4 year old pooing knickers

[Lexi82]

Need some advice on this please

Dd is 4 and has been using the toilet for over a year for wees but she hasn't got the hang of poos yet.

Every time she goes to the toilet she has poo in her knickers, not a lump but skid marks. Sometimes small but sometimes the knickers are beyond saving. She also has wet poo on her bum. When she does poo they are small and soft but she always poos in her knickers before she gets to the toilet.

About once a week she will do a "massive poo" -her words, but half/most is out before she gets to the toilet.

I don't know if she's constipated and this is over flow which was my first thought or there's something else??

The nurse at my gp's said to make her drink more and eat more fibre and give her lactulose. I've tried but no different.

Do any mums have advice please???

Sounds like constipation with overflow and soiling. At which point lactulose is pissing in the wind. The NICE guidance (which is actually pretty good on constipation) advises use of a macrogol (movicol/laxido). Tend to need to get them pooing gravy in copious quantities for days, to get rid of the old rocks, then keep it at the soft end of normal for months whilst the rectum shrinks back down and recover. Recommend www.eric.org,uk