5 year old DS with dirty pants... HELP!

[Britchic]

Hi everyone

I have a gorgeous just 5 year old son who has always struggled to keep his pants clean. He used to regularly do a full wee in his pants, and it is better now, in that it's just a damp patch.

We have tried sticker charts / big rewards etc, but I just realised that he hasn't had a single sticker for dry pants since July.... that is nearly 3 months of dirty pants!!!

Usually it is a bit of wee, but recently it's been poo, 3 times while he's been at school in the past 2 weeks. I know he doesn't like to do poos at school, and it's complicated by the fact that he has a small haemorrhoid (so never sure quite how much it hurts, I don't think it does though).

When I ask him why he sometimes says says that he just wanted to play, but often says 'I didn't feel it' - I don't know if this is an excuse, or if there is a more significant problem.

I have been getting cross recently, and getting him to wash out his own pants, and I'll feel awful if it's a genuine problem.

Please, please, please, does anyone have any advice?! I am taking him to the doctor (on another matter) in a couple of weeks, but really appreciate any help in the meantime.

Thanks so much

ps meant to add that he also still wears nappies at night and usually wakes with them soaking, but that's not bothering me nearly so much as the wet/dirty pants issue!

How regular does he go to the toilet usually and can you try and establish a routine? My dd hates going for a poo at school so after brekkie I make her sit on toilet for 5 mins then same again after tea before she goes out to her evening activities. Took few days to get into routine and she whinges about sitting on toilet but she goes 99% of time she sits on it now and so she doesn't need to go at school

Could the poo marks just be due to poor wiping skills? Neither of mine make a good job of wiping.

Google encopresis and witholding. See if anything rings bells.

Hi,
I totally sympathise with why you're going through. My eldest DS is now 7 and a half and only just managed to stop dirty pants. With him I was always a case of poo and not wee and I'm not sure really what the problem was. He always struggled with wiping himself as his poo is often 'sloppy' but this is due to regular medication that he takes. So many times he was sent home from school because they ran out of spares or because he made such a big mess they couldn't cope! In the last year it has been more small accidents confined to his pants. Within the last few months he has gained the confidence to wipe himself and I've not had an issue for ages. I had him checked at the doctors and hospital and he all sorts of tests but thy never found anything. Does your DS wipe himself ok? I used to get cross with him and lose my patience as I understand how frustrating it can be. In the end I stopped making a fuss about it and just left it and it ran its course. Whether it was going to do that or whether that was the right approach to take I couldn't tell you I'm afraid.
On the night time side, he is still unable to go through the night and until very recently was still wearing nappies. You can't force them into this because if they are unable to do it what can you do?? I tried restricting drinks after 6pm but feel so mean when he says he's thirsty! The doc suggested going twice before bed so you take them once and then again ten mins later as often the bladder doesn't fully empty. This kind of worked and sometimes he is dry all night but he is at the stage now where he realises that no other kids his age wear nappies to bed so I lift him every night before I go to bed and this has worked really well (apart from last night when at 12 he had already wet the bed). I don't know if he's just a deep sleeper and the urge to wee just doesn't wake him ... I don't know! In contrast, my other DS who is 4 and a half has been dry at night since he was potty trained at two and wipes his own bottom since he was three!!
I would maybe try and see if there is a pattern as to when he poos and getting him to sit on the toilet for 5 mins is not a bad idea. He is not alone in not wanting to poo at school - I know an awful lot of children who are the same. Try not to worry too much - I think I made it into too much of a big thing maybe and hard as it is, try to take a deep breath and just remove dirty pants without any fuss.
I hope things improve, I just know how frustrating it can be. X

Also I find wetwipes helps with the wiping dd is 8 and still uses wipes at home. Could ds take a very small pack in his bookbag to school that he could just slip in his trouser pocket if he needs to go at school?

On a practical note - Lidl do flushable wipes. Ordinary wet wipes and baby wipes should not be flushed as they block the drains.

I suffered with encopresis as a child and this sounds very similar to what happened to me and how my mum dealt with it. In the end, I went to a doctor, had my bowels and intestines emptied under general anaesthetic, then went through months of enemas and taking dulcolax (gp prescribed), which I hated.

To be honest, i have ongoing issues today, however, if this does turn out be the case, I can reassure you that it seems to be kept very well under control with a good well balanced diet, lots of fluids, and in the event of a relapse, a couple of days of lactulose.

I remember my mother really stressing about it, and I remember being quite upset myself, especially by her anger, but as I have grown up (remember this was 30 years ago), it has become pretty much a non-issue that is easy to deal with.

Apols if that was TMI by the way

I agree with Chundle. We have had a similar problem. Trying to instil a routine after breakfast and after tea is working! PM me if it would be helpful.

Wow thank you all so much for your replies - really appreciate it.

It's not a wiping issue (because of his haemorrhoid I always did the wiping until the last few months as I didn't want him to aggravate it. He now wipes himself but I check it).

Encopresis sounds like it could be right, in that he does try to withhold poo - I sometimes find him sitting on the floor, squirming and making faces (I think he's got so desperate that he knows if he stands it will come out), he's very reluctant to go to the loo, but if I carry him to it he will go. And he does get a bit constipated at times, even though I try really hard to give him lots of fibre. But.... I don't think he's getting the leakage associated with encopresis, when he has an accident it's a proper (usually fairly hard) poo in his pants... sorry so much TMI!

I might try the sitting on the loo after breakfast, though we're usually late for school by then! And I think I will take him to the doctor sooner than planned.

Diet wise does anyone have any advice? He drinks lots of water, has brown bread, weetabix or porridge (with bran) for breakfast, fruit twice a day, lots of vegetables, for his school snack he usually has a whole grain/fruit muffin and some raisins. Any other ideas? Or anything I should avoid (he loves bananas and I've got a feeling they're not great).

Thank you so much, so lovely to have all those replies!

Cut down on milk a bit if he's having it in large amounts also try adding some prunes or prune juice to his diet. Linseed on cereal is good as well. Could he get up five mins earlier so has time to sit on the toilet? I don't have that issue as my dd is a veryyyyy early riser!!

Hi Britchic,

My boy is 4 1/2, just started school and we had similar problems in the first 2 weeks at school - in that he pooed his pants every day and was unable to wipe himself, and just didn't want to poo unless it was right at the last minute and then too late anyway. He had always been slow on all matters relating to toilets anyway.

We used the biggest bribe we could think of (a mega t-Rex toy) and said if he went for a poo after tea and before his bath, and did so every night for a week, he could earn it.

We then sat and read a story while we 'waited', so it's more 'time for a story' than time for a poo, and amazingly, he pooed!! Then he quickly adjusted to the new routine. I think trying to shift the routine whether its to morning or evening was the best solution for us - and the bribe did the trick.

I know just how you feel about getting cross, too - I was the same. I guess trying to remember they're still young and learning helps us to be a bit more understanding - I know deep down that it's more stressful for my son when I'm angry and punishing with him, so I try and do the positive bribe thing, which seems to be better for me and for him and also every one learns things at their own pace.

Good luck - I know how tough it is. X

My 5 year old equally gorgous ds started the same dirty pant thing when he started school last Sept. Actually, he has been better for weeks then tonight grrrr... So frustrating but I think very common. My ds eats well, drinks well but I truly believe is just more interested in playing than 'missing out' by sitting on the loo! He won't go at school which I think was the trigger. I got cross too, hated myself but it is so horrible to have to deal with the mess all the time.... Am better now as is he, we just had a chat about what a pity he had done it again etc. The penny will drop.... good luck

When looking at diet, it's worth remembering that there are 2 types of fibre: soluble (fruit, oats, veggies, soy, lentils etc) and insoluble (wheat corn and rice bran, whole grain foods, the skin of fruit and veg).

Most people, when they think of fibre, think of the latter type. But if you eat lots of that without a corresponding amount of water, it will cause hard stools and constipation just as surely as not having enough fibre in your diet.

My personal issue as a child was caused by being constipated and then the pain of passing the subsequent impacted stool. Eating a good mix of fibre makes all the difference - if the stool is easy to pass, the desire to hold it in is greatly reduced.

Hope that helps!

Hi all

Thank you so much for even more replies!

You're right, getting angry isn't the right thing to do, I just feel like I've really run out of options! His sticker chart reward is 'Sam's day' where he gets to do and eat anything and everything he wants for a day (my older son had this as a reward a while ago, and Sam has been desperate for the same)... but I think the sticker chart has been going on for so long he's lost interest!

I did tell him he could have a chocolate bar tonight if his pants stayed clean all day, and although they were slightly smelly (wee drips....!), he got his chocolate. Do I just have to live with wee drips?!

Balletmoo thank you for the diet advice, I'm really looking into this.

I did pick up some 'prune powder' at the market today - it's 80% prune powder, 5% salt and 15% sugar - do you think it's worth trying? No idea how to give it to him! I'm guessing mixed in with a smoothy...

Incidentally, Tirednesskills mentioned that he's too young to be washing his own pants... what do others think? I did it because I wanted him to realise (especially as I still suspect the accidents are because he doesn't want to stop playing) that there is some consequence to him not going to the loo. It's not done in an angry way, we just go to the sink together, and he runs them under water (I've got out anything big!)... is that too much to ask?

Sorry for such a long post, really appreciate your help!

My 5 year old (will be 6 in Jan) was medicated for a good while for witholding, constipation issues.

He has been off all supplements for a while but still occasionally soils and pretty much every day you know he has been dribbling a bit of wee in his pants.

Routine routine routine was what improved things a lot for us (coupled witht he supplements for the poo). He is told to go for a wee on waking, before leaving the house, before meals etc. He is getting there and sometimes takes himself now :)

We did the sitting on the loo thing after dinner while running the bath. At first it took 15-20 mins to have a poo and we read most of the works of roald dahl on the loo but now he goes after dinner and does one right away. He now mostly knows if he needs a poo and will go at other times.

I figure the dribbling will improve in time. We say the accident doesn't make us cross but if he hides it then the hiding makes us cross. We are also taking the hygiene route so pointing out that it smells etc and if his pants are particularly wee smelling at the end of the day we have asked him to sniff them just so he realises that it does smell. It is so much better now though so I'm fairly relaxed and I know it will be better in time. The annoying thing is doing the sniff test on school trousers to see if they are ok for another day or not!

www.mumsnet.com/Talk/general_health/553228-please-help-me-with-my-seemingly-incontinent-8-year-old
This thread is one I always remember because I felt so sorry for the little girl, and for her mum once she realised it was a medical problem.
Hopefully it is not anything like this for your poor DS - my DS at the same age was often 'damp', the only time wee were ever cross was if he didn't tell us, I tried to reinforce that there was nothing to be embarrassed about and everyone had accidents. I don't believe that children do it on purpose or because they are lazy, it is far more likely that he really can't feel it.
At 7, DS has totally grown out of it-he started school(German) a year ago and has never had an accident there, and I can't remember many in the last year of KG.
Please do not make your son wash his own pants, make sure he has always got access to clean ones and just keep reiterating that you don't want him to be sore. Not smelly, or dirty etc. Good luck.

I think you are giving too much insoluble fibre. If I had all that bulky fibre in my diet I would end up with large, impacted, rock hard stools.

Stewed fruit, cooked carrots, grapes, oranges - theses are the things that are good for kids.

Weetabix and bran can turn into a huge solid blockage IME.

My 5yo DD1 has pretty much the same issues - damp knickers/trousers/skirts from wee drips/leaks (not full on accidents but pretty damp), poo stains (again not full on accidents but not sure if they're from not wiping properly or 'leakage' - I tend to think the former as she really isn't good at wiping {& sometimes doesn't even bother to try - just knickers up & off she goes!}) & saturated pull up every morning.

We have taken DD1 to the Drs before because she also complains about tummy aches quite a bit & her poos often tend to be a bit sloppy but Dr had a feel of her abdomen & said he couldn't feel any obstruction & just gave us some lactulose to see if that would help (it didn't).

No answers I'm afraid but I totally sympathise about getting cross - its hard to keep your cool when you're peeling off yet another pair of stinky pants! Luckily, DD1 problem doesn't seem to be bad enough for it to be noticed at school yet (at least nobody has said anything to me about it) but I'm dreading the day she comes home & says she wants a sleepover at a friend's house. I would be mortified at anyone else seeing the state of her knickers (plus the fact she's probably the only one of her friends still in nappies at night) .

Hello there - I'm sorry to hear your son is having so many problems and I agree that maybe a chat with the docs might be a good idea. Could the fact that this has gotten worse over the last few months be tied in with anxiety over school (new class / new teacher / or starting school)? I know that my 5 yr old struggled with school and anxiety generally at that age and other behavioural issues crept in as a result. After months of things getting worse and worse we tried a Top Trump Supercar reward scheme. Picked a topic DS loves and reward with a card every day for good behaviour or for a task successfully completed. I just felt that we were always giving rows, being negative and the small successes had to be celebrated more. It worked for us, its cheap to buy, the incentive to collect is a good motivator and was just a happier atmosphere all round. Good luck with it.

Hi all

Thank you again for the responses.

3littlefrogs: he does have a lot of vegetables too, with lunch and supper, and lots of fruit - grapes, apples, mangos, melon, watermelon, bananas... Not stewed fruit, mainly because we live in Asia so have so much lovely fresh fruit, but I might try him on some stewed stuff, perhaps with some of my prune powder mixed in!

Alitoomanykids: don't think school is the issue - he knows most of the kids (they were in nursery with him), he loves the teacher and school, and he's very confident and independent. I think the only issue there is the loos that he doesn't like! But I like your idea of changing reward tactics... the chocolate bar didn't work today - very damp pants

Noomininoo: thank you for the sympathy! Yes I'm mortified for others to see his pants... though unfortunately has happened on playdates!!

Trickodile: thanks will have a good read of that tonight.

Indith: glad it worked out for your son in the end. Yes, need to work on the routine!

Thank you all so much!

How did he get the haemorroid in the first place? from straining?

I think I would be wanting to involve the GP as what you have said 'can't feel it' and urinary incontinence too sound very much like a constipation type problem. If that is the case you can be refered to the continence nurse locally who will work with your son.

Eric is also a very useful resource.

Noomininoo - the only way to really see if there is impaction is to do an abdominal Xray.

Lactulose alone will not make any difference.

Impaction with overflow takes months, if not years to treat, and usually needs a range of different medication.