DS takes SO long to do as asked - impacting on going to the loo...

[BarnMummy]

DS1 (6.5) has always been one for taking his time to do as he is asked - as my mum puts it, he always has to build a lego model between putting one sock on and the next.

For the last 3 months or so, he has been having a problem whereby he will quite often do a bit of a poo in his pants before he will go to the loo (having been totally "clean" for 3 years or so). I have looked up lots of stuff about encopresis, and spoken to our Dr, who has said that she thinks it is not physical, more that he has learnt to ignore the urge, and so it is a question of "brain training".

I am now thinking that the two issues are linked. He ALWAYS finds something else to do before he will do what he needs to do, whether that's getting dressed, coming to the table, getting into the bath or whatever. I think that he has got so used to this pattern that he is even ignoring his own body when it is telling him to go to the loo.

I try to make the dirty pants a non-issue and deal with it lightly, but obviously we need to get this sorted out. It often happens after school, so I try always to remind him to try as soon as we get home, but sometimes I forget, and I wonder if anyone has any thoughts on how to help him remember himself: if he can't even remember by himself on a normal day with no added distractions, he is definitely not going to remember when he is out of normal routine, either at someone else's house or when friends come to play etc.

Am I expecting too much of him to remember by himself at this age? Responding to an urge and planning ahead (which he now needs to do since he seems to have learnt to ignore the urge) are two different skills and I don't know if it is reasonable to expect him to be able to do the latter?

Any thoughts on how to deal with this welcome - and sorry this is so long!

hmm I would be getting a second opinion from a different GP

in the meantime - the poo that leaks; is it skiddy/loose/very smelly?

and the poo that goes in the loo? look at the bristol chart here

if he's lost the sensation of needing to go, that will need professional intervention, and DS needs to see a specialist, you can't be expected to deal with this without expert input. a big face to the GP

Thanks for your message: it sounds as though you have some personal/professional knowledge of this! I am assuming that you ask about the different poo consistencies because of the usual encopresis pattern of constipation + leakage?

I don't think that he is constipated: it is all normal consistency - and he will often do a good size poo 3 or more times a day - which has been normal for him since he was born. This is what has stumped me, because almost every resource I have found about encopresis talks about this as the root cause, and the treatment of movicol etc to clear out, followed by re-training. I cannot think that movicol (of which I have some experience as my dad was given it) would do anything except make DS's life utterly miserable.

I am very interested that you think he will need professional intervention for having lost the sensation of needing to go - I will look into this: could go private (through DH's work policy) if GP still not being helpful. Am I looking for a gastro-enterologist?

yes, one of my children has had periods of dreadful constipation

Press GP for a referral - not sure if the continence clinic, or a paed, or someone else would be best

Good luck