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4 year old has faecal incontinence

14 replies

ChickandHog · 07/01/2024 21:30

We started potty training our daughter a couple of months after her second birthday. She has recently turned four and has mostly almost never been able to recognise when she needs the toilet for a bowel movement; she doesn’t seem to have any sensation awareness or get any warning that it’s about to happen. She also doesn’t tell us after she’s had an accident, but I think this is mainly due to embarrassment/being in denial. She has total understanding about what she ‘should’ do i.e. wees and poos go in the toilet, not in our knickers etc.

She also will rarely self initiate to go to the toilet when she needs a wee, but we are generally able to notice when she needs to go and so tell her to go and sit on the toilet to go for a wee, so we manage to have very few accidents as long as whichever adult is with her (parent/grandparent/nursery key worker) regularly gets her to go to the toilet. I recognise that this is really her complying rather than recognising the sensation of needing a wee and acting on it, but I do think she has more sensation awareness for weeing than with bowel movements as she will often wriggle and dance about when she needs a wee whereas there is no equivalent for when she needs a poo.

The GP’s only suggestion was that she could be constipated but I do not think this is the case - she has very regular bowel movements, at least one a day, and always soft. The GP has advised we give it time, but I feel two years is a long time to be potty training with such limited success.

Has anyone had a similar experience and have any advice please?

OP posts:
Are your children’s vaccines up to date?
ChickandHog · 07/01/2024 22:30

Yes - it says that soiling is rarely not caused by constipation, but we have no signs of constipation so it would surprise me if this was the issue.

OP posts:
KateyCuckoo · 07/01/2024 22:33

Except the issue you are describing IS a sign of constipation...

Very very common.

Amara123 · 07/01/2024 22:47

Have a look at overflow diarrhoea.
A chronically constipated bowel becomes more insensitive to stretch sensation too.

SoIRejoined · 07/01/2024 22:55

We had this with DS and everyone told me it was constipation. It wasn't, it took years to solve. It seemed to be a combination of lack of awareness of messages that he needed to go and urgency due to him having a sensitive digestive system and food intolerances.

He was 6 before we got on top of it.

One thing we did that really helped - 20 minutes after finishing eating he had to go and sit on the loo and stay there for 5 minutes. We did this for every meal for about a year.

It also turned out he is autistic, which could explain why he wasn't noticing the need to go.

VimFuego101 · 07/01/2024 22:58

Constipation is very possible - Google encopresis. Your GP should order a scan to confirm for certain. What did they direct you to do next?

veryfondoftea · 07/01/2024 23:04

How many times a day is the soiling happening?
With my DC we were going through 5-10 pairs of pants a day. Turns out this was over flow and DC was constipated despite showing no signs of this.
We did a disempactipn regime and they are now on a maintenance dose of laxatives. Definitely look at the Eric website. It is most likely to be constipation so best to rule this out first

Cheesehound · 07/01/2024 23:14

I could have written this about my 5 year old DS. He has been on Laxido (a stool softener and laxative) for a few months and gradually things are improving. I think he had constipation for quite a while and this has dulled the sensation of needing to go for a poo. We had to get on top of it as he was soiling at least once a day. He has now started to tell us when he needs to poo and goes daily (a huge improvement). He occasionally has accidents but this is mainly due to not wanting to stop doing what he is doing.

ChickandHog · 07/01/2024 23:41

Thank you for your responses, I really appreciate it. We are trying to get her to sit on the toilet after eating and are having some success, if we aren’t successful with this then she usually soils once a day, a fairly large poo, not diarrhoea. The GP suggested we could treat the possible constipation with Movicol, my worry with that is that it would go too far in the other direction, and cause the issue to get worse before it got better, and so she would have more accidents in the short term but maybe that’s just a necessary part of the process. @Cheesehound can I ask was that your experience with Laxido, that it made his stools very soft/uncontrollable initially?

OP posts:
SoIRejoined · 07/01/2024 23:53

I was also told that if they feel stressed or embarrassed about the soiling it can make the problem worse because they just try to block it all out and ignore the problem completely..

Thefirsttimethegovernmentwasin · 07/01/2024 23:56

We had issues with soiling and it was hyper mobility, muscles just weren’t strong enough to hold it in. Definitely not constipation

MrsPelligrinoPetrichor · 07/01/2024 23:56

It sounds exactly like constipation.

Ruffpuff · 07/01/2024 23:59

I don’t have much advice, only sympathies. My son had the same issues at 4 and I was seriously concerned. Doctors suggested constipation, but like you I didn’t believe it as he was alway regular and ate loads of fibre. The problem sorted itself somehow and by 4.5 it’s seemed to click. At just turned 5, he still sometimes has poo accidents in the early morning if he’s wearing a pull up (still wets at night), but the problem is slowly getting better. I started potty training him at 2 as well, I never thought the whole thing would go on this long.

Superscientist · 08/01/2024 11:10

My daughter found going for a poo a lot harder to master. She has toddler diarrhoea and food allergies and can have no notice that she needs to go for a poo.

During a good spell with the diarrhoea and allergies we realised she was know when she needed to go but was refusing to use the potty and toilet. We jumped on the opportunity whilst poos were in a good place and we knew she was getting notice ahead of time. She got a coloured pom pom in a jar that fit 10. Little treat for 5 bigger treat for 10. It worked really well now all the poos she gets notice for are on the potty. If her toddler diarrhoea is bad or she is have a reaction to foods she has more accidents and doesn't know when she poos but we are happy with the improvement. For us it was waiting for a time when there was a chance she would engage that made the difference with a little positive reinforcement.

Have you looked into allergies and they can give constipation as symptoms as much as diarrhoea

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