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?

Oh the poor kid! It’s awful for her, but she is disimlacting. It will settle down when there is no buildup. When my DD had this problem, the doctor did say that it was the sensitive, anxious kids who tend to get this problem.

A better night as she got a couple of hours relief and then was able to sleep through this morning from about 5am to 11. Things are very erratic as she's now not going as much at all but she's doing very hard poos that are slow to come out despite oodles of vaseline so when she does need to go its taking ages and is a bit sore. I presume this is older stuff that was blocked up higher up but getting her to drink loads in case it's just dehydration?

I think you’re on the right track. Poor little girl is going to feel SOOOO much better when this sorts itself out! She must have been so uncomfortable!

This will definitely be hard poo from higher up the large bowel.
Obviously she needs to get rid of it, before things start to improve.

Poor girl! But on the right track now.

I can hear it thumping the toilet bowl from outside so must be like rock. According to her the smaller the piece the longer its taking to come out- she's getting frustrated at waiting ages for a little pebble! Thank goodness for her ipad or I think she'd have lost the plot by now.

No worries @Apolloneuro . I'm sure if I read back over the whole thread I'd be screaming at myself. I just didn't think she was constipated cos I didn't get it at all.

You can buy pico sulphate from the chemist. But you're supposed to be 12 and over, so say its for you. It makes the bowel contract and pushes it out quickly.

Glycerin suppositories also help to empty the rectum of hard faeces.

I'm pretty sure the Dr was going to give her these tablets if she hadn't gone by the end of the week when nothing seemed to be moving but he wanted to hold off as said they'd be very hard on her tummy at the moment. From what I've read they don't soften the poo but just force the bowel to work harder to push out so would probably give her a very sore tum and not make the actual passing any easier? It's right at her bum rather than in her tummy that the hold up seems to be

If they're still very hard and slow to budge tomorrow I might ask about these although not sure I'd trust her to put them in herself and not sure she'd let me

You can buy them without a prescription.

I'm assuming she hasn't started her periods, so she wouldn't be likely to put a suppository in her vagina.

@TheShellBeach I'm just not sure if she should be taking a suppository because of the fissure though so should probably double check with the Dr

No. Don't experiment with other things. Just follow the doctor's advice. I think people might be forgetting this is a 10-year-old child. Her bowels are moving. There is no need to rush it.

Dr hasnt led us astray yet and I really trust him so would like his advice before I do anything but if there's something that could soften this hard stuff it would make things much easier for her

Poor thing. You are all doing so well.

We did also have very good results with sodium picosulplate so do ask the doctor. (Don't just add things yourself. )
My daughter was prescribed it when she was 6 and stayed on it long term which is a bit unusual. They warned of side effects but she had none. She was also on movicol.
The specialist said most side effects from sodium picosulplate were when the poo was still hard though. So your daughter might not be ready yet.

Big hug to both of you.

There are a couple of books you can buy from ERIC. From memory the title is something like 'a girl like me'.
I feel like I could write a book on the subject after our treatment of this 😁

Thanks @Mynewnameis

Any advice on softening the hard stuff?

I'm pretty sure Dr didn't want dd to take the sulphate tablet yet because he knew she had hard poo to come out and that it would hurt her tummy. If/when we get back to the runny stuff and she's up in the night non stop again I might ask again though to see if could help her get some rest

Glycerine suppositories just stimulate the rectum itself to empty. There is no effect on the actual poo - they just help someone with constipation to evacuate hard stools.

But of course, do ask your doctor. I agree that that is very important.

Def don’t add the pico sulphate yet, not while the poo is so solid. Keep going with the movicol op. It’s horrible but this is normal. It can take quite a while particularly if there is a big backlog like your dd has. Bless her, poor girl. Really hope she gets there soon. You want consistent runny rusty tea like poo to ensure it’s all cleared. You could try her eating something like sweetcorn too and then see when she passes it so you know if the backlog has cleared

If she has a fissure don’t use glycerin suppositories. In my (personal) experience they can further irritate an already very sore situation.

Our DD was prescribed paediatric (low dose) liquid Docusate Sodium. This stimulated movement but just a little bit can be given to be gentle.

I wouldn’t use a suppository either. They are only for hard poo blockages right at the bottom end. OP’s DD is dealing with impaction from much further back in the large intestine.

How many sachets are you up to now @Katiemonkey15? I’m surprised she’s still passing hard stool but it might be a testament to how badly impacted she was, if the poo is still so hard after so much stool softener. Poor kid. She’ll be a new child once this is all done.

Keep up the water and the movicol. (It attracts the water to the bowel). The pebbles are a sign of dissipation so it’s working. If she were to have the tablets, it would cause bowel contractions and more pain, most probably…. speak to her Dr though.

How’s it going, OP?

@Rainallnight good thanks. The good news was that the very hard poos didn't last too long but the bad news is we went back to a bout of severe diarrhea. Its over now (hopefully) but its really left her bottom red raw. She is soaking it constantly (maybe too often?) to try to get some relief but it looks like her entire backside (and down between her thighs a bit but luckily not her front bits) has third degree burns. She's spent a lot of time out in the garden today so got her to wear a dress with no knickers under to try to let some air at it and she's done that happily (seems to feel better for her) but feel like it's going to need something stronger than metanium or sudocreme to heal it up.

Thankfully today she's having what look to me like very normal poos and miraculously she seems to be having the urge when they're coming. Really feels like we are getting somewhere now and hopefully the final stages are on the horizon.

I'm no expert but have found vaseline applied to very sore areas helps them feel less sore.

Metanium is what we use in hospital for the really bad incontinence burns. It is a barrier cream so you want to make sure there is a layer on her skin before she goes to the toilet to protect it. Then reapply after cleaning the area when she's finished.