3.5 year old's poo accidents really getting me down. any advice?

[longestlurkerever]

Dd is 3.5. She has been out of daytime nappies for over a year and is dry in the day but she has daily poo accidents. Today she has had several and I am at the end of my tether.

She has always been a bit odd about poo. For ages she had a poo in her nappy first thing in the morning and rarely at any other time but if she did it was almost always in her pants.

That pattern seems to have come to an end and she will just poo in her pants at any time of day now. It went really haywire when she started pre school and she was having several accidents a day. She was on movicol for a while which got her back to a more manageable one accident per day but we were making no progress with the toilet/potty though she will happily use either for wees.

After a couple of months of just dealing with it and not making a fuss we seemed to make a small amount of progress with some successes in the potty but it wasn't reliable and now seems to have got worse again. She hasn't had a poo in the potty for a week now and is again having bits of poos in her knickers throughout the day.

I have just changed her for the fifth time and am trying to get her to drink some movicol which is a battle even mixed with juice but I feel so upset and down. She starts school in september and I can't see us making any progress really. Nursery and health visitors have no suggestions. Nursery were really unhelpful at first but we have resolved that and they now deal with the accidents without complaint but it still dominates all their feedback and I am feeling like it's going to ruin her school experience too.

Has anyone any experience or ideas? We have had our best successes with rewards but these are very limited really. She will happily sit on the potty for ages but nothing happens.

[FleetwoodPacaMac]

Sorry no personal experience but a friend found good support from ERIC.

[PrincessOfThemyscira]

My DS is 6 and only just getting continence. He's been diagnosed with a mega colon. Basically, his colon is stretched so it stores up and he has a series of accidents over a couple of days, and then a massive poo the size of his arm. The accidents are caused by the massive poos desensitising his bottom, so he doesn't realise he needs a poo until it is too late.
The continence clinic at the hospital put him on movicol. At first he was on massive doses to clear him out, and is now on the daily low dose to keep things moving.
It did give him a bit of a poo complex though - it's been a struggle to get him to wipe himself, but his independence is improving.

I'm not saying that this is what your DD has, but it might be worth pushing it with the GP? We got our referral from the school nurse.

[longestlurkerever]

Thank you. They helped me sort things with nursery which was my most immediate issue at the time so will try them again.

[happyelf]

She sounds badly constipated to be honest. Basically what happens is the poo builds up to a level where the bowel is impacted. The bowel will likely be stretched and she may not have any sensation of needing to go. Then what happens is small bits of poo will leak into her pants as the poo is very big and only these small bits will leak. If you've seen your gp and been prescribed movicol then I would go back and ask for a referral to paediatrics.

My youngest dd is 4 and had problems since potty training. It was so hard watching her hurting and struggling to pass a poo. Sometimes she would go 2 weeks but keep soiling her pants. When she did go it was huge and very painful so in the end her bowel was badly stretched.

We got a referral and are now in weekly contact with her poo nurse. At first the consultant put her on 10 movicol to get rid of the impaction. It was a messy fortnight but things have improved drastically since then. She's been cut back to 2 movicol a day for the last month and if I notice her soiling or if she hasn't pooed for 36 hours I just give hrr extra until she does go.

It's a long haul but I'm hoping dd is sorted by time she starts p1 in august. We do try hard getting her to drink plenty water and she eats lots of fruit. Other thing is we make her sit on loo and try for 5 mins about 15 mins after every meal. She gets a story on the loo.

Hope you can get your dc sorted out but definitely ask to see someone who deals solely with these kind of issues. It took 3 weeks for our appointment so they were really quick

[WineWineWine]

She's constipated. If you can't get her to take movicol, go to your GP to get something different. Sodium Picosulphate is very effective. Encourage her to sit on the toilet for 5 minutes after breakfast or dinner every day. She can try blowing bubbles or blowing up a balloon but don't hassle her about trying to poo. You need to make sitting on the toilet less of a scary time for her, so do a reward chart just for sitting. Eventually the laxative will start to take effect. Keep up with the laxative until she is regularly and reliably pooing on the toilet.

[EskSmith]

She can't help it. She really really can't. Once you accept this it gets easier.

She sounds constipated and most likely needs to be on daily movicol I know it's a battle but she will eventually become resigned to it, I used to let dd2 mix her own which helped slightly.

Dd2 was hospitalised with an impact bowel and at that point only sodium picosulphate helped, was grim & messy..

Something just clicked with dd2 eventually but even after that she was on moving for 9 months. . Even now 18 months on I keep an eye on her if her diet changes, (holidays Christmas etc etc)

[EskSmith]

Meant to add good advice from winewinewine on making toilet a less scary place.

[Haggisfish]

We put Movicol in hot chocolate every morning.

[longestlurkerever]

Thanks everyone for your replies. I hope you get your issues sorted too - it's nice not to feel alone with it. I will go back to the movicol and try and get a referral to a specialist. I don't think the physical issues are the full story though as even when her poo is loose she won't use the potty - or at least extremely rarely. It's obviously become a complex and I don't know how to get her over it. She is very articulate and chatty but refuses to discuss this issue at all except for saying "Next time I'll do it on the potty".

Thanks for the tips re sitting on the potty, though at the moment this isn't a problem and she will happily sit on it for ages, though I have given up trying to make her sit on the actual toilet for now (though she will use it for a wee). It's just that nothing happens - even if she clearly needs a poo and it happens in her pants shortly after getting off the potty. So I think maybe she's holding it in even while sitting on the potty? I have tried the bubble thing to no effect but maybe worth another go after the movicol has done its job.

In retrospect I shouldn't have stopped the movicol but physically everything seemed back on track and we were still making very little progress. She eats absolutely loads of fruit though she has always been a bit rubbish at drinking fluids so I think this is where the issue is. When I said she hadn't had a poo in the potty for over a week I didn't mean she hadn't pooed - it's just been in her nappy at night or in her pants. I will keep trying and just hope she has a breakthrough before school starts. In every other way she is desperate to be a big girl and do what her friends do and even begs me to let her go without a nappy at night but somehow this is a bigger fear than being seen as babyish.

Hot chocolate might be a plan. She's never had that but it might appeal.

[WineWineWine]

Constipation can very quickly change from a physical problem to a psychological one. They can continue to withhold even when they don't need to. Fear that it might hurt because it has before or just fear of the sensation of pooing can be all it needs for them to start with holding.
That is why you need to continue the medication for quite a while after the physical problem has been fixed.
Be patient, she will get there.