become constipated.

if he does poo on the loo, is it soft? He may need more movicol.

He's not crying on the loo.

It's like he's leaking poo all of the time because he's never clean for long and I'm utterly ground down by it- the washer is never off, I'm spending a fortune every month on bedtime pants and underpants.

If I ask him to use the loo, he refuses. If I insist, he gets upset and starts crying, throwing himself on the sofa, and getting angry. It's like watching an overtired toddler have a tantrum.

I've tried being firm, tried reward charts, only letting him have tablet time on the loo, sweeties as a reward and the tantrums/meltdowns over using the loo are just getting worse.

He genuinely had me in tears tonight with his behavior over it. I knew 100% he'd had an accident and he denied it several times, then when I told him he needed a shower he ran off into the kitchen, threw himself on the floor, told me he hated me, and screamed at me so much he nearly made himself sick.

I just genuinely don't know what else to do. He's tall for his age, and I'm quite petite so I can't physically make him do anything. I've never raised my voice, never used threats or anything but irs just getting worse.

He's also getting 4 movicol a day which is the matainance dose recommended by the practice nurse who referred us to the continence team at the hospital.

I don’t have a lot of advice, but sympathy as I have one who is similar and is 7 in a few months. She does dribbles of wee and small amounts of poo sometimes. I recently felt it was worse and did an incentive thing where if her pants were dry by the end of the day she’d get a prize, and discovered she really can’t do this, she hasn’t had one day, she got one prize when I reduced it to a half day. So concluding that she would do it if she could. I think til now I’d not felt it was a big deal but am on the stage of feeling this needs looked into. In her case she seems to struggle to identify needing to go until things are at an urgent stage, and she describes it as ‘too painful to hold’ when it is urgent. She does little dribbles at school but never enough to smell and teacher unaware. Anyway, solidarity. The shit is the worst. I agree with pp they feel the frustration, even when we don’t say it. But be kind to yourself; it’s not an easy thing to accept. And personally, I just buy cheap pants and chuck them if they are too pooey. I know wasteful but keeps me sane.

Without being graphic…is it full on accidents or just leakage/stains? My child had the latter for years and it was due to constipation. Even now he produces the most humongous turds I’ve ever seen. But at that age the doctors said it was because poo was sort of leaking around the big blockage. It’s unpleasant for everyone, especially him so I would just keep up with the gentle reminders and try not to get too frustrated. I’m led to believe it’s quite common.