HELP!! Stool withholding? Marks in pants!

[n13arw]

We toilet trained my little boy when he was 2.5. This went pretty well, within a month or so he had pretty much nailed it. However, we always seemed to have a problem with poos, in that he would seem to hold it in and leave a mark on his pants. I can only describe this as a skid mark (sorry TMI). Not actual poo, not what you'd call an 'accident'. Not enough to smell it, or leak out of pants or anything, just a really faint smear/mark.

I had assumed this was just an extension of toilet training and that he'd grow out of it. He's now almost 4 and due to start school in September and this is still happening from time to time. We have good phases and bad phases.

He knows 'the feeling' and a lot of the time will either tell me he needs a poo and I take him, or sometimes he'll take himself off to the loo and shout me after. However, other times we seem to have this withholding which causes the marks his pants. He tends to sit down cross legged, sometimes sat on his hand and will have a sheepish look. I know what's likely to have happened/be happening and I obviously rush him to the loo and encourage him to have a try, there'll be a mark in his pants, then sometimes he'll poo and sometimes he'll have a try but nothing comes.

He definitely knows the feeling of needing the toilet as sometimes he goes without issue. I've picked him up from preschool today and he's had a change of pants due to marks again.

In November last year I was due to have another baby so I took him to the GP as we'd had a particularly bad phases and I didn't want to have that to deal with as well as a new baby, she suggested he was constipated and prescribed Laxido. This did nothing but made the marks worse/looser/wetter. His diet is varied and balanced. He's not great with veg (unless hidden) but has plenty of fruit and fibre etc. drinks lots etc.

We go through phases, some weeks are great with no marks, some are terrible and I have to change his pants every other day.

We encourage him to have a try in the morning every day and again in the evening or before bed, even if he hasn't got the 'feeling'.

I'm really overwhelmed and at my wits end tbh. I've tried everything (or so it feels). We've chatted to him LOADS. Explained it all a million times. When we ask why he didn't go to the toilet when he got the feeling he'll say 'because I wanted to play'. We explain that by not going to the toilet, it takes him away from playing for longer with a change of pants etc! so it's best to just go when he gets the feeling. We've tried taking toys away and discipline but that doesn't work either.

Like I say some days are fine but others, this happens.

Has anyone been through this? Is it just an extension of toilet training? Is he just a typical lazy boy? Has anyone been through this and got through it?

Any help is massively appreciated!!!

This absolutely sounds like constipation and overflow (encopresis).

Have a look at the Eric continence website.

I also suggest going back to your GP.

Laxido/movicol is used to clear an impaction higher up in the bowel. Watery stools are part of this.

Sounds like constipation. Ask for a referral to a Paeds encoporesis nurse- the school
Nurse might be able to refer too if you can't get a gp appt and he's in a school nursery

The stains are overflow from an impaction further up.

Thanks for your replies. Is it really constipation even though the stools he does are a good soft consistency? And that he goes every day on the toilet, sometimes twice? He has zero signs of constipation (apart from this if is one)!

Is he passing wet farts for want of a more delicate phrase, that leave a pooey mark.

I’ll disagree and say it may not be encopresis yet.

Trying to speak delicately, if a child really needs to go and they’re withholding, there is likely to be some staining of underwear.

Withholding can of course lead to constipation, which can cause painful bowel movements and further withholding. It’s always a psychological thing. Lots of young kids find the business of pooing kind of yucky and don’t want to do it. Some just refuse to listen to their bodily signals. I don’t think it’s pure laziness. At preschool it’s very likely to be that the toilets are yucky and he doesn’t want to use them. Or they’re noisy or lacking in privacy. Or he struggles with wiping. There could be all sorts of explanations.

Not wiping properly seems like a good bet too.

You have my sympathy as we are going through this with my DD 3. It's really common but hard to cope with. I don't have any advice, sorry.

My daughter is also 4 and starting school in September and she went through similar last year. Potty trained for over a year but we were having to change her pants every other day due to her having (for want of a better word) considerable skid marks. It was like she didn't make it to the toilet in time. It was enough to have to chuck pants out, but as you said, not enough to smell!
when she did go to toilet it was soft and I wouldn't have said she was constipated, however, we knew something wasn't right and wondered if food was a factor - she was having shreddies every day and we cut them out and that stopped it, we think she had an intolerance to too much fibre. Ever since we've started mixing up breakfasts more she's been absolutely fine and not a single accident!
Not saying it's that but thought I'd share my similar experience! 😊

Not wiping properly is not an issue, I still wipe him every time, usually with a water wipe or two and would always ensure he was completely clean! Even if he attempted to do it himself I would still check it myself.

I don't think it's the environment of preschool, he does it at home lots too. We still praise him like mad if he does a poo on the toilet, sometimes we even reward with a present or toy if he has a really good run of no marks.

I didn't think it was constipation but maybe another GP visit would help. He doesn't any other signs of being constipated.

Sorry to hear others are going through this. It's real tough!!!