10 year old won't use toilet

[Katiemonkey15]

We are at our wits end now with 10yo dd who has fairly frequent accidents in her pants because she just won't go to the loo.

She eats a good diet, no food allergies (we tested), no learning or behavioural issues and nobody else in the family has any issues. We have a 3yo who just toilet trained like a dream yet were dealing with this with a 10yo. I do try not to get too cross or overly embarrass her about it but it's really tough because she will literally sit on the sofa and poo her pants rather than take herself to the loo. Sometimes her sister will tell me that she's doing it cos she can tell by her body language (and the smell and somwtkmes noise) but dd herself just sits there and shows no urgency to get herself to the loo. Unless I frog march her and make her sit she won't go to the loo at all.

Have tried incentives, punishments and nothing seems to work. GP thought she might be constipated so we tried laxative drink sachets for a while but only made it worse as gave her diarrhea.

Anyone any advice on how to basically re-toilet train a ten year old?

Tell her to put vaseline on her bum BEFORE she goes for a poo during the diarrhoea stage. Stops it burning her skin so much when she wipes.

@TheShellBeach I feel terrible myself as I did tell her off and get quite cross with her a few times when it had seemed to me like she'd just made no effort to get herself to the loo. Ive told her how sorry I am now and could cry thinking about it really. I'm still hoping we get the child psychologist referral through sooner rather than later because while we know now why it was happening I still think being able to talk to someone about it and what it's been like for her would be good as she shuts down the conversation with us and didn't even tell us or the doctor she was in pain.

Thanks so much @Balloonhearts. These little practical tips are a godsend. Have already stocked up on vaseline so will definitely give that a go.

Stocked up on wipes too but saw another mum on fb say its the wiping rather than the diarrhea that does the most damage to the skin and a few different people recommended a little tub thing called a sitz that attaches over the loo. Their dcs then just sit and soak their bum in the water for 15-20 minutes after a poo to give some relief and instead of having to use wipes or paper and cause further irritation. I ordered one straight away (I'm easily influenced!) but then remembered the doctor specifically said to avoid having dd sit on the toilet too long cos of the position of the fissure in her anus so maybe adding time on it with the sitz bath is a terrible idea in our case.

I do think that you should explore the possibility of neurodiversity, OP.
Even though you're unsure because you think that your DD doesn't seem to fit the profile.

I wasn't diagnosed as autistic until I was in my sixties. But as a child, I now know that I showed clear signs, which my parents didn't recognise. Not surprising, in the 1960s.

@TheShellBeach yes it's something I don't know enough about tbh. As I said it's not something that has ever been on my radar with dd but if its something a psychologist points us towards for whatever reason then I'll trust their professional opinion.

Thinking now I should own up to dd that I have to tell her teacher the truth?

Is there a school counsellor? Ours was brilliant with dd. Her issues were anxiety related so giving dd control over how things were shared really helped her. There were non negotiables we had to share with school and we explained why but we let her decide how and in what language. Also avoid putting anything very personal or intimate about dd in an email to a teacher as these days emails are no more secure or private than text messages. Go into school for face to face meetings rather than have any lengthy email exchanges.

I’m so pleased you managed to get your DD cleaned out. I know it must have been very stressful for you both. Just to reassure you about the movicol, my DD was on it for YEARS. She had held on for ten days and stretched her colon. I remember the amount that came out! 😱Poor little kid was terrified. For extra reassurance, she’s 20 now and bulletproof.

@Kira4 No counsellor onsite as its quite a small primary school but the school is great and accommodating generally and dd loves her teacher. Wise advice about the emails, thanks

@Fraaahnces Shes full of energy now this evenjng so think its definitely made difference for her. It is a lot to get my head around that she might be on laxatives now for years but stories like your dds are reassuring too so thank you

I'm glad you got it sorted at the hospital. Unblocking her is great news, so that the movicol will break down future bowel moments. It's taken 2 years of laxatives to correct my daughter's enlarged bowel. We now just use califig and kefir. Epson/magnesium salts in the bath really help too. You may be on movicol for a long while. It might be she needs less over time, for example she goes from 2 sachets to 1 to half. She'll need to communicate how much she's been to the toilet, and how hard/soft it was. You'll need to know. Your daughter must be feeling much better. Mine used to feel so tired all of the time, it really took it all out of her. She's full of energy now, she's like a different girl! I wish your daughter all the very best.

Thanks @Beautiful3 She's full of energy this evening so think she must be feeling the relief.

Had no idea epsom salt baths were good for constipation? Used to use them a few years ago for d2 when she had a bit of eczema but worth a try now for d1.

Glad to year your dd is doing so much better

@Katiemonkey15 I have been reading through this post for ages and I just wanted to say I am so glad you got to the bottom of this. I hope your DD is feeling much more comfortable now x

Just want to say thanks @Pleasegotobed This arrived yesterday but have only cracked into it now since kids went to bed and already feel it's really helpful for me.

Could anyone recommend any books for kids dds age? There seem to be lots for younger kids but would be great if there's a book that's child friendly on this topic without being babyish.

Thanks @sunshinecitrus1 . Feel really lucky we got to see a fantastic doctor really quickly. I was totally baffled by what was going on (genuinely didnt think she was constipated even though it seems obvious now) and hate to think what state she could have ended up in if people didn't spur me to take her back or GP and get a referral. Might not feel so positive about things this time tomorrow once the movicol has kicked in but can see dd was feeling more herself today already so think we're going in the right direction.

And if tomorrow is hard, remember, it's only a week since you posted, and look how much further you have already come.

My DD was younger than yours and there were lots of books aimed at toilet-training toddlers and making light of pooping. By the sound of things, your DD has no learning difficulties and won’t enjoy the ones I am thinking of as she is too old. (For those with little ones, “Everybody Poos” and “Who Flung Dung?” were my DD’s favourites, but again, they were age appropriate.

For a 10y/o I would recommend just buying a series of books she enjoys. If they are amusing, even better! Try something like this series… They’re hilarious! (I think the audio version is even better, btw. Good for read and listen practice.)
Heroes Guide Books

Good to hear she's feeling so much better!

A thought - I was advised by a bum specialist (colorectal surgeon, imagine wanting to do that as a carer!) that paper wiping can cause abrasions and skin fragility. He recommended wet wipes (not to go down loo), and I've also seen an aloe vera product called Wype, a gel you put on loo paper for gentle wiping.

https://wypeuk.com/

I’m so glad your DD got sorted, OP. I thought it had constipation written all over it.

A few tips -
— yellow Metanium cream is brilliant for bums made sore by disimpaction (disimpaction is the name of the clear out you’re doing now)

• I’ve had an anal fissure once and it was the sorest thing that’s ever happened to me. It was like being stabbed in the arse by a shard of glass. Do read up on all the self care things you need to do to make it better. I found sitting on hard rather than soft surfaces was better for healing.
• dealing with this is going to take a long, long time. DD (nearly 8) did her first disimpaction when she was 3 and her consultant says she’s likely to be on Movicol well into her teens. I need to be really vigilant about how things are going down there for her.
• The accidents may continue because a situation like your DD’s can cause a loss of sensation which will take time to come back.
• I really encourage you to join the Facebook group Movicol mummies. It’s an absolute godsend. So supportive and helpful.

Thanks @Fraaahnces The doctor and nurses in the hospital did such a good job of explaining what's happened to dd (it was like a teaching session as much as an examination appointment) that I could see a little light bulb going off for her and I think understanding what exactly is going on in her body might really help her to see the importance of breaking the witholding habit. She also seemed to really like learning the medical terms and seems to find it less embarrassing to talk about her rectum and colon rather than her bum or tummy so I'm trying to remember to use that language with her too to encourage her to talk about it and tell me if she has discomfort etc and so far it's working

@JFDIYOLO Thanks. I'm stocked up on wet wipes and got a sitz bath that she can soak her bum in on the loo for a while after a poo. Saw someone recommend giving dcs a spray bottle of water to help too because wiping gets hard once the skin is irritated and they can tend to avoid cleaning the sore bits which makes them more sore in the long run.

She can put a little soothing cream on the toilet paper and clean the fissure with it.

Conotrane is good.

Thanks @Rainallnight . Joined that group. There is so much information (maybe too much for me all at once at the moment) but the practical tips from other mums are a godsend.

I've never heard of yellow metanium cream. Does it go by any other name? Dd suffered so badly with her poor bum the last time we did the movicol that I felt I had to stop. Obviously that was a mistake but dreading the same happening again so will give anything that might help her in that department a go. Vaseline on before the poo comes seems to be a common tip too but there was barely a 'before the poo comes' stage last time to have done that because she was going non stop.

I've been reading as much as i can about the fissures. Doctor didn't give us any medication or cream or anything for it so not really sure what to do for it other than have her soak it and keep it clean. She's not complaining of pain from it at the moment and she's happily using the special stool for sits so hoping that will help.

Sorry to hear abour your dds problems but sounds like you've been on top of it. I think it'll be hard to balance 'viligalance' with wanting her to he independent. I don't like the idea of her relying on laxatives or on reminders/nagging from me to go. I'm really hoping she'll get back to a point where she's just going to the toilet naturally and without my encouragement but I'm not thinking that'll happen overnight.

Doctor said the same about sensation, especially because there might be some anal damage with the fissure. Getting that back is the key thing I think. Doctor couldn't tell for sure how much her bowel has been stretched but thought we caught it in time to avoid longlasting damage but at the moment probably not possible to predict how long it'll take her to get normal urge sensation back? I'm hoping because she's young it might recover quite quickly as long as she doesn't get blocked up again.

@TheShellBeach do I need a prescription for that?

No, you can just buy it.

And OP, getting her to shower twice a day, suggesting that she points the nozzle with warm water in the sore area where the fissure is, will also help.