Toilet issues - 4 year old

[Laura1990111]

Hi everyone,

I’m at a bit of a loss of what to do next.
My child is up and down with his toileting (he’s just turned 4). He’ll go through phases where he has accidents - mainly poo. He will always use the toilet for wee. However recently there are constant wet patches. Very rare he has a full accident but always has wet patches. Sometimes big ones.
hes been at pre-school well over a year now and it’s just started. So don’t think it’s that. Although he’s full time now and wasn’t before the summer - he did half days. He’s just had a new baby sister but he started it before she was born. He absolutely adores her and his routine hasn’t changed except for school.
the teachers ask him he needs the toilet and he says no. But he’s got a wet patch.
he said he feels when he needs the toilet. He’s doing it when he’s at home and when he’s out with me too - not just school.
I have tried reward charts, prizes, all sorts and it works temporarily and then he starts again.
im going to phone the GP tomorrow but just don’t know what to do from here.
He’s coming home every single day like it. Today he’s had his trousers changed twice at school.
we’ve had problems in the past with him withholding poos as well. This sometimes happens still but mostly issues with wees.
im a teacher so I know it’s normal but it’s just a lot and I want him to be happy and confident.

any advice for a worried mom?

sorry for all the grammatical errors etc, I’m trying to write this quickly while caring for two kids!

thanks everyone

I should say that when he needs the toilet, he does go and says he needs a wee or a poo but seems to leave it till the last minute so he’s basically running there

It could just be 'he's busy' but it could also be caused by constipation.

How often does he do a poo? When he does one is it colossal? I will say right now that if he was referred to a continence service they will look at his bowel movements before even beginning to look at wetting. The problem is the bowel sits really close to the bladder and so constipation (mostly due to with-holding but also can be unexplained) puts pressure on the bladder, stops it from working properly and stops him from feeling the urge to go (both poos and wees).

The answer is to address the poo first through a combination of stool softeners and good techniques to get him going regularly (and all of it). Have a look at the Eric website. You may think he doesn't seem constipated but the wet stuff kind of by-passes the dry or icky stuff!

You could try a sweetcorn test, give a bowl of sweetcorn (once) and see how long it takes to pass through his system, it should be 1-2 days. I would get advice from a dedicated continence service but don't wait around to address the constipation, prolonged constipation can cause problems...GP can prescribe something like Movicol.

Yep lots of trouble, the poo was the major issue though, in the end he gets the opportunity to go to the toilet any time, gets prompted after every meal at home, and after evening meal it's toilet time if he hasn't already been. He always insists he doesn't need but usually does in the end.
Wee I can't get as worked up about, I prompt him a lot but it's not going to cause any knock on problems.
Also see eating and sleeping for other things he doesn't handle without being told it's time.
He's 5.