Please help me with my seemingly incontinent 8 year old daughter - getting worried.

[StartingToGetVeryWorried]

My daughter is 8 (9 in october) and to put it bluntly she stinks! She always smells of wee and poo and it is very very very rare that she keeps her knickers clean all day.

Sometimes it is so mortifyingly embarassing as it is really quite strong and I cant imagine what others must think.

She potty trained normaly at about 2.5 yrs and although not as good as my son was was fine, usual amount of accidents.

She then had an accident when she was about 4 which involved hurting her bum and from then on started a cycle of holding poos in until she became severely constipated etc etc

It seemed to improve for a good while but recently over the last few months it is back with a vengeance.

Now she is approaching 9 I am really worrying for her as eventually the kids in her class will pick up on her as the stinky kid and start bullying her Im sure.

I keep finding knickers covered in poo and wee hidden stuffed at the back of drawers.

The part of it I dont understand is taht she doesnt seem to care - every night I lay her clothes out for the next day including clean underwear yet often she doesnt use the clean knickers and keeps on the dirty ones???

Can anyone give me any advice on how to deal with it?

It is not full accidents she is having, her knickers are normally stained with varying degrees of skidmarks from light to very bad but not actual full poos iyswim.

Im not sure where the wee comes into it but that is certainly an issue too.

HELP

Are you sure she doesn't have a urine infection, or some sort of problem. I have a friend whose 10 yo is the same but she actually has a problem with her renal system (kidneys) and gets lots of urine infections. This can cause constipation and also constipation can cause urine infections, as can feaces in the front "bits" and it certainly sounds like that is a strong possibility with the skidmarks.
I assume you have sat down and talked with her about the smell and how it is unpleasant, and she should keep clean because of the risk of these infections which can make her poorly. My friends 10 yo needs meds and refuses to take them, but that is due to their relationship problems more than anything else. She also tries to hide when she's had an accident tho it is obv when she has as it smells.

Have you talked to your gp and/or health visitor about this? It does depend what the actual problem is as to what the solution is. There can definitely be medical reasons for what you are describing. My goddaughter had something similar and would not poo on the loo, had to take her younger sibling's nappy and sit in a corner somewhere! It was found there was a small blockage somewhere, minor surgery resulted and no further problems. If it is not a medical issue, you clearly need specialist advice on how to "retrain" and I would have thought the gp would be able to point you in the right direction. HOpe it works out OK.

trying panty liners or a thin sanitary towel could help as long as she removes them after an accident

then she doesn't have to worry about owning up to stained knickers which I presume is embarrassing her, as she is hiding them

it sounds like the chronic constipation could be causing leakage round a very hard bowel movement - this would be out of her control, the faeces just leak out past the blockage

a visit to gp could help the constipation, plus change of diet?

Constipation can result in leakage. I would get her checked out by a GP.

I have been to the doctors a couple of times (though not recently) and they were very dismissive.

Do you think I should make an appointment on my own to explain the situation properly rather than take her as she would be mortified?

When I try to talk to her about it she either completely ignores me or gets very angry.

It is very, very upsetting

I think most/all health centres have specialist nurses, ask the school nurse for a referral?

I would say she is very embarrassed, hence the anger, but you must make her see that it is nothing to be embarrassed and angry about and that she can trust you and you can help her, if she talks to you about what is going on. Perhaps you could make an app for you and talk about it first, or call them for a dr call back and see what they say then take her in, and perhaps let her do the talkign once you get there, as long as they know what you have already told them. She may feel more in control then.

I think she does have a problem with it else she wouldn't be hiding the stained pants. She probably also keeps the dirty ones on so that you don't 'discover' them when she takes them off to put on the clean ones.
Definately try the GP again (even if you see a different one in the same practice if you feel you have been dismissed). Maybe you could go in first to explain the situation and then have her come in to be examined.
I think you need to also sit down and have a sensitive chat with her. Explain that you're not cross and you're only worried about her. Say it may be a little medical thing that can be sorted out and not her being 'dirty'. Maybe you could show her how to use the washing machine so that she doesn't have to hide her undies and feel less embarrassed (maybe too young I don't know what kind of 9 yr old she is). If she is getting angry at you it is almost certain she is embarrassed. I feel for you both.
It could very well be constipation. The more she feels embarrassed about it the more she will hold it in, the worse it gets.

You really must get her tested for a UTI. Make an appointment to see your GP and take a sample of urine in a clean container with you. You can get sterile containers from the chemist or use a small clean jar. A sample of wee from first thing in the morning is likely to be more concentrated and give a clearer result. If this is clear, I'd insist upon a referral to a paediatrician. Poor girl must be really embarrassed.

I think I have been in a lot of denial about it TBH.

I need to face up to it - I want to set her free from it as it cant be nice for her either.

We were at a social event recently, she looked beautiful but at some point I noticed she smelled and I was just devastated, I noticed a few people looking around for where the smell was

It is so incredibly hard to talk to her about it, not sure we can get beyond the silence or anger at the moment.

She is starting to get invited to sleepovers and things so something must be done.

perhaps you need to be firm (but sensitive with it) and state you've had an accident here is your bag go and sort yourself out - ie pack of wipes, clean knickers, nappy sacks for smelly pants, used wipes etc.

Oh I do feel for you, same here with my dd 8 but I know the reason is constipation and "leakage". Also, sounds silly but does she wipe her bum thoroughly, not being flippant at all here but I literally gave my dd "lessons" in wiping and for a while we used wet tissues.
It is hard to discuss but you really have to have the conversation. Empty house, the 2 of you snuggled up on sofa, lovely positive, sympathetic words and you are going to help her with this, my dd was actually really relieved when we got it out in the open!

Is there anyone she trusts who could talk to her about it? It is such a tricky age and they start to get very self-conscious.

Really feel for you both

What about any charities or support groups, they may help you find the best way of approaching the medical professionals. Am that your doctor is unhelpfuyl and agree that the practice nurse could be a good bet or speak to another (female?) doctor.

You really need to get her referred to the paediatrician either through your GP or school nurse. Your daughter's school will know who her school nurse is. I work as a school nurse and if a parent called me for advice about this i'd be referring to the community paediatrician without a doubt.

She probably has no control over her soiling and wetting and as has been said before she might well have a urine infection.
The hiding of soiled underwear and the appearance of her not caring about it is also really common in kids with this problem.
To be honest i am really that your GP has been dismissive about this.

Hope you get some help with this soon

Therealmrsosboure - to be honest I havent taken her for a couple of years and when she was younger they dismissed it as being within the realms of normal.

It is now it seems back worse than ever and she is now older it seems such a worse problem.

I hope when I go to the doctors (which I will this week) they take me more seriously.

I feel bad about the way I have dealt with it sometimes, cringeing now when I think of the threats I have made of telling her teacher and putting her back in nappies. I have usually thought of it as a problem with laziness and being a bit of a scruff as she does have these traits too. Tries her best to avoid getting showered, lies about brushing her teeth etc

Well most kids do that I think that is normal, but that does explain why she now hides it from you and wont talk to you about it - sorry. Now you have to try the softly softly approach, you can't bury your heazdin the sand wihth this, urine infections can lead to kidney infections, and trut me, they hurt like hell and can damage the kidneys.

You need to win back her trust.
Can you make her a nice hot chocolate and get some cookies and sit her down at the kitchen table and have a big girls talk????? Try some sticker charts or reward jars or something, everytime she is dry and clean or has a shower she gets a sticker, 10 in a row and she gets a couple of quid to spend in poundland, is she stil at an age where that would work????

I tried the reward approach (and the 'stick' approach) for a similar problem with my ds who was soiling for a couple of years from about 4years.

Eventually went to the gp after his teacher called me at home when he had an accident at school - much more than a skid mark

The gp was great. Prescribed lactulose and recommended that he also make sure he drank plenty of water everyday.

I think the mixture of telling him it wasn't his fault (completely beyond his control as others have said, hence the carrot/sticks not working), that we would sort it out together and that we would not be angry with him if he had dirty pants all helped.

He already had quite a healthy diet but was chronically constipated and the meds helped to clear it all. Stll not perfect but so muh better now.

I think a big part of dealing with it is to take the blame away first.. That at least stopped him hiding his dirty pants!

Also agree that she needs checking for uti.

Good luck

STGVW - please do not wory too much. My dd is 9 this year and we have had exactly the same problem for about the last year but this seems to be improving a lot of late.

I am embarrassed to say that I initially put the problem down to laziness. What I didn't realise is that she was actually suffering with chronic constipation and the soiled pants were because the soft poo was passing past the impacted poo in the bowel. We took her to her gp and she was given lactulose to initially clea the blockage and now we give her a small dose now and then if we feel that her bowel movements aren't as regular as they should be.

The problem hasn't completely gone but it has improved greatly. Apparently the constipation causes the muscles in the bowel to stretch for a while and until it has returned to normal they therefore loose some of the sensation that tells them to go when the need to so the problem can go on for a little while longer -it's not just as simple as clearing the blockage IYKWIM. I think the pressure in the bowel can cause pressure on the bladder too so that might be why your dd has a problem with both.

I think you need to take her back to your gp and try to get them to be more sympathetic. It is more common than you think but toilet matters not exactly a topic for discussion amongst mums in the playground when dcs reach a certain age is it?

DD used to hide her knickers too - the fact that you dd is doing this is because she is embarrassed, she knows that 8 year olds shouldn't be soiling their pants and theefore realises that it is a problem. Perhaps she doesn't change into clean knickers because the longer she can keep the soiled ones on, the less you'll find to wash???? I got around this with dd by sitting her down, promising that I wouldn't get cross with her for soiling herself, that I realised she couldn't help it and what was most important was that we kept her clean and sorted the problem out together and with gp. As soon as the problem became something not to be ashamed about or hidden at home and I started to hide my own frustrations with it all we came on leaps and bounds - I think beacause this helped me become more aware of the frequency of the soiling etc.

I did take her to our gp but I rang up to make the appointment and spoke to the gp over the phone and explained that I needed it to be handled very sensitively. Told dd before we went that it was important to get the doctor to hep and that he will have seen lots of childen with the same problem before - something that that my gp backed me up with and was very good at making her feel that he had seen hundreds of kids come through the door with the same problem as her. I also spoke with her teacher over the phone and made her aware of the problem, dd is not aware of this and I knew I could trust her teacher to be very discreet. As a result her teacher ensures that dd drinks plently of water throughout the day and reports back to me if she feels that dd not eating properly or making frequent toilet trips during school time as a result of the constipation.

Sorry long post I know but just wanted to reassure you that you are not alone, that these measures have worked for us and I'm sure that you'll get there with dd. Good luck.

I have a similar problem with DS, aged 11 who has AS.
He has never had a problem with contipation but like your DD really smells at times and has badly soiled pants.The smell doesn't seem to bother him, I sometimes find pants in the bin.
I seem to have narrowed it down to the fact that he is not wiping himself after he has had his bowels opened.
I am contantly checking, but as he's 11 and likes privacy when he's on the loo I can't physically check him. I insist on checking him myself before he gets in the bath and he's invariably dirty.

Sounds like you need to rule out constipation in your DD's case.

Sounds very worrying...however if you look up encopresis on the web - your daughter seems to have a classic case. It is a definite medical condition caused by constipation - and then somehow the reflexes all seem to go wrong and children lose a lot of control.

Your daughters psychological response seems to meet the criteria too

these might be good sites to start

forum

and

another

and another resouce

www.soilingsolutions.com/

a difficult problem and I hope you find some support.

DLEEDS - YES!!!! reading that first link was like reading about her, definitely that¬

encopresis it is then - so at least something to discuss with doctor

It says its very common to stem from an original injury too which seems to be the case.

Poor, poor girl - she really has no control I feel really guilty as I have been convinced at least part of the problem was her laziness.

STGVW

Hope you find the links a useful starting point both to do some interweb research and to get a bit of support for you! It really must be difficult on both you and her.

I have a bit of knowledge in this area - and from doing a lot bit of googling these seem to be the best of the very limited sites.

Take care.

Once she has been convinced that it is not her fault, it should be a lot easier to get her to change dirty knickers straightaway and leave them in a previously agreed place. Dd who is mildly incontinent due to connective tissue problems rinses hers out and hangs them over the bath, no problem.

I think it's really important for her to understand it is not her fault...in someways how can she not believe it is her fault currently when she has no information otherwise (friends, no books, role models, tv programs ever mention this problem) - at the mo her only logical option is to think it must be something about her causing it. It is also likely that her general 'don't care about her appearance and clothes' approach is a bit of a defence mechanism. After all how can she begin care more - it can only increase her distress at 'failing' (a bit of percieving the cause and effect the wrong way around).

It might be useful for her to 'rehearse' with you and explanation she can give to friends and teachers if anyone mentions anything to her. She won't have the right 'words' to use. And it might reduce her stress to have an explanation / answer in her head, even if she doesn't actually have to use it.

I have been thinking about this tonight and feel terrible to realise that I have never even discussed this with DH, he must have realised surely?

Ive done her a big disservice havent I

Ive been reading archives on encopresis and feel reassured that it is relatively common - just wish I had posted about this years ago