4 yr old DD holding in poo and staining pants.

[SantaLucia]

DD potty trained easily at 2 yrs 9 months. We've had the odd wet pants if she was rushing to the toilet or if distracted - nothing out of the ordinary.

Pooing was always great. She took to it straight away. She was also dry at night after 1 week of training and has only ever had 1 night accident in her life.

Recently she has had poo stains on her pants. I thought it might be due to inadequate wiping when she is at pre school but it's been getting worse. I'm pretty sure she is holding poo in as she used to go once a day and be very regular. Now it's not regular. Her pops seem soft and normal, she hasn't reported any pain and her anus looks fine. The last few days she has had major weeing in her knickers as well. Really out of character.

I've tried ignoring it, getting her to clean it, throwing away favourite pants and replacing them with boring white ones, reward chart, talking about it, reminding her to go. But it carries on and I'm now at my wits end.

She is otherwise well behaved and enjoying life.

She also fiddles with her bottom a lot and says there is a funny thing in her bottom but I've checked it and it all looks fine. Tried thrush cream too and metanium in case poo causing irritation.
C
Please help!!!!!

We didnt go private - biggest mistake ever but anyone can go private but you need to see GP first which can be an NHS or private one to get referral to a peadiatrician. Dont know how much it would have cost but only hundreds not the thousands we have then spent on legal costs. I would have paid almost anything for my DS's at the time as his life was being totally destroyed with bullying over it and in extreme pain etc but I trusted the NHS.

Doctors and paeds can sometimes feel for impaction but not always. An xray will show for sure. Impaction cannot be ruled out if they cant feel it if there are other symptoms. Nice guidelines do not recommend x-ray as standard which is reasonable but woth pushing for if they have no other explanation as it is far more conclusive than someone feeling.

Remember NHS research shows 95% of children with soiling is due to impaction. There are other less commom causes too but unlikely to be behavioural/emotional unless your DD has suffered some trauma or abuse so best rule out the most likely cause first in my opinion than focus on the less likely and miss the obvious.

OP - my DS2 was similar at that age. He was stopping himself from going, and then getting in terrible state, wetting himself, marks on his pants etc.

I saw the GP, she checked his tummy, said it wasn't impaction, and suggested a few things which have generally worked.

Most are obvious - fruit, brown bread. I found rice cakes made it worse. Lots of water to drink.

We had a long chat and planned a sticker chart, for home as well as school. He was to go to the toilet as soon as he felt the urge, no matter what he was doing (part of it was that, if he leaves it, it become more painful, and he puts off going even more).

It has worked, although he is still unsettled if there is any change to his routine.