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?

I'm sorry you're experiencing this too. It genuinely is exhausting and costs a fortune too. I've thrown probably fifteen pairs of pants out already this month, especially the ones from school where he has an accident and they sit and fester all day. I'm convinced all of my clothes stink of it too, even though I use a washing machine cleaner every week, bio power and simple solution enzyme stuff.

My 7yo is in nappies for poo but he’s autistic and non verbal so I know it’s different, but it sounds like he’s feeling pressured and overwhelmed.

What is his cognition like? Does he have additional needs? Have you had a conversation with him about it?

Hey OP, Paeds doctor here. It really sounds like your little boy is still constipated and that he has never been fully disimpacted. I would ask for a doctor to feel his tummy and possibly an XR, we can see faecal loading on them.

there are a couple of well boys I have looked after into early adolescence who needed to be admitted to the paediatric unit for dissipation every few months. One 11 year old literally blocked the toilet he used there was so much poop.

it sounds like it’s really impacting your lives so I would really push to be investigated

Are you getting support from school? If they are aware they should be ensuring he isn’t sitting in poo at all or for long.

Ok, you said liquid in your original post and bio liquid isn’t anywhere as good as powder.

If you are doing the proper wash routine then it won’t smell, that’s just in your head. I used washable nappies and wipes when DD was little so am used to the laundry routine for shit.

He should be having regular reviews though. We had to taper DD off periodically to see how she got on as you stop being able to tell what is leakage and what isn’t.

DD witholds because she doesn’t want to stop what she is doing and go. She is also poor at drinking fluids. If she goes regularly she is much better but she is rubbish at school. She has started to get some sensation back but it’s inconsistent. But we get all the lying, hiding pants and tantrums still. But the “poo nurse”
team have been very useful. I can see light at the end of the tunnel at least but we are 2 years in.

The constant leaking like that (with that absolutely rancid poo smell) is b3cause of the movicol.

For it to do it's job, it also causes the leaking to happen.

We had this til my eldest was in year 7 or 8, by that point I was very awake to subtle signs he was heading for impaction and I'd give him a bisacodyl pill or two with a lot of water, and chuck fruit at him.

His eating habits weren't great and his water consumption wasn't adequate. So it was a case of me handling it when he was home (primary was pathetic with 'helping').

He's about to turn 18 now and is doing fine. He's autistic though, and has adhd. He wasn't getting the signals and was unable to sit on the toilet long enough to go, or fully empty.

Where he’s crying about going on the toilet, and also about having to wash etc after an accident. I’m wondering whether he has other sensory issues generally.

Does he struggle with noise and lights? Take off shoes or clothes when he has a meltdown? Rock or rub his arms or flap when he’s agitated? Hide under things like blankets or tables when he’s upset? Have difficulty with the texture of foods?

If so it’s possible that he’s also having trouble with the feeling of having a poo which is causing the constipation and the accidents are occurring as the poo leaks around it.

You have my sympathies, I’ve been there, it’s a nightmare. I recommend joining the Facebook group Movicol Mummies. I was amazed how common these problems are.

My daughter had the leaking poo thing - it was due to constipation. Essentially a hard dry poo is higher up and nothing can pass it, so anything less solid above it liquifies and runs down - it's like a discharge rather than a poo so he won't have any control over it. My daughter's resolved eventually with medication, and we were then able to make sure she drank lots and had lots of roughage so it didn't recur.

Sounds like our situation, my son is 6, we are just coming out the other side but it has been around 1.5 years of it. His was constipation, then emotional I think because he was worried/scared, and also his ability to focus on one thing and nothing else, plus he became so used to the accidents he didn't remember in that emotional moment of an accident what to do and what to do before the accident was a thing, he needed retraining.

Is this problem at school also?
When he has these accidents is he focused on something? A screen, playing, whatever it may be?
Does he have just wee accidents too, or fine with wee and accidents always include poo?
Does he have contact with dad, is it the same at dad's?
Have you/school noticed sensory or SEND traits? My son possibly has adhd which we didn't consider at the start of our journey.

No judgement here, I've gone through the stage where refusing to tell me or go to the toilet was a thing. But in our situation the above questions made me see some patterns and it helped me understand.

With the toileting i had to give my son asked much control as possible. So we sat down at a time when he didn't need the toilet and we talked about a list of compromises. I placed the toilet blame on the toilet almost saying, 'the doctor said to do X, so mummy is trying to help. How can we make it easier for you?' Likely to say screen time, have a little basket of the screen, book, Fidgets, toys. It stays there at all times. My son needs the smaller seat and a stool too, so we left it ready on the toilet or he wouldn't use it or find that too much to deal with while panicking. So for every rule you put in, come up with a compromise. ' the doctor said we need to sit for X amount of time, could we use a timer that is left in the bathroom. As soon as you are off would you then like the option of a treat' have a treat basket. This means there is routine and pattern to the toilet which helped my son a lot. If my son gets upset I explain i am going to walk away and give him a minute, and then I return because I found my presence alone sometimes made his behaviour escalate. He still thinks he is going to get told off, despite it just not being the case, but I have to be positive/nonchalant/easy breezy with it all and while we are sorting it i talk about the most silly things, I even sometimes make up a dream I had that makes him laugh. These times have now become less friction and more about 1 on 1 time/connection.

Also, knock on the door before you go in to the bathroom. Privacy is big from 6 years and up from what I have read.

Sorry, also I had to teach my son to check in with his body. How does your body feel right now, name the emotion. Your belly hurts? Could you deacribe that feeling, where abouts, read a book from the library about the body paying particular attention to the poo side. Eventually, and it took a lot of time, he now says he feels he needs a poo, he checks in when he has wind, pain, a funny feeling. But my goodness it has taken a lot.of time.

Thank you.

I asked for an X-ray last time and was told it wasn't necessary.

He has no additional needs.