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

Well....................Firstly can I give you ladies a MASSIVE heartfelt thankyou. I cant begin to express how grateful I am and how glad I am that I started this thread.

I went to doctors and thankfully she was lovely, really lovely.

She was very sympathetic and took it seriously.

I told her all of the details and she wants to examine her tomorrow, refer her to a "constipation clinic" at the hospital, speak to my health visitor and has suggested that DD may need some behaviour therapy alongside physical treatment.

So that was step one of the start to solving this and I cant even believe what came next.

I was stumped as to how to even get DD to the doctors with me tomorrow due to the way she reacts whenever I say anything.

You guys were obviously right as she must have been presuming I think its all her fault etc.

I gave her a cuddle and said firsty I have an apology to make to you. I have been to see the doctor to talk about your tummy problem and I have learnt about it and learnt that none of it is your fault at all, its not lazy, its absolutely out of your control and I am truly sorry that I ever thought it was. I promise that I will NEVER ever get cross with you about it and will never blame you.

She burst into tears

God, I feel so terrible (but relieved as well as we have the communication going now)

It has obviously been such a big issue as this was at about 5pm and i have been with her and talking about it ever since.

She seems positively relieved that i have taken action and made doctors appointment. We have talked about telling her teacher and she is happy for that to happen, she is happy to speak to the doctor, she even asked me to tell my sister (her auntie) with her in the room what the problem was and what we are going to do to help solve it.

She showed me where any hidden knickers were and I talked to her about just chucking them - she was happy with the plan to have loads of extra knickers, bags and wipes so she can always see to herself.

She got very upset a few times, she seemed just so overwhelmed with being able to get it all out - she has long had a problem with getting changed in front of people at swimming and pe - I always thought it was a body issue but it turns out as she never knows if its happened she is scared that someone will see some poo - bless her heart.

She is such a bright, articulate girl it has been such a wonderful chance to reconnect with her and im really proud of her. I told her that she had done such a brilliant job of coping with it alone but she doesnt need to anymore.

She was really happy after our chat and kept hugging me.

It turns out the problem is worse than I had feared - she was telling me that she cant remember it ever not happening, it is getting worse and happens at least once a day, she cant feel when she needs a poo, only knows if she is gonig for a wee and one starts to come out. She hasnt had a poo for about 6 days at the moment and said her tummy hurts alot.

My poor, poor, brave baby.

Anyway, such a long novel but wanted to fill you all in after so kindly offering your support.

Could anyone offer my DD and I information on what might happen next - DD is anxious to know who she might have to see and what might happen etc

Just to say that is all such good news-well done! it must be such a relief- sorry pun not intended! It can only get better.
Don't know what happens next,but do post back so we know the happy ending.

Good luck!

LOL@pun

Its funny because despite my despair I had to stifle a fit of the giggles in the doctors when she started talking about her appointments "backing up" tomorrow and would have to squeeze DD in.

Ah, bless you, well done!!!

I've checked this thread a few times to see how you got on with the docs. I am sooo pleased it went well. (I wiped a tear for your poor daughter if i am honest) - she sounds wonderful.

I hope it goes well, and do post back with progess - it would be so lovely to hear (but don't feel you have to).

Well done to you both!

I'll come back tomorrow about what might happen next.

have been lurking
sounds like you had a real heart to heart, it brought tears to my eyes
you are doing a fab job and are a great mum

bless her, I had a tear in my eye too. Well done on your lovely heart to heart. This thread is mumsnet at its best

oh bloody well done, i'm thrilled for you that you're now an ally for her, i'm sure that will mean the world to her. i've been lurking too, i think we've all learned a lot. who knows, one or other of us may have had this to face in the future so you may have helped others too by posting. well done.

Great news! Obv not great for you poor DD but great that the doc was supportive and helpful and great that you DD opened up to you.

I think what MAY happen next is an x-ray to see how impacted she is and meds - movicol is one and lactulose is another to soften everything up. A friend here (another one - this time with a boy of 4) took her DS and he had to have an enema. Wasn't nice for him but he has had no probs since - and he would go up to 2 weeks without going.

Your poor DD having to go through all this for so long. Am angry on her behalf at the doc who didn't take it seriously in the past and at least warn you that it could become an issue.

Well done for getting the help - I am sure your relationship with your DD will improved tenfold now that she knows you are on her side so much.

Good luck today - let us know what happens.

Have tears running down my face,
mumsnet at its best,
so glad your getting this sorted must be such a relief to both of you,
hope the appointment goes well today

Hi again

Just a quick note as you seem to have it all so in hand!

What might happen next? (I'm not a medical professional so the protocols might be different in your area). The doc will definitely feel her tummy to check if she can feel the impaction / constipation. She may want to look at her bottom (check everthing is normal). Going forward the priority will be to clear any existing 'back up' of poo (suppositories or laxitives), and then find a way (maybe softeners)of keeping her regualar and the consitipation at bay. This will proabably also involve timed and regualar 'sits' on the toilet.

The other thing I would advise is to download some pictures of the colon from the internet so that she can see for herself if you 'block' the colon and poo can leak out. I think it is also important for her to realise that her colon has been a bit stretched (think balloon gone a bit baggy) and the nerves are now not working (they will get better over time) so don't expect everthing to be fixed on day one! Blowing up a balloon while on the toilet often helps get the muscles working in the right order btw. Also you may want to to try a mp3 player or the like and time the sits to say, 3 songs (whatever get her to co-operate!).

It is so all entrenched now, both physically and emotionally I would expect some back sliding. She may 'forget' and revert to her defensive ways - all to be expected. It is hard to change overnight!

As I said you sound so sensitive and have it in hand I am sure will sort it out.

My final thought is as I said before, help her find suitable age appropriate words to use if she is ever asked about this or needs to speak to someone (and other kids WILL have mentioned it or at least whispered about it). There is so little she can pick up from the outside world you can help her 'researse' some good explanations. Even if she doesn't have to use them, she may replay them in her head. Which will act as a sort of defence for her.

I'll sign off now - she has been a brave and wonderful girl trying to deal with this. I am so pleased you can get this sorted. It must have been making her very unhappy (never mind the stress for you).

It is such a shame this is a taboo subject - it is just not common knowledge at all. Sex and rock and roll are easy to talk about compared to poos at the wrong time!

What a wonderful thread. So glad that you and your dd will be getting the support you need.

Final post

Copied from a forum from another lady who had a daughter with this problem - basically the advice to 'cure' encopresis and is a summary of advice from a top clinic in USA. Might be useful summary for you - and for anyone else who has to deal with this (sorry it is long)

'Most of this you all probably know as it's basic stuff. Like I said some of it did surprise me. This is for non medical issue kids only. With the tests we had we fell into that catagory. Hopefully I remember everything and excuse the obvious.

1. Won't work unless totally cleaned out

2. High fiber/lots of liquid

3. Stool softeners as needed

4. Regular sits. Pick a time and stick with it always. We picked after school as mornings would be too rushed although "they" say that is the best time? I had been paying attention and my kid didn't happen to be a morning person so afternoons seemed to be our best bet. What surprised me about this was the amount of time. I always did about 10ish minutes...maybe 15? They said MIN of 30 to 45 min. Entertain as needed.

5. Reward even just the sits. I bought all kinds of fancy suckers at ToysRUs that are only allowed while sitting. I also read to her if she wants or we sing songs etc. You know your kid so whatever you think will work.

6. Never comment on mistakes. Clean it up and no big deal.

STGW: My 3yr old wants to know why I am sad. Difficult to explain 'happy tears'!

Well done both of you. I really hope that you and your dd can sort this out as quickley as possible, although in reality it may take a while. You've hopefully done one of the hardest parts of discussing it with her. You have a very brave daughter.

Good luck- teary one!

DLeeds - thankyou for all of that info, very, very useful!

Thanks to everyone for their comments, Im really chuffed with out progress - quite apart from the aim of getting this sorted it feels like we have broken a barrier in her trusting me to help her. I feel sad that the barrier was ever there, but it was and now I can work on rebuilding her faith in me.

She is suprisingly happy to talk about it at the moment, even actively wanting to talk about it - it must be such a relief for her.

She collects yugioh cards and had a selection of them out for me to look at with her handwritten notes - they all had different key words in

ie Judgement - "i wont have to be judged anymore"
control - "now it wont control me anymore"
freedom - "im going to be free when its fixed"
happiness - "how i feel now"
and because she has such a good sense of humour
"wetlands" - what it feels like when it happens!

Isnt she amazing?

I am very proud and relieved which is AGAIN thanks to you guys.

We see the doctor at 4pm.

lol at 'wetlands'! Good luck for this afternoon, hope it goes well. DD sounds so lovely. After bottling things up for so long she deserves to rattle on as long as wants!

Sorry about the lengths of the earlier posts - but I think it is so hard to get info about this condition and I couldn't think how to condense..

Research I can help with, however yugioh cards??! shall be ever a mystery .

There's some great advice on here and I hope your DD gets the right medical support. My DD responded well to Movicol whereas Lactulose gave her more tummy pains and severe wind

It will take time to sort this as from what you say it has been going on for a while. My DD took 6 months to get things under control but everyone is different. Once the initial clear out has been sorted, you may need to completely change diet including much more fruit and wholemeal bread, wholemeal pasta etc (not sure what her diet is like now) and lots of drinks whilst cutting back on milk and bananas and some other things which can block you up. Even now, if we go away for a couple of days and have a "bad diet" she will have problems - I know I have to be alert to this.

I would enlist the support of the teacher/school for the short term; my DD has special smoothies to take in for playtime for example and is allowed to go to the toilet AT ANY TIME. If necessary get the GP or clinic to contact the school to say this (hopefully not necessary but do this if they dont appreciate the importance of it). The teacher also needs to say this directly to your DD not just to you - I asked the teacher to say in front of me to my DD "you can go to the toilet anytime you want, just tap me on the shoulder or ask the assistant if I am busy".

My DD is only 6 but the smell was commented on by other children even at age 5. She said to other children that she had an "upset tummy" and had to take "special medicine" for it and sometimes had to go to the toilet all of a sudden because the medicine made her go. She was 5 or 6 at the time and this explanation was based on the truth as we thought anything else would confuse her.

I dont know if its been said before but initially the medicines/treatment might make accidents worse so I would consider time off school if needs be.

Good luck with it all - I'm sure you will get it sorted now the problem is out in the open.

Oh yes, you might need to prepare your daughter that for the initial clear out may involve strong laxatives, suppositories or enemas to clear the impaction. And the initial treatment may trigger more accidents in the immediate short term (best to take time off school). I am raising this as she is in such a positive mood this may bring her down. Forewarned you and she may find it easier to cope with (especially if she undestands why) - and a good clear out is essential to move forward. Sorry.

I was wondering about time off school - the last thing I want to do is send her in to potentially have a bad accident and encourage teasing she seems to have so far avoided.

when is she seeing the doc today?

Make sure you ask how long the wait is for the constipation clinic and ask your GP is she feels able to prescribe the laxatives that will prob be needed to get the backlog out and down the bog (stand by emergency plumber).

GPs sometimes like to be very gentle with laxatives but be brave and ask whether she can have a decent dose right from the start.

Do explain to your dd that this is the first tiny step to getting the problem sorted - if you say "by the time you go back to school" she might have a realistic idea that it's a long term approach that is needed.

There are children's pages on the Eric website - look at them and see if they're suitable for her?

how did it go? been thinkin of you. My ds had to have a bowel transit scan , we fed him different tiny plastic shapes - triangles one day, square the next etc. as instructed. then they did a scan which showed how far the shapes had progressed thru the system on an xray.

This showed how the bowel was working. They may also talk to you about incontinence products which help yr dd whilst she gets this sorted.

I have just seen this, I hope all goes well for you and dd. My ds went through it - and it was hard to find help, yet to me it seems it is now as common as bedwetting. I'd like to second the poster, if one medication doesn't work try another.

Really pleased you seem to be making real progress.