My 3 year old has lost all control of his bowels! Pls help. GP no advice

[CoveredinCrap]

3.5 year has been fully potty trained for a year. He is a v easy going kid and was easy to potty train - no accidents really and took himself to the loo independently for a year.

A couple of months ago he became constipated - no idea why. He started holding onto his poo and not going. Then he started pooing in his pants. Or if just poo himself a bit, so i would smell something and then realise it was on him. It's like he has no control or knowledge of it coming. He gets upset a home about it - he says "I don't know why it happened" and just cries. He hates it being on him

It started at nursery and he's doing it nursery but doesn't tell anyone is has happened.

I've taken him to a GP and they gave him laxatives saying it sound like he had chronic constipation. It actually worked the first time - and for the first time in 2 months he told me he needed to the loo, went there independently and used it - he was so happy withi himself and said 'mummy the medicine worked' but i kept using it daily for the last week but he has gone back to poo in his pants, all over him, he crouches in the corner of the room crying

the nursery are trying to say they can't handle it and asked me to sign something to say they hvae a right to exclude him.

any advice at all? He really really doesn't want to be doing this, but it' slike he has no idea how to control it anymore.

There is an excellent you tube video that has been recommended on here called the poo nurses. It is really informative and not too long to watch. It is particularly clear about how you can tell what stage you are at with the process. Your husband sounds ignorant and unhelpful so perhaps he needs to watch it too.

Completely agree. OP when you do an disimpaction regime, you are looking for the poo to be brown water when you can consider the blockage to be cleared. What you are describing sounds to me like overflow of softened poo from starting to take movicol. This is the page the private GP we spoke to recommended to use as guidance - https://eric.org.uk/childrens-bowels/parents-guide-to-disimpaction/

Ended up going private as our NHS GP refused to prescribe anything for DD stronger than lactulose which is beyond useless!

I will reply with more detail later but keep giving the Movicol and if no improvement ask for paediatric referral.. could be coeliac disease!

The poo builds up inside them because they withhold because they get scared it’s going to hurt. As poo stays in the bowel it becomes drier and harder as the bowel draws water out.
The new softer poo makes its way around the old poo and coats it with another layer on its way past, so that the blockage gets even bigger each time. The rectum gets stretched by the old poo so the walls get baggy and the nerves stop reacting the poo pushing against the walls. It’s like when you blow a balloon up a few times it stops going back down to its original size and goes saggy.
The child then doesn’t get the message that they need a poo. So it just sneaks out without them knowing it’s about to happen. Children often pretend it hasn’t happened because they find it upsetting so want to block it out. They also know adults don’t like it, so that’s another reason to deny it’s happening.
the bowel needs emptying completely. If you’re off work over Xmas I’d make a start then. After he’s had 2 weeks of Movicol he’ll need a stimulant like senna or sodium picosulfate. You don’t want to give it before the poo is soft inside as it can cause stomach cramps.
The GP should be doing blood tests to rule out things like coeliac. I’d also consider if it could be a cows milk protein allergy. Any history of reflux or dry skin or eczema?
Once the bowel is clear they need to take Movicol for 6-12 months before you start to wean them off. As it takes time for the bowel to regain the muscle tone. You want to give a maintenance dose that means they going every day or every other day without pain and you want it to be a type 5 on the Bristol stool chart.

This is what to aim for when you disimpact/clear the bowel out. It can take a few weeks unfortunately.

https://www.instagram.com/reel/CweuZfKMuaS/?utm_source=ig_web_copy_link

You need to stop giving laxitives or give weaker ones, otherwise he will continue to pooh himself and this will continue into school.
string laxitives give him no time or option other than to keep soiling himself.

That is terrible advice. OP needs to continue to disimpact and retrain the bowel as per the correct advice already given. This is a long process and needs patience and understanding. It needs sorting out before school.

Watch this OP. I have seen this recommended and it is really good and explains everything. It is the poo nurses video and it explains fecal impaction and the management really clearly and simply.

You need to watch the video all the way to the end.

There’s a really useful group on FB called Movicol Mummies. For some reason, the NHS aren’t properly trained in this, but ultimately I suspect your child has at some point had a poo that hurt coming out and now they’re avoiding that happening again.
Sympathies as went through it with my YP and it’s horrific until you know how to manage it. It’s a process now of getting your child comfortable enough to realise that it doesn’t hurt every time.
Honestly, the group mentioned above has hundreds (or thousands) of parents that haven’t been told proper information on managing it with the laxatives and have had to find ways to control it themselves.
I also suggest reading the book ‘Witholding: what to do when your child won’t poo,’ which is great for setting your expectations on how long it will take to get back to ‘normal’ and how to do it.

FFS think I’ve commented on this before. I’m using the app and went on the wrong section.
Apologies, hope you managed to get it sorted!

You need to disimpact him. Giving him lots of laxitives. I think we got up to 12 a day with my daughter until the blockage is cleared. She then went on to a maintenance dose which we have slowly reduced over a couple of years

As others have said the Eric website and the Facebook group mentioned will give you all the information. Follow that advice not the GP they are often very misinformed.