Still soiling herself and nearly 7 years old.

[Raximobie]

At my wits end. My daughter will be 7 in November. She never really potty trained properly. Always contrary, she refused to go to the toilet from the start. I tried delaying till she was older, to no avail. She calls the shots with the toileting and will only go when it's in her own interests to go and not because I suggested or asked or demanded. I have to keep checking her regularly for soiling or wetting. If I don't physically sit her on the toilet sometimes, she will not go and then she'd soil herself minutes after I've stopped asking her . I have tried every positive and negative incentive under the sun. She gets bored after a few days even if she is doing well and getting her rewards and will revert back to soiling again. She is on long term movicol laxatives to prevent constipation because she'll hold it back to prove she doesn't need to go. She is seen by pediatricians and other specialists but they are unable to help, but to give suggestions on incentives and routines.
The house has a constant smell about it. I'm constantly throwing out her clothing which are too soiled to be washed, she goes through underwear like tissues for a person with a cold. I cannot let her go to friends houses because I'm embarrassed that she soils herself.
I'm exhausted.
If there is a light at the end of this tunnel, please show me.

Ps, she is the third of three girls and has a younger brother who is two. I'm now dreading potty training my boy because of all this stress and am worried he might follow in her footsteps.

So she has control over her elimination functions, she just chooses not to use the toilet at appropriate times?

What about school? Is it selective when and where she soils? Would she ruin something for herself like a trip by soiling herself?

DD is 8.5 and we are exactly the same, no help I know but just to let you know that you are not alone. She has a paediatrician, is now under CAMHS.

My 7 yr old DS is similar. On movicol and nalcrom (for possible allergy) Has seen gastro for 4 yrs and a psychologist for a while. He says he doesn't feel it coming. We make him try for 10 mins after breakfast and tea which lessens soiling.

Weirdly 2 years ago he had a 2 month period when he went normally then it stopped. This suggests its more mental than physical.

We think DD's is more mental than physical but it has taken for years for the paediatrician even think that. it doesn't help that DD stuffers from stress and anxiety, she has very sudden and very painful stomach aches that she now throws up on.. I work for a mental health team and have been getting some good advice from them and our last paediatrician appointment she did say she was going to talk to a psychologist.

I haves to say after 10 sessions with 2 psychologists ( one a trainee) over a year it made no difference. But your dd sounds very different. We got some help with his anger (at being made to go to loo and spilled over into bedtime)

Our DD had problems at a similar age with poos. She would poo her pants, and said she didn't even feel it. I was a bit until I started reading about faecal impaction. Basically what happens is that after a bout of constipation, the rectum gets stretched, with the result that the nerve endings don't pick up the feeling of fullness that one gets normally when they need to poo. The result is that the poo just slips out without them being aware of it.

eric.org.uk is very useful and we saw a paediatrician who said it would take about a year to sort out and that is almost exactly how long it took. Our GP recently said he thinks wheat causes a lot of constipation, and we are trying to reduce DD's wheat intake.

My ds had a special procedure called an analrectal mannometry to test if he had those nerve ending and they are fine. The paediatric Gastro we see says it usually takes as long to fix as it has been going on for. Unfortunately in our case its already been double that.

I found Eric informative but the forum is very depressing. Kids even older than mine and still suffering.

My DS has done 10wks dairy free and 10 wks wheat free as a marker for allergies came up in his initial blood tests. But there was no difference. He also had a colonoscopy which found an area of redness which indicates an allergy. He was prescribed nalcrom which is meant to mimic the effect of giving up what you are allergic to.

Sorry to be so negative but after 5 years of this we have come to the end of the road medically and with the psychologist. No one has any new suggestions. I can't see any way for my son to have a normal life.

This could have been my Mum posting this. I had to take spare pants with me to school for years. I was treated for IBS and it helped. It turns out that I was intolerant to cow's milk protein - once we cut that out completely from everything (whey powder, etc) it solved the problem. If I over do it with dairy these days I get stomach cramps and have to run for the loo. She could also be contrary! But possibly it's her frustration at not being able to control herself too?

FYI, reup it wasn't doctors that identified my allergy. I saw a homeopath who did kinesiology (the thing where you resist pressure on your arm) and that was how we identified tannin, cow's milk (not goat's milk) and something I can't remember. It sounds mad but my arm went completely limp whenever we tested for cow's milk - I kept retrying because I couldn't get enough of the stuff (sometimes a sign that something isn't good for you as it turns out!).

Good luck. I don't remember every getting teased about this at school - it was just part of life. I guess my teachers were all informed, poor things.

Yes, exactly.

Thanks for all your comments. do is being seen at CAMHS and so far has had 5 sessions with a psychotherapist. School are trying to be understanding and helping but they say they cannot monitor every time she goes to the loo. She fibs about going too.
She went on school outings previously and they always had to take spares in case of accidents.
For specific situations she'll be more careful to go to the loo eg before seeing the pediatrician. They explained to me about faecal impaction and the effects on the nerve endings etc...she needs to learn how to feel the signals. But if she refuses to go to the loo regularly, how will she learn those signals?
I think she has more control than she lets on, and she doesn't care if she misses out on going places with her sisters - intact she's used to being left behind now, it's become matter of fact.
The pediatricians say they can't find anything physically wrong and that it's most probably psychological. They're hoping the psychotherapy will help.

If you are sure that she has control then maybe make her deal with the mess herself rather than you cleaning up? Then, apart from that, you back off completely. Suggest a couple of times a day that it might be a good idea to go to the toilet but stress that it's her decision. Maybe it's a power struggle and if you stop giving her something to fight against she might change her attitude as well.

We put books in the loo, and she had to sit on the loo for 10 minutes after mealtimes, whether she went or not.

Could it be that she is afraid of going to the toilet because it has been painful in the past?

Lastinglight, I rarely clean her up anymore. It was one of the first things they suggested - to get her to clean herself and remove her soiled clothing for disposal or laundry and to clean up any mess she leaves behind in the bathroom.
I think she doesn't always have control which makes it harder for herself to decide whether she needs the loo or not, but when I mention toilet time, she'll have lots of reasons why she can't,shouldn't or won't go. Sending her to the bathroom to get cleaned up is another struggle. She'd rather remain soiled and be left alone than have me nag her.
I believe it is a power struggle and maybe backing off might work. I'll give that a try.

Berylstreep, we have no space in our bathroom to store any books, but I do offer her the choice of books to take into the bathroom whenever I send her in.

Raxi do you know what happens at the psychotherapy sessions?

My ds plays on my I touch which relaxes him but maybe too much as he genuinely doesn't know if he's pooed or not if I go in to ask.

mine was like this. i remember feeling amazingly stressed at the time

if I can advise. sorry if im annoying you. I remember not wanting advice but a magic fairy wand to fix it all..... I lost my wand years ago. I might have broke it in a fit of temper...

ignore it. leave all responsibility to her to toilet herself and clean herself up. she needs referred to cahms

if she is somewhere fun... and she dirties herself. ask her to clean up but dont judge dont get angry or frustrated. negative attention is still attention... then once she is clean remove her and calmly take her home. even if it puts you out.

I used to get dd1 to carry a bag with wipes....clean knicks and nappy bags. the responsibility has to be hers to deal with.

and have a cuppa. this will pass xxx

Raxi, we have similar issues with out. 6 year old DD1. The stress of everyday living can be overwhelming.

We're on movicol and dulcolax. And will be for years to come. Our DD1 is a withholder. She also had an irritable bladder.

The things that have helped are;

Morning toilet routine with blowing up of balloons and a play on my Nintendo DS

An alarm watch which prompts her to go the toilet every 2 hours at school

Making going to the toilet her responsibility and not nagging her to go (which I find very, very difficult).

I have lost count of the amount of underwear which has been binned and have on occasion lost the plot over the whole business. I am dreading toilet training DD2.

In the meantime I drink wine and fantasise about not needing to cart about changes of clothing.

Reup, the psychotherapist has not actually given me a straight answer to what his strategy is. DD tell me all she does is play while he talks but she can't recall what the convo's about.??? I'll probably get filled in a some point.

Drewswife, DD attends CAMHS and psychotherapy. When the psychotherapist asked me what I expected from the sessions I told him a complete recovery. He said I was very sceptical.

I had this with DS2, now 11.

My advice, which will go against everything the experts are telling you, is to relax and let it sort itself out. I'd stop all the professional help.

Much easier said than done but I found the "issue" was really affecting my relationship with DS and my idea of who he was and what constituted good behaviour. e.g. Oh lovely picture DS2 but you've got dirty pants haven't you? Great score in your spelling test, but have you got clean pants? We would have had a lovely day out today if only DS had kept his pants clean.

Horrible though it is, cleaning him up, or him cleaning himself takes only a few minutes but could affect my perception of the whole day.

Also, for DS1 it was definitely, in part at least, as control/attention seeking thing. Once I learned to not show let it bother me and to have him clean up without a fuss and get on with the rest of the day, it made me far less miserable and did eventually resolve itself.

Frontier, my husband says the same, to leave her to it and she'll sort herself out in her own time. But how can I do that? If I ignore her soiling or wetting, she'll continue her day as though nothing has happened, completely ignoring her state of mess. She gets sore sometimes and I explain to her that it's because she didn't go to the loo and that if wee or poo stays on her skin and not cleaned off straight away that's what happens. She shrugs and moved on.
How do I deal with that?

Movicol is the bloody devil's work, and the drug reps have really done a number on GPs... it liquidises the poo. She cannot have any control over when / where she is going. It solves the back up but does not address the cause and in fact only serves to make it worse because it destroys all bowel muscle control.
We've been there.
What sorted it for us was a doctor who got us off the Movicol (slowly, titrating down gradually) while simultaneously giving an increasing amount of senna daily - titrating up to about 20ml / day until we got a poo a day. What senna does is send the brain a message that a poo needs to be done - it triggers a sensation that requires a response whereas movicol just makes it happen in a way that she can't possibly control. Senna use will help re train her bowel and let her recognise the sensation of needing to go, which Movicol simply removes.
for us, the withholding was a control mechanism. It was a purely mental issue, not physical, so it does depend on that being the same root issue for you.
Happy to recommend the miracle doctor's name to you by PM.
(NB this was a slow process, I'd say 6 months or more on the senna, but there was NO soiling as soon as the movicol was stopped and it took maybe a month or so to get to the stage of a poo / day. You could set your watch by it. Years on, never any repeated issue)

Yes, I said it was easier said than done!

She has to clean up, obviously, but there doesn't need to be any discussion about it and you don't need to be there while she does it - except maybe to make sure hands thoroughly washed afterwards.

Once I got to grips with the ignoring it thing I made a point of not speaking at all during the clean up.