soiling in a 5yo need some advice

[nicnack2]

my godson soiles al the time. This has been going on for over a year. Has has chronic constipation in the past and has had laxitives now on movacol. Thoughts from the professional are as follows autisic, neurotic mother, behavioural, blockage, constipated. I have had gs to stay for the last three days and he has not poo'ed in the toilet even when put on tiolet. poor mother can change him up to 8 times a day. It is very strong smell which infiltrates the house and you have to wash clothes 2/3 times to remove smell. Mum now justs throws underwear out. she is now at a loss as gs starts school in august. any advice gratefully recieved.

please anyone?

Surely they must be able to more for him. Have they tested for him being autisic or just mentioned it may be the course.
Is there another type of laxitive he could take maybe this one doesn't agree with his system.
I hope someone else can give you more advice.

thank you .they say that this can be a sign of autism but i do not think this is the correct. They have tried most laxtives. Movacol is apparently the best for young children. It is a shame as he will get teased at school if this continues. Also the school has said that Mum will have to be called everytime he soils as they can not clean him.

Hi nicknack2
My ds did this for nearly a year but I have pretty much cured him now, bar the occasional relapse. I've just cooked my dinner so I'm going to eat it then post my thoughts!

cheers

My dd did this and I got her referred to hospital in March - now poos almost daily and very rarely soils..... But think she will probablyu be on Movical for quite a while...

cece what did the hospital say/do to help you?

Bowel/gut problems are often seen in autistic children but those problems alone do not mean a child is autistic IYSWIM. There would need to be other signs, eg problems with communication, social skills etc.

i do not believe he is autisic and he show no other signs, The professional have been imo to quick to place this at a behaviour issue rather than a physical

Hi again
I think I ate my dinner too quickly but never mind.
This is a horrible problem but from what I read on the internet about it,it is really quite common. Anyway, my doctor and health visitor were no use whatsoever. They basically told me not to worry because he would grow out of it. At worst, I had to change him 12 times in one day. At that point, I was at my wits end.
I found this article on the internet which really helped
\link{http://familydoctor.org/166.xml}. Sorry can't get the link to work properly but if you type this in you get there!)
It basically says that a child gets constipated, either through diet or just because they start holding it in or other reasons, then the poo builds up so much that it starts leaking out round the edge and hence the soiling. Then they lose the sensation of when they need to go due to the build up of pressure. So it says the answer is to go back to basics and toilet train them from scratch for pooing again.
I did try this very softly softly approach but got nowhere with my ds. I realised that he'd only pooed on the toilet or potty about 3 times since being potty trained 8 months earlier. So I decided he needed to actually experience going on the toilet so the next time he soiled I told him he had to sit on the toilet until he did a poo. It took nearly an hour. I just left him to it. I kept doing this every time he soiled plus I had a jar and some big cardboard stars which I took everywhere. I took a star out if he soiled and put one in if he "practised sitting on the toilet" 2 in if he pooed on the toilet. After about a month he was going normally of his own volition. He still does it sometimes now but I just threaten him with no TV and he usually gets back on track.
I hope this helps and I really sympathise with your friend. It is so horrible. Throwing away the pants helps to keep you sane!

My ds is not autistic and according to the American website the condition of soiling in children has a name: encopresis. I'm not sure why doctors here think it's a behavioural thing. My HV reckoned it was caused by his reaction to my dd being born. But it started 6 months earlier when I potty trained him, before he even knew we were going to have a new baby!

thanks seahorse will go and have alook at the link. The soiling can be quite solid sort of the consisteny of clay. i had him on the tiolet a few times a day whilst with me and i felt that he didnt even undestand that he had to push. will come back once i have read the link!

try childhoodconstipation.com there is lots of info on there.

nicncak2 - the doc at hospital said she had impacted feaces due to being constipated for years. he put her on movical but quite a high dose - 2 scahets per day - for a month. she is now on 1 per day and is trying to establish a maintencance dose.

oh and he siad to sit on loo after meals and for them to blow bubbles. Helps with the pushing I think.

Oh and only one cup of milk per day and no apple juice. (she is 5 though)

Nicknack2
To be graphic, my ds's soiling is also quite sticky! He also did not understand about pushing, etc. He was only 3 at the time. I just figured if the soiling meant the poo was leaking it was ready to come out. I get irritable bowel syndrome and a book I had on that said you should not push if you are constipated but if you just sit and wait long enough it comes out. I gave my ds a huge pile of comics to work through. The bowel gets all distended though so the poos were enormous. Sometimes I think it was really painful but he was a different boy once it was out - so much happier and livelier! I think with a 5 year old you might be able to explain some of this to him. I had trouble getting my ds to understand that the poo had to come out eventually - that there was nowhere else for it to go so there was no point in him holding it in.

Only very limited experience of soiling but my ds does have chronic constipation. Has your godson seen a paedatrician? We saw a fantastic one after ds had been constipated for 4 months, no luck with lactulose or senna. He gave us movicol which was like a miracle. This helped for ages but after a cold ds was terrible again and we had a total nightmare for two weeks where he would only go in his pants, was frantically holding it in and I was just in tears. Paed told us to double everything movicol plus senna and basically make it so runny he had to go. he said we needed to keep on with this for a couple of weeks until he forgot that it hurt then reduce the doses and establish a good pattern. We did this with a new fancy loo set, chocolate buttons when he pooed in the toilet as a reward, ignored soiling ie made no comment. Paed said you need to break the cycle of poo hurting, only then can you break the psycological side of it. Ds now needs no laxatives and will poo on demand. Have to say he's about the only paed I've heard of that does reccomend this, a lot of them do seem to be preoccupied with the behaviour thing. Hope this is helpful

poptot thanks. Gs going to paed next week. Chatting to firnd on the phone whilst reading this. friend says they have upped the movicol to eight sachets but this has not made any different.

Seahorse i tried to explain pushing to him but although i think it is constipation it now has become a habit.

try getting him to blow bubbles it does work...

i told her that cece. i think we will have another recruit to mumsnet. she is off to look at all the websites!

My DS2 is 5 and has spells when he soils. What I have found helpful is not to get cross about it (easier said than done, I know) so he will tell me when he has got skiddies (sorry if TMI ). As soon as he tells me I get him to sit on the loo until he poos. Give him books if necessary. I think he was holding it in and instead of reacting to the urge to go to the loo, he waits until he is on the verge of soiling. Don't know if this is how your gs is.

Throwing away the undies definitely helps one's sanity, too.

oh, forgot to add that a child in DS1's class (yr 1) soils and his mother puts PJ pants on him with boxer shorts on top, so no-one can notice. The TA helps clean him up when he soils and the mother gets her a nice Christmas present!

thanks everyone, have passed this all to my friend and she is glad that there are others suffering with thi prob. reassures her that she is not going mad!