4 year old soiling herself

[PP788]

Hi, this is my first time posting.
My Daughter is 4 years and 2 months old. She is in reception class.
Sorry if this is TMI.
She will not open her Bowels in the toilet or potty. She will consistently do tiny bits all day for days and days. This has been happening for a year. But until recently she would eventually go after 5 days of this behaviour then it would start again.
I've been to GP three times. They seem to think she is constipated but her stools are loose. I feel like I have nowhere to turn.
Today she soiled 9 pairs of pants and still has not passed a proper poo.
Has anyone been through this? Any advice?
I have tried ignoring, rewarding even a bit of bribery 🙈 But nothing. She also does not seem to care.
Any help would be more than appreciated.
Thank you x

Hi! I'm sorry you're experiencing this. Your GP is right I believe. My nephew has the same problem.
When there's a build-up of constipation, eventually there is an overflow. The children are not doing it on purpose. What they may do is hold the poo in (because they're anxious to go, the poo might be hard or they do not like the toilet for example) but once there's the build-up, they cannot control what happens anymore and poo comes out. Look up the condition called encopresis to understand the mechanics of this.
The main treatment is laxatives for as long as necessary (and this can be years-my nephew has been using them when necessary for a couple of years now). The laxatives will keep the poo moving and prevent the overflow.
Talk to your GP again and ask them to be on repeat prescription and when you should use the laxatives (probably everyday to begin with and then whenever your little one skips a poo).

To ease the stress of washing (but with the laxatives, this should not carry on for long), you can buy degradable sacks you can put directly in the wash. So no need to rinse clothes, you just put everything in the sack and then in the washing machine. That's what they use in hospital.

Hope the problem goes away soon. 😊

The GP is correct, the loose stools are leakage.

Thank you so much. I will persevere with the lactose. Xx

I can sympathise my 3yo son is very similar. Its hard. Lactulose I find sometimes makes it worse- ie it's very loose which makes constant soiling so unpleasant and he gets sore easily. Warm baths help him and honestly you'd think we've won the lottery any time he uses the toilet, we cheer so much!

Some weeks are great others are awful.i hope it resolves for you.

Lactulose is not very effective for children’s constipation. Your GP needs to prescribe a Macrogol such as Movicol or Cosmocol. This is a powder you mix with water which delivers the water to the bowel to help break up the hard poo that has collected there. The recommended course of action (NICE guidelines) is to disimpact with the macrogol (increasing the number of sachets each day until poo is brown water) and then slowly reduce to a maintenance dose to keep the poos nice and soft and regular. Not all GPs are aware of these guidelines, but don’t be fobbed off with lactulose, suppositories, prune juice or similar.

Read the ERIC website and google The Poo Nurses

You need to understand the problem before you can deal with it.

See GP, definitely sounds like constipation/overflow diarrhoea, and she won’t be able to control it at all. I have been through this with my DS. Hopefully your GP will refer to a Paediatric Gastroenterologist, some are better than others we saw two, first one did not solve the issue. I was feeling really desperate by the time we saw a different specialist, 18 months ago, what a difference, explained clearly what was happening and why, arranged allergy tests, prescribed meds movical Paediatric two sachets every morning and pico sulphate at night. It solved the issue completely and he is absolutely fine now. Good luck OP I know how worrying it is.

+1 Thesunrising's comments
Don't get fobbed off.

My daughter (now aged 24!) was like this for years. When she was 8 was diagnosed with a 'lazy gut' - food took so long moving through her stools became very hard and would pass as 'rabbit droppings' interspersed with mucus etc. Ask to be referred to Paediatric Gastroenterologist asap. My daughter was basically left to get on with it. Sure enough laxatives would clear her out only for the problem to start up again. At 22 she was diagnosed with severe IBS . With hindsight her bowel was damaged during a bad episode of systemic chickenpox (spots inside and out) which left her lactose intolerant. I wish you well!