Apologies if you find this unpleasant or TMI.
My ten year old son has had issues with soiling that have been going on for years and have never been properly resolved despite my best efforts. He found toilet training difficult and since going to primary school has had both wee and poo accidents and smearing in his pants daily. He has never seemed fully conscious of when he needs to go the loo and still has to be told to go and sort himself out when the smell makes it obvious that this is necessary.
3/4 years ago I took him to the GP for some extra help. We were referred to a paediatrician who diagnosed constipation, and also the local children's bladder and bowel clinic. He was prescribed lactulose, Movicol, Senna in various doses including several disimpaction processes. Also regular sitting on the loo. None of these really solved the problem.
The last time we saw the paediatrician she decided he wasn't constipated anymore and took him off all medication. His problem is now worse than ever. His pyjamas are always soiled in the morning. His pants are always soiled when he gets ready for bed at night - often so badly that they are beyond washing and have to be thrown away. He tends not to have separate 'accidents' when in a familiar environment - home or school, but for example when he has been on a school trip or in a show he has them regularly making this sort of thing extremely difficult for him. I am also constantly picking up bits of dried poo from the floor at home.
I am absolutely desperate to help him. He is such a lovely boy and his situation is severely life-limiting and there seems to be no way forward. He is starting secondary school next September and I am so worried about how he is going to cope. The clinic have effectively washed their hands of him - I have spoken to them several times recently and they have been very sympathetic but basically have nothing more to suggest. Similarly the paediatrician - nothing makes any permanent difference.
If anyone has any helpful experience or advice I would be really grateful.