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

Try not to feel guilty it is a condition few people know to watch out for unless they or their dcs suffer! No doubt your dd was old enough to feel very embarrassed when the problem started, and tried to do what an adult would do - keep it private.
Ds (who has LD and ASD) has suffered since starting school - he is now 8 and is still monitored by the paediatrician. He has daily medication and we reward his sitting habit - an essential part of the recovery to regular function. The constipation recurs from time to time and then he benefits from calpol before his sit time! (Ds has little language so cant tell me -but if he is figity, larthargic, off his food, cant sit down - time to up his doses in the morning as per our regime and get out the calpol an hour befor sit time -if he seems in pain - your dd will be able to tell you! The aim is to never get constipated (beyond the odd day or 2) again. We had some helpful support from the school nurse in the early days- who suggested the calpol and a blob of vasaline on the bottom before sitting to help things along. Onc things were running more smoothly, we gave meds in the morning to reduce the chance of an accident at school - ds sits in the evening.
Hope things go well, and I think letting her stay off school is very sensible. It also reinforces that the problem is a medical one and not her fault. (TMI but panty liners can be helpful!).
Good luck!

And don't forget it is very counter-intuitive condition. Who would think constipation (being bunged up) would cause leakage and soiling. At face value it is not logical. And defensive young children would try to hide things due to shame and embarrassment thus making it worse. But it does! I think I have said earlier in this thread it is such a shame it is a taboo subject - so the shared 'knowledge' and experience doesn't happen as it might for other conditions. So don't beat yourself up, you weren't to know - I guess you have enlightened a lot of people along the way this week by continuing to post. I think you can be proud.

It is about the secretest condition any of my children have had! Until your child has it, you don't know it exists, and it does get downplayed by professionals. I am sure your teacher is right, after my ds gor sorted i discovered another boy in his class was going through it. It will get sorted, but takes a while to get working well. (And my ds is 16, and takes a book in with him now!)

you could contact your school nurse they are employed by the primary care trust and cover several schools and may run continence clinics.

alot of children wet becuase they dont drink enough - this is due to the bladder never stretching to full capacity therefore needs emptying more.

also constipation causes wetting as the bowel presses on the bladder.

sounds like she has overflow which is where some liquid poo leaks out down the side of the constipated poo.

take her to the gp to get some medication to get her going some movicol should do the trick (may need to keep off school as when she needs to go she will need to go).

Ask Gp for a referral to a community paediatrician and/or school nurse continece clinic.

STGW, i absolutely LOVE your dd, she sounds just brilliant on so many levels. how fab she is!

Hi everyone

DD had a bit of a rough night, was up crying a few times with pains. Think that any sort of pain or grumblings must be scary for her.

I have kept her off today and we have had a poo so far! She showed me!! Never thought I'd be proud and happy to be returning to the look at my poo stage but such a huge leap forward for her to have lost the embarrassment and shame and include me.

The poo was a reasonable amount, a bit hard and made her bum bleed but good sign that things are moving and it wasnt too traumatic for her.

She is asleep now, tired from being up in the night.

I hope this thread will help others searching the archives - the few people I have told IRL have ALL said "Oh XYZ had that etc etc" it really is quite common but so untalked about.

For a while ds needed a little bit of magic potion, aka vaseline, around the 'exit' which seemed to help him relax so it would glide out. He was 5 when it was being sorted, so a star chart was more age appropriate, as well as the big present for ten poos we had visits from the toilet elf on random nights. He left small shiny things. It kindof takes control of real life! Your dd could do with a duvet day today, she deserves to be pampered a bit. (As do you!)

Hi STGVW.

I posted on your thread earlier. Remember I am still going through this problem with dd also 8 (9 in August) but like I said before we have come on leaps and bound over the last few months. I'm also glad that you are getting the support you need off mumsnet. I initially posted about the problem but refrained from doing so after we got help from our gp because in one of my posts I commented that I felt guilty because there had been times when I had told dd off for soiling, not realising that it was beyong her control and although most mumsnetters were supportive, one tore strips off me making me feel ten times worse. Ended with something along the lines of '' she's 8 - do you really think she'd be s*ing herself if she could help it, ignorance doesn't wash with me etc etc".But i was ignorant, she did appear to be simply not going to the toilet when she needed to and ahe was still having bowel movements, what i didn't realise is that this was just the soft stool passing over the impacted stool.I hid away after that. Wish I'd had this ongoing support

Oh poor DD, hope she has a lovely sleep. Though I do suspect there is lots more to come out yet (and push for that x-ray if necessary) - it would be awful for her to go through all this and still have an impaction of old poo still 'stuck' if you know what I mean. Please don't underestimate how much poo a colon can hide away! It is probable she bled as the poo was so hard and solid (having been there a while). She might need some re-assurance that this is only a temporary issue. She can only move forward from an empty bowel. And because it will take a few months for the colon to return to right shape / sensitivity it will be quite hard to keep her unconstipated at first I would imagine.

Weird though isn't it. If folk in RL has talked about it you would almost certainly have picked up on it and applied to dd - you are clearly an intelligent and thoughtful person.

Lol at you reverting to poo inspections - by the end of next week you will be completely blase! I thought about DD last night - and really hope this week isn't too difficult for her. She is doing well, but expect more pain and movements yet....

Just to briefly add that DD was prescribed Anusol cream (usually used for piles!!) to help with the sore bum (bleeding etc) as hers had got quite sore and cracked (sorry if TMI) when the problem was at its worst.
You can buy this over the counter and I do think it helped.

Also that DD had said she was a bit itchy and was treated for worms - if there have been lots of soiling accidents then its not uncommon to be a bit itchy but also worms are more likely so the GP said she should have a one off dose of worm stuff (again you can get this over the counter) just to be on the safe side - worms can aggravate the problem with a sore tummy etc so it was a precautionary measure as a one off dose.

Glad to hear that things are moving along!

Oh Worrybum - you must have felt dreadful.But it is such counter-intuitive condition. Hope things are better now for you. Even a lot of older info / web sites say it is behavioural.

STGVW - Just in case you are wondering how I quite a lot about this - I had it as a child, I grew out of it and have done quite a lot of research as an adult. I didn't get much help as a kid, and was bit misunderstood. A painful time for me. I sort of recognised your DDs reactions straight away.

I don't normally post on MN much more of a lurker, but you story touched me and I couldn't not post. I was going to say I'll name change after this...but doesn't that re-enforce the point. It is such a taboo subject, even now.

worrybum, that must have been awful - hardly helpful is it? i have been/am beating myself up enough without any extra hel from anyone!

feel free to use this thread as your support too, it would be good to see how your dd is getting on especially as they are so close in age.

DLeeds, I did wonder how you knew so much! Sorry it happened to you but a) well done on getting yourself over it with little help and b) WELL DONE and THANKYOU for turning the situation round and offering your valuable knowledge and support to others, must feel good to know your helping kids not to suffer the way you did.

No problem, got the scars but long time gone. But your posts did make me so vividly remember a few things! But I guess that's why I feel so stongly about how stigmatising the whole issue is - and am so ridiculously pleased your DD has overcome the major barrier which is telling people. Kids are egocentric. In someways is it impossible for them to feel it is not their fault without outside intervention. I think the shame thing about bodily functions is hardwired - you can't imagine a child hiding a broken ankle can you!

I genuinely do think you are doing well though in handling all of this, now you are on the right track.

how is she doing today? been thinkin of you both.

hi. Just wondering how things are going?

Hi

So sorry I didnt see the posts asking how we are doing. Thank You!

Well, 2 weeks down the line and I'd say things are better.

The accidents are more regular (and just as many wees as the liquid poo - is this to be expected?)

She is now having some poos on the toilet and thankfully they are starting to hurt her less. I'd say input still far outweighs output though , (she has had probably 4 poos in just over 2 weeks)

I took her back to the doctors yesterday and the referral to hospital is now in place but the doctor estimated a 6-8 week wait.

The doctor has asked us to double the dose on the senna and lactulose but Im a bit wary, would hate for her to lose even more control while the blockage is still there.

Does anyone have any thoughts on that?

hi stgvw - i have read the thread and my thoughts would be to wait until the school holidays before upping any laxative doses - at least then if the effects are a bit'dramatic' your dd is in the comfort of her own home and has you for instant support. hopefully, the 6 weeks hols will be a really good time for her to get more 'in control' so that she feels more comfortable when going back in september.

have they not tried using movical in addition to the current dose rather than just doubling what she's on. I thin movical does something different which would therefore be more helpful?

Just read the whole thread and in answer to your question, I wondered if those glycerine suppositories might help. I've used them on Ds a few times when he's become constipated and they really helped from the exit end so to speak. Holland and Barrett do them I think as well as Boots etc.

I really think you should for movicol in the hols. It is excellent stuff.

C & P'd these commments by me from another thread

We had this with dd1. Is your medication called movicol?If so, dd was on this for about a year.
We were told that movicol was designed to be used via doubling doses
i.e. day 1 - 1 sachet
day2 (if no result day 1) - 2 sachets
day 3 (if still no result) - 4 sachets and so on - up to 16(!) sachets!

We used mostly 1 per day except for occasional bad periods, then dropped it to half per/day, then every other day until we could drop it altogther.
What you describe suggests either the dose is too high at the mo, or that she has a blockage and is getting leakage around it. (We had this a few times when we 1st started).
I would persevere for a few weeks, by which time the runniness should have settled. If not, drop the dose.
HTH

This was me, DD is going into hospital on Sunday for 4 days

Hi hows it going - hospital? nice to see the updates. What's happening now?

Well, yesterday was the long awaited hospital referral and we saw a fantastic consultant who said she likes to deal with these situations aggressively, thoroughly and quickly and will not have a child of 8 suffering from continence issues that can be solved in hospital.

So she will be admitted on Sunday (which is my boys birthday but never mind) and kept in for 4 days - they will be thoroughly clearing out the ball so there is absolutely nothing left inside then allow it to rest and recover (which it does, quickly, apparently once it is completely cleared and rested)

She wont be about to eat for 48-72 hours then we will leave hospital with a plan on reintroducing food and keeping regular bowel habits going.

She said that this will be absolute cure so I just her optimism is correct!

Hi many thanks for the update - yours is one thread on mn which really moved me - I have often wondered how you got on over the summer

I know hospital sounds scary - but for what it is worth, from every thing I have researched on the internet this is exactly the right sort of treatment - which consultants actually rarely go for. (I didn't say this on your first posts as I sort of guessed you needed to be guided by your own GP). My own feelings are it is best to be vigorous - (although hard in the short term) than risk longer term psychological issues arising from incontinence.

I wish you and your daughter the very best of luck and hopefully a good clear out will provide a better start to recovery. Am also hoping your daughter is still as wise and balanced as she was. Take care.

Im feeling very tearful about it to be honest. Just worried that it might be really awful for her and stressed because of the other two kids i wont be able to be there 100% of the time and she is my baby so feel split in all directions.

She is still handling it brilliantly, she could tell I was worried and said mum, im in good hands, they will look after me so if you cant be there all the time ill be ok. SOB. Which makes me feel worse!

I am really grateful for this consultant, she said herself that its not the way most doctors choose to go but that she thinks its the only way to do it properly and prevent long term problems.

Does anyone know actually what will happen?