Five year old avoiding toilets outside the home and having accidents

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Hi, asking for help/tips for anyone who has been through a similar situation.

5 year old boy, toilet training since age 3. Can take himself to the toilet at home most of the time, does still have accidents if he has pants on but if naked does not have accidents.

Main problem is not going to the toilet when out of the house. It seems like toilet anxiety - he has recently started laxido for constipation which may also be linked.
He says he can't feel it but i think this may be denial for fear of being in trouble - obviously he is not and we always reassure him it is ot a problem.

I just want to try and help him but just don't know how. We have done all of the positive reinforcement, reward charts, treats over the years.

Thanks

One of mine was like this. Still having accidents in Year 2. Then suddenly they got the hang of it and now they’re fine.

I incentivised the “just in case” loo trip before we left the house, to reduce emergencies.

I ensured most playdates happened at our house so a familiar loo was within reach, to minimise “holding in” and constipation.

If we went on playdates, I would stay for a cuppa and make a point of taking my kid to see the loo, “Look at this, what lovely wallpaper!” so they were not approaching it apprehensively and alone when they really needed it.

As in most things in life, you just have to practice and persevere.

Thanks so much for your message! Did you try and talk about it and find the reason?
Its hard to know whether talking about how he is feeling is going to help or draw too much attention to it.

Constipation can cause a child not to be able to feel when they need to urinate, especially if it's chronic. All the nerves get confused. It's not his fault.

Get on top of the constipation and your issues will disappear. Make sure you use the laxido every day, don't skip a day, and don't be alarmed by his poo being constantly runny, that's what you want to help his bowel shrink back to a normal size to prevent constipation continuing (it'll have stretched and become 'baggy', so you need to allow it time to tighten up, this often takes a year).

Yeah I was going to say it’s down to the constipation too.

Tell us more about the accidents, OP? There can be overflow in constipation which they can’t help.

One Of mine was like this and still won’t use the bathroom outside of home to have a shit as he now now says 🤣🤣and he’s 18 🙄🙄🙄 I used to on days out at that age take him in with me and pretend I needed to use the toilet in public places then get him to pick a cubicle of his own and tell him I’d race him to see who was finished first. Bat shit crazy I know but it worked 😭 It so transpired at his age he was terrified of the hand dryers! Completely random but popping in with him and making it like a stupid adventure really worked for me. Regular breaks as well to the bathroom as well whenever I saw one x

We have started treating the constipation over the last 2 weeks, he has 2 sachets a day currently. His last poo was type 4 on the chart yesterday, GP advised to increase until poo is everyday. Before laxido it was 2 times a week with overflow 1-3 days before.
The constipation does seem to be chronic, I wish I had done something sooner but things were improving then going backwards again.
The wee accidents if he has them at school or somewhere unfamiliar (holiday club) they are big full voids of his bladder. If they are at home it is usually a small amount and he will go to the toilet when he has to wee a larger amount.
It sounds like a mix of constipation affecting his bowels and bladder as well as some anxiety when not at home.

Yeah, if he’s that constipated it wrecks sensation, and it takes a while to come back after treatment. I also suspect he may need a proper disimpaction regime. Have a look at www.eric.org.uk

Thanks, i have been looking at ERIC so will look for that specifically.

For anyone that has done the disimpaction, how long did it take?
I obviously want to get it sorted as soon as possible but I can't have a week or 2 off work or him to be off school for that long.
But equally I don't want to have to wait 6 weeks either.
Maybe school but with nappies in case of accidents?

Disimpaction can take 2-3 days, but then once that's done you must keep on top of it for at least a year, making sure he's going every day. If you skip days, or think it's getting better so it's not needed, his constipation will return as his bowel won't have had time to shrink back to normal size and strength. It's not a quick fix, and will take far longer if you mess up and forget a day or two - I know this from bitter experience!

Also, expect his poo to be runny for a long time till his bowel goes back to normal size - don't make the mistake of thinking that he doesn't need to poo every day, as long as it's regular and softish, that's not correct. He needs to be pooing every single day without fail.

Sort the constipation properly, then consider urine issues. The bowel will be squashing the bladder.

If he’s got reasonable bowel control and awareness and will use the toilet at school then can disimpact and still go to school. Pull ups might be a useful back up to make cleaning easier if needed. There’s also the approach of getting school to do the laxido so the affects land after school.

Thanks so much for all of your advice, it is all welcomed!
I will definitely be doing it all by the book and keeping at it. I am going to start at the end of the week and hopefully the worst of it will be over the weekend.
He does go for a poo on the toilet at home when he has no pants on. But if away from home or in pants, he will have an accident usually small amounts until he is naked and can go fully. He says he can't feel it when it comes and if he does go he needs to get there straight away.
I am really hopeful that this will work, I know it will be a long road. But the last 3 years has been hard for him and me, so I feel there is a light at the end of the tunnel. So thank you!