5 yo unable to feel when he's pooing

[ShiftyFades]

Just back from GP, DS (5.6) has just been referred. Since potty training he's had accidents. Sometimes it's just a big skid in his pants, sometimes it's a full poo. I've never caused a scene, just dealt with it, thinking he'd stop doing it. He's never been constipated.

So, as the problem's not going and he poos himself (on average) once a week, I tried rewards, it sort of works but it took 5 days to get 3 stars, 10 days to get 7 stars. He gets to choose his prize and loves it.
This week he's had 3 accidents, on the second I shouted at him, I'm not proud but I'm at the end of my tether and he'd only just had an expensive toy 2 days before because he'd got some stars. He went on to poo his pants on the 3rd day - proving shouting doesn't work!

Last night, before going out and knowing he's been going in the evenings, we got him to sit on the loo. After a few mins he said he'd only done a wee yet when he got up - a full poo was there - he hadn't felt it.

I took him to the GP today who asked if he's ever constipated, nope. His poos are always of a decent size and soft consistency, he poos once a day, occasionally twice. So he's referred him. He has a good diet, plenty of exercise, no traumas and a loving home. I'm quite worried now.

Anyone else had a similar experience?

Yeah DS (8) can't feel he is doing poos or wees but he has a number of special needs and medical issues so this has sort of just been out on the back burner and he's still in nappies. I am hoping to give potty training another go in the summer with some bladder strengthening medicine but I haven't a clue what to do about poos

Ds doesn't have any special needs, tbh I thought he was just being lazy / too distracted by TV / playing. But the other night he did it in the bath, with the loo right next to him!
I think he doesn't get any of that pressure so he's unable to keep it in until he finds a loo. I just don't know what it is.

I hope your potty training goes well

This can happen with constipation, it's confusing as the child does poo and had regular accidents.

Sorry I wasn't suggesting that he did, I was just saying that because of all my DSs other problems this one hasn't been addressed properly yet and I really am interested in what it is that's causing it. DS is the same. He will sit on the toilet and try but I don't think he actually needs one when he tries (seems to be at set times like before the bath) but he just howls and screams because one isn't coming our (because he doesn't need one) so I think he definitely can't feel when he needs to

yes, I've never know him to be constipated. Can constipation be hidden? Going regularly every day, at roughly the same time, nice soft poos, all in one movement isn't what I consider constipation.

I knew you weren't suggesting that Hurr1cane
it's a crappy (pun intended) nightmare.

Constipation can actually present itself as diarreahea. Sorry to be graphic but the 'back up' escapes. I've known children poo themselves 5x in an afternoon through constipation. The fact he goes the same time each day though suggests it's not though.

Easy to have accidents in the bath as everything is relaxed .

Yes, I read about the back-up thing when I got back from the docs, but I really don't think it's that at all. This has been going on for 2 years (since potty training), I thought it was just learning / not being used to the feeling and so not knowing when he was going to do t. It's neither hard nor liquid, just utterly normal poo.

Maybe he's just taking longer to work it out, he's still only young, but the fact that he had no idea he'd poo'd yesterday mass me wonder if there isn't more to it. I can't find anything on the internet similar.

I will continue to support and not make a fuss - it's blinking hard though!

They suggested the constipation runs thing with my DS, I was sceptical, he had the medication for it, it made no difference. I think the stuff that comes out when they're constipated is a lot more watery and very loose as it has to squeeze through the sides (graphic sorry)

yes, like an overspill. His poos are utterly normal and regular - he just doesn't seem to feel it. It's very odd.

I shall make sure I'm extra supportive of him. I've tried describing the feeling - he doesn't seem to feel the poo.

DSs are also normal, that's why I was skeptical about constipation and was proven right after the medication thing.

I often wonder what it could be but always get a condescending "one thing at a time now hurr1cane" but he's getting old now at 8 to still be in nappies

The paed gastroenterologist explained to me this week that you can be constipated and still have a poo every day. It's about emptying fully the bowel, not pooing. And vice versa, only have a poo every 2-3 day and not be constipated.

We've had skid marks for years. Sometimes every month, sometimes every week, sometimes everyday. I also thought it was laziness, but when things got worse and he started getting accidents, I took him to the GP. A Xray showed he has fecaloma, in others words he is absolutely full of balls of feces. He eats tons of fruits and vegs, is very active, slim and tall, but still has chronic constipation. We are taking the movicol route to help him clear it.
DS2 is almost 8

It doesn't sound like constipation. Some sort of nerve issue maybe?

My DS was exactly the same and no one including us thought it was constipation as he had no obvious classic signs. He had never passed hard stools or strained to our knowledge. He passed regular soft stools.

We now know the wetting especially at night, the smears in the pants, the soiling and lack of sensation, passing poos in the bath plus the anaemia, irritability and poor appetite are all signs and there are many more. The warm water makes it easier to pass the stool hence passing it in the bath or after a bath. As someone else said you get blocked if you have not fully emptied each time rather than due to not pooing daily. If the rectum is stretched then you loose sensation and some poo sits in the stretched part so you do not fully empty each time. The excess poo/impaction presses on the bladder giving less warning for wees too. I could go on and on but you get the idea.

DS was actually totally blocked up and had lost all sensation. Sadly for DS he has not regained the sensation after years of medication and is due for an operation very soon and the success rate is not great. The faecal impaction was only diagnosed by xray which is not the recommended route to diagnose impaction but the Paediatricians were unable to feel it. A GP is very unlikely to be aware of all this.

Only the most experienced professionals in this field seem to be aware that a child can be impacted without showing obvious constipation. Gordon – you were very lucky with your consultant, we were not as lucky.

Please dont listen to people posting saying this cannot be constipation. It may not be but it certainly could be. Failure to treat the problem can cause long term or permanent damage.

Fingers crossed for your DS movicolforimpactation.

ShiftyFades, start reading about encopesis. I found these websites very clear, and some of the signs made alarm bells ring encopresis and mayoclinic.
Diarrea and constipation can co-exist. My DS's tummy was soft and flat, you couldn't feel anything, and he was not in pain. But his X-ray could have been use in a movie about drug mule, with dozens and dozens of these balls of poo up till the top of his rip cage. You need profesional advice, bowel education and maybe medication. So don't accept the "we'll wait and see" attitude. Things don't get better on their own. Go to your referral prepared.

should be encopresis

No ones said it CANT be constipation, it can be, we went for a treatment of movicol and went through all that and it didn't help so it's not constipation for my DS

I just said it's not the only thing that causes it because it's not the case in DSs little life.

HurrIcane - just because movicol didn't work for your DS it doesn't mean that your DS hasn't lost sensation due to constipation. Movicol has not worked for my DS either and he now needs an operation but we know due to xray that he was impacted and presumably that has caused the loss of sensation. If you have not had an xray done you cannot be sure.

Don't give up. Please ensure you are referred to a leading consultant gastroenterologist and that all the relevant tests are done including xray and in our case colonoscopy, endoscopy etc to rule out other causes. Movicol does not help children regain their sensation it just softens the stools and that may be enough for children who don't have a long standing problem but not for DS and many others. Sodium picosulphate is more helpful in regaining sensation but again didnt help DS hence the operation. If it is not due to an impaction then you still need an expert to find out the cause. Apologies if you have already had all these investigations and are under a leading gastro.

Thank you movicol, I will insist on an x-ray at our first appointment. He doesn't have any appetite issues / behaviour issues, just this poo issue. He does sometimes wee in his pants.

Thank you for arming me with areas to look at.

How old is your son now? I wish you both all the luck in the world with this op xxx

Thanks ShiftyFades - DS is nearly 10 and was diagnosed at age 6 but we don't know how many years he was misdiagnosed for. It is not easy to get agreement for an xray so don't be too hopeful. You may be better to see a private gastro if waiting times are lengthy as it is not ideal to leave it untreated for too long. Not all children will have all symptoms. The NICE guidelines list more. Constipation should always be considered as a cause of day or night wetting.

How odd wrt getting an xray, you'd think that was the most obvious thing to do! Things must have changed as it was the first thing they did when my friend had problems, this was years ago though I imagine cost cutting has something to do with it!

Movicol, right I didn't know that. They suggested that movicol would definitely work if there was a black age and said that even if they found one with an X-ray that they would just use movicol anyway then scared me with the X-ray stats and how he'd have to be sedated to have the X-ray (because of his needs) so I just believed them. I'll ask for a referral next time I visit the paediatrician (which should have been over a month ago but you know how these things seem to always be late)

HurrIcane - sorry I may not have explained that clearly enough. What I was trying to say was even if the movicol has cleared the impaction (as it did with my DS) they can have lost sensation due to late diagnosis. Clearing the impaction with movicol will not help some children regain the sensation. We have managed to fully clear out following movicol instructions ie 12 sachets a day but the sensation has not returned. Therefore even if you do an xray and it is clear now it doesn't mean your DS hasn't lost sensation due to stretching when he was impacted (known as mega rectum). I would get to a gastroenterologist, privately if you can as paediatricians rarely have much knowledge of this. How long did you do movicol and what type of dose as that should give you an idea of whether he was impacted or not? If it was not caused by impaction you still need an expert to find out the reason, not a paed.

It was last year now so I don't remember but it didn't make a difference to his loose stools and pooing lots of times a day, so I assumed he had no blockage. I don't know.