faecal soiling - 4, nearly 5. Plse help

[Mummyisamonster]

I know, a lovely subject for Sunday tea-time but I'm desperate.

DS is 4, 5 in November, and has recently started soiling his pants every day. Prior to this he'd been ok, using the toilet appropriately etc.

We're tried bribes, reward charts, being 'chilled' about it and pretending we don't mind etc etc. Even when he smells of poo he denys he's done anything. We always have to 'inspect' his trousers and inevitably find that he's soiled himself. He's always very sorry, and promises he won't do it again. This has been the pattern for the last 2 weeks.

Thinking he might be constipated we took him to the practice nurse who prescribed lactulose. So now when he poos himself it's runny, not solid little pellets..as before. Progress maybe?

He won't go to the toilet himself. Except for wees. We ask and he refuses. So we leave him, with warnings to go, and then he poos himself.

It is driving me mad. And DH. And I'm ashamed to say I've just threatened to throw his toys away if he does it again. .

Any advice?

Hello MIAM. I'm quite an expert on this now having a dd who has suffered with constipation from being potty trained (she's now 8).

Forget about throwing toys away - that's implying he's doing something wrong (it's not your fault, it's what anyone would do)

The lactulose is going to wrok by clearing out his system and once that's happened, he needs to find a pattern to make sure he poos regularly. Perhaps letting him draw a chart so that for example, he has a bath, tries for a poo (5 mins on loo) and then a story before bed. Let him tick off after each one is done.

When he soils, just say "whoops, let's clear you up" or similar and don't make a fuss just like you say.

It needs to be consistant so even if you go away for a couple of nights, make sure he sits on the loo at the same time - the Movicol (stool softener) chart recommends 5 mins after each meal.

Check out too the Bristol Stool Chart (google will find it) and have a look at the poo types . His poos need to be a number 4 (sausage with no cracks). From your description, I would say he was a about a number 2 so quite constipated.

Increase the amount of fluid he drinks - give him loads to drink regularly and increase the amount of brown bread, green veg and weetabix type products as it will builk up his stools.

If the bowel muscles become slack and you just leave it and hope he'll work it all out, the problem will get worse (like my DD's) so my advice is if it doesn't get better in a few weeks, ask GP to refer to consultant. Once you're on the books, you'll have regular apps so they can monitor it all and they can investigate more quickly if they're already seeing you and you need further stuff checking.
Hope this helps.

ps - in this hot weather, my top tip for spoiked pants is take them outside and blast with a hose, then wash as normal!!! Or chuck - it's really not worth the hassle!!!

Hi, I have just joined mumsnet. If you are still experiencing problems google encopresis. Your childs symptoms sound just like mine and there does seem to be a lot to learn to get this situation right. Our GP's didn't seem very clued up about it sending us away twice till I identified the condition myself a year later and requested pediatrician. He was excellent and offered a strategic course of treatment of Senekot, lactulose and intermittent enemas to break down the impaction.
Reading blogs I learnt he should also avoid carrots and bananas. Apparently eating popcorn helps but my lad doesn't like it. Trying to get them to poo can be impossible because of the fear of pain. The loss of control is due to nerve endings of the overstretched bowel being numbed. It is crucial the blockage is dealt with. Food was not really the issue in my childs case. It turns out he was terribly stressed because of a bully at school and a very fierce teacher. Reassure him he is not alone. One child in each class may suffer from this.