8 year old incontinence!!!

[Suwzlouisa]

Please someone give me the answer!
My 8 year old son is exhausting me with his incontinence. I can’t say he’s ever had more than a month of no accidents at a time and I am pulling my hair out.

Ive spoken to doctors. I’ve spoken to eneuresis. I’ve done everything they’ve told me. We’ve had desmopressin, lactulose, movicol. We monitor types of drinks and diet.
NOTHING WORKS

Night time he’s yet to be dry which I have no problem with. I get that some kids just take longer so I’ve never held it against him and have always been very chilled about it. But day time is becoming relentless. We’re going through 6 outfits a day some days and I am 99% sure it’s laziness. I’ve tried all the approaches, “never mind darling these things happen”, not acknowledging it other than changing him, allowing him to help me clean up, all of them. He’s pretty much admitted it’s cos he’s busy doing other stuff but surely it’s not normal to walk around caked in wee and poo?! Hes getting sore on his groin and quite frankly he stinks!
I’ve tried alarms and regular prompts but he merrily ignores them or argues like mad that he doesn’t need to go. I’m losing my mind! I don’t want to be telling him off but at the same time it’s really bloody hard not to right now.
do I punish him when he’s admitting it’s laziness? Do I give movicol etc even though it makes absolutely no difference whatsoever? Does he need to be embarrassed to make him realise? He just doesn’t seem to care. He has this mentality that as long as he gets changed then what’s the issue.
theres no mental health or physical health issues but he’s the type of child that if you planted the seed that he couldn’t help it he’d run with it. But he’s more than capable of going he just chooses not to.

I’ve had so many mixed pieces of advice and I just need some help because as silly as it sounds it’s really affecting how our days together pan out and I don’t want that.

This sounds very difficult and frustrating. Does he have any motivation to use the loo? are there things he can’t do eg sleepovers with friends that he wants to do? ie what is the carrot?

two things which have worked with children I know:
night time - community nurses leant him some pants that had an alarm fitted as soon as they sensed liquid. Very very loud and so everyone wakes up and you put them on the loo. That technique seemed to adjust the brain messages if night time
wetting

day time- the mum explained that he’s now old enough to wash and change himself. Also explained they couldn’t do x eg play PlayStation if they were wet. This was annoying and so the child got fed up with it and started using the loo as he didn’t like cleaning himself up.

Also I would ask for school support. Ask if TA can ensure he goes to the loo before break and lunch and end of the day?

Gosh, I’m not sure. It doesn’t sound normal for a boy of 8 to be dirty and wet and not be bothered. I would be making sure whatever he is busy doing stops the minute he soils himself and then he can clean himself up, wash his wet and dirty clothes, and do something else. Try to remove the distraction. I would consider mandatory toilet sitting too, with a very plain ‘no, you need to sit on the toilet every x minutes because otherwise you just go in your pants and that’s dirty.’

And get to the GP regularly. Force them to help you.

The nurses have given us an alarm but they’ve said there’s no point trying to sort nights until days are sorted. He wears a pull up at night and even just I’ve gone up and it’s full even though he’s still awake and his rooms next to the bathroom. He’s got a sleepover with school on Thursday and I’ve tried to put his mind at ease about helping him disguise the pull up for bed time but I’m at a stage where I’m questioning even letting him go. I feel really harsh and I don’t want to be but nothing seems to make a difference. He seems to latch on to something that he thinks makes it ok, at first it was as long as he told me, then it was if he helped with the washing, now it seems to be if he follows it up with “it’s cos I was lazy” that it makes it all ok?!

I have a 7 year old with some similarity. He doesn't have wee accidents but still soils himself regularly. We've been gentle about it for years because he was previously constipated and the specialist nurse said it would have affected his nerve endings so he would not get the full signals about needing a poo.

Sometimes it's small smears, which he claims he doesn't know about and it's just about plausible but ocassionally it's more and he admits he just gets caught up in stuff.

Sometimes he gets so short notice nothing can help. We've been out and about when he's suddenly said he needs a poo but it comes within a minute, no time to get to a toilet.

I don't know what the answer is, but I can be here for some solidarity.

Latch on to the sleepover - tell
Him he can't go unless he's dry by then? Desperate times... desperate measures.

This doesn't sound right for an 8 year old. I'd be pressing the GP more/switching gp to one who took it more seriously. I wonder if there's something physical going on. For example, my DC has cmpa and when they're allowed dairy they have wee accidents, it took me ages to put two and two together.

I just feel awful. I love him so much and he’s got so many amazing things about him. But when it’s the same battle over and over it makes me really dislike spending time with him. Which I know makes me terrible but I just feel like I’m banging my head up a wall because I just know it’s coming.

Is he actually passing formed poos or is it watery bypass from constipation?

Is he having accidents at school?! What are school saying? And is it both urine and faeces?

Has he had a scan of his bowels? Could he be impacted? When my son gets impacted he has constant accidents as it pushes on his bladder.

Accidents anywhere and they’re anything from skid marks to full poos. School have ensured me he can go to the toilet whenever he wants

I have a 6.5 year old DS who is similar. He's always been lazy going to the toilet (although he's been dry at night since he was 3)
Every single day he leaves weeing til the last minute and dribbles in his pants. Last week at holiday club he tried to hold it all day and wet himself twice. He stinks and I've told him so but he doesn't care.
We've also had incontinence nurse and used movicol. It's bearable as it's only a small patch each time, and he never tells us (plus it doesn't leak onto his trousers so he doesn't get changed as we don't know it's happened)
He's admitted it's coz he didn't want to stop playing to go for a wee.
I'm just hoping one day he stops doing it as we have to put sudocrem on his bits most days where he's sore.

Is he soiling himself at school? What happens when he does this? Kids are pretty unforgiving of these things do I’m surprised comments haven’t been made by his peers that would make him embarrassed and not want it to happen.

Have you seen a play therapist from the continence service? We have been under the continence service for a couple of years (DS is 9) and they have not been v helpful apart from ruling stuff out eg bladder scan. But last week 2 play therapists came to the house and we have a new plan in place - nothing revolutionary different to what we have done before but for the first time I feel that we are being properly supported.

I have also found giving him a picture of a toilet rather than telling him to go works sometimes - takes some of the frustration out of the situation

Honestly @Suwzlouisa that sound exhausting for you. I would be cancelling the sleep over though- how can he do that when he’s not even going to the toilet before bed. His pull up will be full before he’s even gone off to sleep .

It sounds exhausting op. My dd has had continence issues so I understand some of your frustration.

is he pooing and weeing in school? Is he actually constipated because I’m not sure if movicol would be any use if he isn’t. It would possibly cause more accidents. Are the poos he has in school actual poos or overflow from a constipstion blockage? Also what dosage of movicol is he on?

it’s unusual for an 8 year old to happily poo and we themselves in front of friends at school. I think you both might need more support - play therapy as mentioned above might be useful. Is he worried about the sleepover?

we were told to encourage dd to poo on the toilet by letting her use her iPad on it. It didn’t even matter if she didn’t do a poo, just regularly sat her on the loo with the iPad. She loves her iPad so was happy to do this. It then relaxed her and she was more able to go which we praised her lots for. Could you do something like this perhaps to encourage the use of the loo?

An 8 year old wetting and pooing himself 6 times a day is not normal op. It's so easy for the abnormal to become normal because fighting it is exhausting, you need to keep reminding yourself of this.

I'd totally separate out the day and night time because you're right that he can't control it at night. I have a 13 year old on desmo who still wets nightly without it. Its beyond their control when sleeping.

But if you're absolutely certain there's no medical problem then it's behavioural in the day time and something he can control.

8 years old is far beyond the age for needing a softly softly approach. I would sit him down and tell him this needs to end now. Right now. No more chances, no more messing about, he's not a baby and he needs to make sure he makes it to the toilet every single time.

If he doesn't, I'd punish him. If he's too busy watching TV/playing Xbox/building Lego - whatever it is that took his attention so much it stopped him going to the toilet, ban it for two days. Let him cry and be upset or sulk. Warn him in advance this will happen.

When his banning of xyz ends, tell him the next time it happens it will be 4 days. And the time after that a week, then a fortnight.

I would keep going and I'd be extremely harsh with it.

You know this already, but this is not formal. Are there any other learning difficulties I wonder as this is very unusual and I'm sorry I can't be more helpful.

This sounds behavioural. Definitely do not start punishing him for accidents. I would seek some professional advice and probably go down the route of psychological support for him. It is not normal and there is something underlying it, most probably not a physical problem.

Do not do this. It will exacerbate any issue he already has in relation to toileting/bodily functions and probably escalate his behaviours. No child wants to go round smelling of wee and poo. Somewhere along the line he has developed some complex behavioural issues around toileting and these need unpicking and understanding, not punishing.

I would suggest going back to the GP. Ot does sound like there might be more to this than just being a bit lazy about using the lav. My friend was at the end of her tether with her DS9 constantly weeing himself. She was told it was very common for boys to not be bothered etc... They recently discovered that he was actuality having frequent but very minor epileptic episodes.

Check out ERIC.Org. Sounds like chronic constipation and overflow. He may need a complete disimpaction and then a regime of timed toilet sits. It’s very hard work but check out ERIC and Movicol Mummies on Facebook

I agree with this

My daughter had continence issues for some time and it started off as a physical issue (recurrent UTIs) but two unkind nursery nurses in preschool made it 100% worse. She would hold her wee in because in her head if she continued to hold it in she didn't have to deal with the toileting issues. Of course it always ended up as an accident.

It took a lot of work at school and home and basically for a couple of months we took the lead and the teachers and I told her to go to the toilet every 2 hours. That worked and then they got her into a routine at school where she goes before she leaves for school, at break, at lunch and before she comes home and hasn't had an accident in almost 2 years now. She is an anxious child and when there's a new teacher in the class they're told to let her know that if she needs to go at any time she can and even though I don't think she ever goes in lessons it takes the worry away and means she can keep her her routine.