I am completely fed up with everything smelling of wee all the time - DS (5) still wetting/soiling himself almost daily (long sorry)

[iwouldgoouttonight]

Its really getting me down now - I just don't know what to do. DS is in year 1 at school and every day gets home and smells of wee - he sometimes doesn't get to the toilet in time, and sometimes just doesn't want to stop what he's doing to go. His pants are normally quite wet.

At home we have to remind him to go to the toilet but its always met with resistance, especially if its a poo. Today he's doing lots of smelly farts, says he has a tummy ache and hasn't done a poo since yesterday so I'm sure he needs to do one, but he is just refusing to even try to go. I've said he can't have any hot chocolate (which I'd promised him earlier) if he doesn't try, so he sat on the toilet for about 30 seconds and said he's tried and got off. Then the more I tried to pursuade him the more upset he got. I know he'll do a poo in his pants later if I can't get him to go on the toilet.

Yesterday after school I nipped out to get the washing in, got back inside and he'd done a big wee all down his legs, and was just standing there in a puddle on the floor. When I asked him why he didn't go to the toilet he just said he didn't know.

We've been to the doctors and had tests done to see if there was anything medically wrong but they couldn't find anything. We do reward charts, and he gets very excited if he does get a sticker, but he's not bothered if he doesn't get one either. I'm not sure if he's a bit old for sticker charts?

Sometimes he will go for a whole day and just go by himself all day - he'll just stop what he's doing get up and go, or if we're out he'll tell us he needs to go and we find a toilet. So we know he can do it, but he doesn't seem bothered about wetting himself.

I don't know if I should be more strict with him about it and tell him off because he's doing it on purpose, or whether he genuinely can't help it (but I find this hard to believe because of the times when he does go to the toilet without being asked - and even if he doesn't go to the toilet, if he needs a wee he will wriggle about and cross his legs so its obvious he needs to go, so he must know too).

DD is 2.10 and I'm putting off potty training her because I'm not sure if I can cope with both of them weeing everywhere. We did try to potty train her earlier in the year- we went for two weeks and she only did one wee in the potty in that time and the rest in her pants, so we stopped assuming she wasn't ready.

I don't know if we are doing something completely wrong, have two children with uncontrollable bowels and bladders, or just two very stubborn children!

did the gp carry out the full range of tests, or just lie him down, prod his tummy, and say he was ok? was he referred for ultrasound in the first instance?

have you been asked to measure urine output at any point? did the gp ask how much he drinks etc?

you aren't alone at all, btw, but some gps can be a bit lax about this stuff.

look up 'encopresis' - sometimes if a child witholds then they end up essentially constipated, with th result that softer bowel movements slide round the outside of the blockage and soil pants etc. it can also lead to urine leakage.

sometimes children aren't drinking enough, so their bladder doesn't stretch sufficiently, etc.

there are lots of possible reasons.

ultrasound is usally the first step (they will measure the bladder empty and 'full') but ds1 has also had bloods and x-rays etc.

two out of three of mine have still been wet/ one dirty at that age. and the third one was dry day and night at 2. so they are all different.

the one thing that does definitely help is sitting on the toilet after breakfast and dinner, for ten whole minutes each time. (one paed suggested a hot drink about ten minutes before, whilst finishing meal)

get a kitchen timer. it's non-negotiable in our house. 30 seconds doesn't cut it.

Thanks for your helpful comments. The doctor did a urine test and asked various questions but didn't do ultrasound or blood tests or anything. It was about a year ago when we took him and the doctor kind of pursuaded me I was worrying about nothing and DS will become dry in his own time. But now he's 5 it does seem a bit old to be having accidents so often.

I wonder if there is some psychological reason why he is holding wee and poo in - I wonder why he doesn't want to go to the toilet. I personally couldn't imagine anything worse than holding a wee in if I was desparate, but DS would rather hold it in until he just can't hold it any more and then it either leaks out or he rushes to the toilet at the very last minute.

I'm worried if he smells of wee the other children at school will pick up on it - I don't want him to be picked on because of it.

I can't imagine him ever being dry at night- his nappy is completely full in the morning and often leaks. We get him to go to the toilet before bed, but it doesn't make any difference.

Maybe another trip to the doctors is the next step then.

urine test just rules out uti, so just tells you he doesn't have an infection. (sorry, they do usually do that first, it's been such a long time - none of mine were ever +ve for uti! )

yes, i would go back to gp and ask for referral to local continence clinic. they aren't worried about night time stuff until 7 or so, but daytime issues do need to be checked out in yr 1.

ds1 does have some specific anxieties/ probably now classed as phobias around toileting in public, and we are probably awaiting psych as the next step. but it's not uncommon for kids of this age to be just too involved in what they are doing that they can't really be bothered to go - but constantly witholding etc can lead to more issues lol.

if it helps, ds1 has (to date) not been picked on at all personally. it will happen at some point one of our gp's used to say that would be the point he would decide he would use the toilet. but as a parent it isn't something you want to contemplate, really.

sure it will be fine, but go back to gp. if it solves itself in time, you'll know it was developmental.

(later on they will discuss meds or alarm for the night time stuff, but generally they focus on the day first. at 5/6, bedwetting is still entirely normal)

My ds constantly has wet pants and began to soil himself last week. He's in Reception but has never pooed in his pants previously. I tried telling off and ignoring, but frankly neither worked. However, a start chart did the business with poos very well. I broke the day down into 3 sections - morning, afternoon and evening (3.30pm till bed time). At the end of each section (e.g. end of lunch, 3.30pm, bed time), if his pants were clean he got a smiley face. He also got a smiley face for a poo in the loo. Six smiley faces equals a chocolate bar. He picked it up instantly and the poo issue has resolved itself completely. I'll be moving onto wees soon.

Would it be worth resuming the star chart (I don't think Y1 is too old), but breaking the day down into very small chunks, say every 2 hours, or even every hour. Basically, it will only work if he gets rewards. You will have to get the school on board. Work on poos first and then wees later? Obviously this will only work if he has control of his bowls and if he is constipated, he won't.

Good luck!

I know how you feel OP my DS wets his pants most days (though not often the floor anymore) and quite often poos them too. He has been badly constipated in the past and movicol helped shift blockages and stopped the weeing to the floor accidents.

He's nearly five.

Will watch with interest

I wouldn't get tougher on him when he does it, I'd imagine that it would make the whole subject more touchy. Could you try rewarding him more on the days he does go to the toilet? (I know you already do the sticker charts though ... )

I don't know if this still exisits, but when my partner was a kid, he actually wet the bed until 7 I think it was. (although to my knowledge, no daytime problems). They apparantly were given him these pants that made a sound when he began wetting himself at night - like a buzzer went off that fully woke him. He said that the problem was totally gone in about a week! Not sure if that kind of thing would help though if it isn't just a night problem?

I would go back to your GP as whilst it might not be a physical problem, it is clearly a behavioural one and they must have specialists/strategies to help.

Good luck to you and your little boy :-)

I would put the ball in his court. Start a reward chart/bribery thing that if he is dry/clean at certain points of the day then he gets a star and so many stars equal a treat (decide between you what this is). When he gets the hang of it up the number of stars needed for a treat. Have a chat beforehand about why this is a good idea- eg "we need to help you with your toileting as wet/dirty pants/clothes is not good for anyone" and this is what we are going to do. Straightforward, not emotionally charged.

Try to ignore all the accidents (hard I know) and praise praise praise when he is good.

I am just going through big time regression with my nearly 3 year old but I think she is coming out of it as quickly as she went into it. It's hard, but sometimes all the attention for the negative behaviour entrenches it rather than anything else and I think once they are reception/year 1 age unless there is an underlying problem they really need to know that they are in charge- actually even before this, I think my daughter is much better when she is in charge rather than Mummy nagging all the time. They get confused if you start to take responsibility.

DS is very good (just 5), but used to "leak" a little almost everyday certainly until 3 and a half and I could never let him wear the same pair of trousers more than one day for example. Somewhere between 3 and a half and 4 and a half this behaviour completely disappeared though without me doing anything. I think this is quite normal after they are trained- although it might not feel like it, I don't think there are that many children who go from not trained to trained in one clean sweep.

No advice I'm afraid re wetting/soiling but would second everything madwoman says as she seems to know her stuff.

RE toilet and poo. Blowing helps relax the anus so sitting half hour after a meal for 10 minutes whilst blowing up balloons can help. I did this with DS when he suffered impacted bowels and started Laxico.

Just on the sitting on the toilet for a long time thing, I tried putting DS on the loo after breakfast every day for ten minutes - sometimes it worked, more often he just got fed up

Our GP said look at when he naturally poos and work with that - don't try to force it at a time it's not going to happen or he will have bad associations with the whole thing. DS poos only in the afternoon and when I worked that out it made it a bit easier.

Not to contradict those on this thread who have far greater experience than me, but just another thought

You're not alone.

1. This book may help www.amazon.co.uk/Constipation-Withholding-Your-Child-Soiling/dp/1843104911

1. Movicol may also help

Just re-read your OP. DS's major wetting stopped when we treated the constipation properly with movicol - worth a try?

same for us levantine. Movicol has had a transformational effect. Don't know where we would be without it.

yy - that's the 'encopresis' bit - it just means constipation really, but has generally built up and caused a bloackage that can take some time to break down, and can cause damage to nerve endings if it is ignored etc, which makes it all worse as with an overstretched bowel and lack of sensation, accidents are inevitable ds1 had lactulose to start with (same as movicol really) and now takes lansoyl for the same reason. we also have to use enemas if he gets really bunged up.

agree that the timing thing can be varied - with school aged kids the paed recommends trying to get their bodies used to 'going' in the morning and the evening, but when ds is having a lot of accidents he also sits on the toilet as soon as he comes home from school. as he's a refuser, i'm almost certain that even when he says he's using the toilets at school, he isn't.

op - the symptoms you mention are all absolutely classic signs of faecal impaction - day wetting, excessive night wetting, smelly farts, stomach pain etc etc.

Please refer to NHS mapofmedicine website which lists all symptoms for it under constipation in children. we went years with doctor misdiagnosing it as our son did not display classic constipation but actually when you read all symtoms he had all the others.

we had huge dose of movicol to clear out and now have 4 sachets a day and 5 months later our lives are transformed with no accidents and hence no fighting at school for being called stinky.

Paediatrician decided it was behavioural without examination or xray because I said his poo was runny not constipated but of course I now know it was overflow (had never heard of it then). Had I not demanded an xray from another paediatrician and got a diagnosis consequences would have been very different as once professionals decide it is not medical they are trying to find another cause such as abuse!!!

I would strongly recommend going private and getting proper check for impaction if you can possibly afford it and dont run the risk of the accusations of it being abuse.

just to clarify in case op is confused - these are all terms for the same thing - faecal impaction/ encopresis/ form of constipation. we are all talking about the same issue.

Thanks for all your really helpful comments - I don't get a chance to check MN much so have only just seen them.

A question about the constipation issue - he does do a poo every day and it looks like a 'normal' poo - not runny, not hard and black. I had thought if he was contipated he would struggle to go, or it would leak out in a more runny form. But his seem quite large and solid looking. He doesn't seem to struggle to go physically, he just doesn't want to sit on the toilet so he will sometimes do a poo in his pants instead.

So to me it seems more behavioural. But could it still be constipation/encopresis if his poos look normal?

I know we need to try to get him to sit on the toilet for longer but it tends to make it into a huge issue and I was worried this would make him worse. I could get him to stay on for 10 minutes under sufferance but he would be upset and might he then associate pooing in the toilet with being unhappy??

I don't know I'm just talking out loud searching around for ideas.

Will take him to the doctor to check out possible constipation issues anyway though.

ds1 poohs on the toilet twice a day. sometimes v normal. i don't get it either.

try eric for some ideas and info - might give you a wider idea of how to move forward.

there's no way of telling, really, on tinternet, but encopresis is the most common and least dx reason for childhood soiling, so it makes sense to rule that in or out first, probably.

As i say i was convinced my son did not have constipation because he could poo on toilet and it was not dark or hard (I thought it looked normal) sometimes several times a day in addition to the soiling up to 10 times a day, some of which was runny and some grainy and poos in bath etc (as water acting as an enema). Because of this our paed dismissed faecal impaction and decided there was no medical reason.

We were at risk of losing our children because they decided it was ABUSE despite no evidence other than no reason for toileting problems. If I had not got an xray done I dread to think of the outcome.

My aim is now to raise awareness of this condition as a child can be totally impacted and you can be convinced they have never had any constipation as they can poo on the toilet. Our paediatricians did not even consider constipation because he was pooing on toilet in addition to the soiling which is so wrong and ERIC were equally ill informed.

NHS guidelines state that any child over age of 4 with faecal incontinence/soiling more than once a week for a period of 8 weeks should be checked for impaction even if no other symptoms so they should have assessed for this.

This is why I say go private because the 5 percent of children who are believed to soil for non medical reasons will be due to serious abuse not slight naughtiness or being lazy and being accused of this is the most horrendous situation to be in.

We are well educated parents and had researched all the symptoms, spoken to ERIC at least 20 times and been private as well as to 2 NHS paediatricians and my son had suffered for years.

He was fighting every day at school due to being called stinky and this has all stopped as movicol has solved not just the medical problem but all the knock on issues for the family.

I would push to see a specialist or at least a paediatrician as this is not normal.
If possible you could consider private to get a diagnosis. In the meantime work with school on a reward chart. Record any accidents (both you and school), including time, what he a was doing and type of accident to see if there is a pattern. This would help to identify when to really insists he has to go to the toilet, properly, not for a few seconds.

But I don't think a reward chart is going to be enough, I expect he needs medical help.

I've made an appointment to see the doctor about it in a couple of weeks (the earliest appointment I could get!). Very scary what you say about possibilities of being investigated for abuse latesummer.

Thanks for link to Eric site too - helpful to find more information about it.

I wouldn't know how to start going private for medical treatment - I would guess it would be unaffordable for us though.

Today DS did a poo and two wees in his pants and several wees in the toilet. This was quite a bad day but he has a cold/cough and is feeling rubbish so I think going to the toilet was the last thing on his mind.

DD is on 2nd day of potty training and has donea wee in the potty, which is fantastic as I have such negative feelings towards toilet training after DS that I'm sure she must pick up on them. Think the wee in potty was a complete fluke because she just happened to be on the potty at the time, but we gave her loads of praise and a reward and she was very pleased with herself so a good first step.

I was in tears about it all this morning though - the thought that there could be a medical issue with DS and what people on here have mentioned about it not being picked up my medical professionals is quite worrying. I feel like a bad parent for not knowing what to do and for allowing the DCs to pick up on my worries about toileting - its only going to make it into a bigger issue for them.