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NT child soiling pants

22 replies

Nat1H · 11/08/2008 00:01

I have a (nearly) 8 year old who soils his pants daily.

I am ABSLOUTELY FED UP!!!

Today, at his grandparents house he rushed to the toilet after eating his tea. He wasn't long. I went to the toilet about 5 mins later and saw flaky poo on the toilet seat I shouted DS to come to the toilet and asked to look at his pants. I had to bin them, there was so much poo.

This is happening daily. He usually puts them straight into the washing basket for me to find later. He once hid them in his bedroom.

This has been happening for 2 years.
I have asked the GP about it and all she can suggest is to remind him to go to the toilet. He lies to me about whether he has been or not, and avoids going if at all possible. He cannot explain why he does it. I asked him tonight if he knew he had soiled himself and he said yes. But he couldn't tell me why he didn't go to the toilet.

I am at my wits end. I am sick of cleaning pooey pants!
Am worried that it might be behaviour due to his SN brother.
Any ideas?

OP posts:
Raine3 · 11/08/2008 00:13

Hi, I just had a quick google and most of the websites say that the most probable cause is constipation (which I know sounds silly)

www.medic8.com/healthguide/articles/soilingwettingkids.html

r3dh3d · 11/08/2008 08:08

Have to agree w Raine - only time I've heard of this in an NT child, was due to fecal impaction. Child dislikes going to the loo (possibly behavioural), holds poo in, becomes constipated, retained poo becomes larger and harder and more uncomfortable to pass. Problem gets progressively worse and impacted poo gets stuck. Poo behind the impaction "flows" round the blockage and leaks out. The child can't control it by this point, and can't tell you what is wrong.

Solution seems to be huge amounts of laxative gradually washing the blockage away and then allowing the bowel to retrain. It's very messy for a few weeks. But painless.

Romy7 · 11/08/2008 09:59

agree here. try a couple of weeks on lactulose - it sorted out my ds (he's 6 but similar problem) not necessarily as a result of deliberate withholding either - ds has always had a reasonably sluggish bowel and whilst happy to 'perform', he naturally finds the whole process quite laborious
and don't then stop the lactulose instantly. top tip. gp said it often makes the problem even worse. wean off gradually so you can top up if things deteriorate again.
we were advised not to start with 'huge amounts', but build up gradually until things loosened. ah - i do like a nice bowel discussion before breakfast.

twoGsinBuggerOff · 11/08/2008 10:07

my little brother used to do this. im sure it went on for a few years around this age. poss even up to about 10. was really awful for him and everyone really i think... never did find out the cause.

the toilets at our inner london primary's were really despicably bloody awful (were talking crap all over the walls/loos/place here) so we all learned to hold ourselves all day to avoid using them... but still.

persoanlly i think it was his expression of unhappiness/stress. an unconcious cry for attention. which i mention in response to your last sentence re this being to do with his brother. is there a chance hes stressed/feeling under-noticed in the family?

if this were me, id try the 'how to talk...' book first to see if i could coax any info out of him (bearing in mind he prob doesnt conciously know why hes doing it)

Romy7 · 11/08/2008 10:15

i did wonder at first if it was an attention thing here, but lactulose sorted it out nicely - not saying that it is not linked for some kids - obv siblings have a lot to deal with and the stress manifests itself in different ways, but i'd try the usual NT route first, as it is quite common in NT kids and impaction is usually the cause. but i'll join you in a general 'urgh i'm fed up of chucking out pants or peering at them to see if i can bear trying to get them clean' rant.

Arabica · 11/08/2008 10:17

Hi, we have been struggling with exactly this problem! DS (NT) is 7 and still regularly soils. He was making good progress until DD (2) arrived and demanded way too much (in his eyes) of our attention (she is SN). To cut a long story short, yes it is caused by constipation--they maybe get constipated, therefore pooing is painful, so they withhold their poo for as long as possible and then have an 'accident'. GP would suggest lactulose as a stool softener, which might work for you, but in our case, the only thing that has helped is child psychotherapy (all of us go) to deal with the ongoing underlying emotional issues. We are lucky in that our child development centre offers this service as part of their commitment to siblings of children with SN, so we didn't have to wait long. If you want to know more about how it has helped please feel free to CAT me.

Romy7 · 11/08/2008 10:18

i just reread your post and you have already been to your gp - what a total numpty! your situation is exactly the same as mine and gp instantly said impaction, have lactulose. who trains these people?

maisykins · 11/08/2008 10:42

Please do a search of some other recent threads on constipation. There have been a few other cases on here in recent months. I am hopeless at doing links or I would find them for you.
The sad thing to read is how the parents sometimes (unknowingly) make it worse by criticising the child or implying that the child has some control over it - they generally dont.
Buy lots of cheap pants, get some lactulose or Movicol to unblock the system, concentrate harder on the diet (fluid, fruit and fibre) and try and get him on side by explaining you want to help him and know its not his fault. Often in hot weather the problem can be worse due to lack of fluids.
If it has been going on for 2 years you may need specialist help - the other common theme on here seems to be how GPs dont seem to know much about this or offer much help. There are specialists out there - usually nurses attached to a children's centre - and if you can get a referral you will find someone who understands and knows what they are talking about. I think there are also helpful websites too.
Now is the time to try and sort this - it is so much harder once they are back at school. But it can take a long time to sort out - the bowels lose sensation in the nerves and need to regain it. This can only happen once the system is unblocked/working again.
HTH

Arabica · 11/08/2008 14:45

I think by all means try these strategies (we did), but in DS' case there is definitely an underlying emotional issue so it's worh exploring that too.

Raine3 · 11/08/2008 15:37

Just as an after thought you could try stomach massage to encourage the flow of the poo ... I have a booklet that shows you how to do this massage so if you want it let me know and I will scan it and email it to you.

twoGsinBuggerOff · 11/08/2008 17:08

oh dear, i dont think any physical causes were explored with my db... poor kid. ho hum, hes 28 now, and not still doing it so there light at the edn of the tunnel, eh?

pagwatch · 11/08/2008 18:39

My eldest DS had this. (ds2 is ASD ). He had similar bowel probs to DS2 which were causing his problems. I feel so terrible now about the fact that, because he is smart and NT I would go on at him so horribly! Poor boy.
We found that GFCF diet sorted him out. he is now older and able to eat full range of foods again

Nat1H · 11/08/2008 21:35

Yes, I worry that he may need a gluten free diet too (I am a coeliac), but he doesn't seem to have the stomach pains I used to.
He has never liked going to the toilet - took me ages to get him properly trained. Wee's were easy - about 2 days, but poo's took much longer. I eventually realised that he was very sensitive about doing them in fromt of me and I had to leave the bathroom while he did it. He always locks the door if he is having a poo, or gets really upset if we go in.
I can't work out if his problems are due to stress due to his SN brother or medical. Trouble is, I don't have any faith in my GP either
I am sick of moaning on to health professionals about my children's problems. Just want a break

OP posts:
pagwatch · 11/08/2008 21:54

No,my DS1 never had stomach pains or any issues re digestion for what it is worth. He was actually never constipated either - just 'slow' digestion IYSWIM.
He still responded to gfcf though.

( and my GP couldn't help either. He supported metrying gfcf but that was it. I'm just grateful that worked. School trips and time away was becoming a real worry and he was so embaressed and so concerned he would have an 'accident'.

desperatehousewifetoo · 11/08/2008 22:25

Have a look at this thread

Hope the link works - it's the first time I've tried it!

Hope the thread gives you a few suggestions that might help. It's very distressing for child and parent.

Nat1H · 11/08/2008 22:47

Thanks for that. Have just read the part out to DH about it affecting urine as well. DS pants are always wet as well.
DH "I just think it's because he's lazy"
Why do I ALWAYS have to sort everything out myself?

OP posts:
desperatehousewifetoo · 12/08/2008 09:15

I'm sorry your dh isn't taking it seriously yet.

There are loads more threads if you search under ' soiling', 'encopresis', 'pooing'! Maybe if he reads some of them, he may realise that it is a real problem and at the moment it is out of your ds' control.

It may take some time to remedy but the first step could be to acknowledge to your ds that it is not his fault and that you will go to the doctors together to find out how you can all help sort it out. Hopefully the gp will help to work out whether there is a psychological component.

Hopefully, you will soon only be worrying about whether yor ds has washed his hands after going to the loo - like I am now! It's such a relief (scuse the pun!)

zopiano · 19/03/2010 11:16

Hey Nat1H,

Having same problem now developing with our 7 year old over the last 8 months. From perfectly normal to up to almost daily soiling of pants and occasionally wetting as well. We have been extremely conciliatory about it with him but are beginning to get a bit desperate. Sometimes he stinks because of the amount of time he has been 'holding in' or because he has a 'clod' in his underwear. Even if it is pointed out to him that his friends at school will be able to smell him or if he is invited to smell the back of his trousers/bottom of jumper as evidence of the validity of the arguement...nothing seems to convince him.

Last night, again without prior warning, he just disappeared for a few minutes and when he returned he was obviously in the process of trying to stash his soiled underwear in the wash bin. When I went up stairs I found his urine-soaked trousers on the bedroom floor.

After a very, very long chat with him ? which was like trying to pull teeth in terms of getting information ? he finally just caved in and came out with it all. What I mean here is that he literally opened up and started describing everything; exactly what he was doing (complete with a little demo just so that it was absolutely clear). Prior to this, it has been virtually impossible to get any info out of him as to what was happening.

Basically, he has developed a sort habit where he squeezes/clenches his buttocks tightly together ? either to hold poo in when standing or to stop it slipping out when on the toilet ...causing the poo to get squeezed out in bits. He isn't doing this to put off going to the toilet because he doesn't like the toilet or doing a poo; he's doing it as a habit from which he derives some enjoyment.

Of course, this means he messes up his normal stool rhthym completely, leaving his backside in a mess (sometimes with bits of poo on the seat etc). Most importantly, I think/suspect it leaves stuff in his back passage which dries out a bit and then later, during the day when he has the beginnings of another movement, this stuff comes out and sticks to his backside/underwear when he does his clenching routine. Separately to this, he also holds in his stool and pushes it down and back again in his rectum during the day ? because he 'likes the feeling'. Sometime he misjudges and there is an escape...

After he had told me all this he was very much concerned to know that I was not angry with him and wanted cuddles/reassurance, etc.

All this info ties in with the evidence. In particular, poo on his underwear and in the toilet is unbelievably pungent ? consistent with what you might expect with faecal material that had not ejected from the body when it should have been.

I also wondered if the recent wetting was bladder spasms brought on by all this deliberate clenching and tension etc over prolonged periods of time. Basically, he is creating havoc with the natural rhthym of that area...but he doesn't get it because he's 7.

I hope this helps in some way or is a line of enquiry that might be worth going along.

From our perspective the question now is, what to do about it. We've tried the charts and the marble reward jar and the removal of privileges etc., but so far we haven't hit on something that will work. As he is a happy, popular and well-adjusted boy in every other way I think we just need to work out how to prerform a reset/reboot in that area of his mind.

Any suggestions gratefully received.

improvingslowly · 19/03/2010 18:13

it might be helpful to see if gluten free/casein free diet might help? helps many with digestion/toilet problems

niminypiminy · 19/03/2010 20:53

Have you tried ERIC (Enuresis resource and information centre)? link here I've phoned their helpline about this very problem and they were fantastically helpful, they also have a good range of books and other aids. I bought a booklet called 'Sneaky Poo' (aimed at 5-11 yrs old so just right for an 8 yo) which was really helpful explaining the causes of soiling accidents and what to do about them -- the aim is to get the child involved in 'beating sneaky'. This is a great strategy because the book makes it sneaky poo's fault (SP is always trying to get out we have to beat him to the toilet) rather than the child's and so helps to break the cycle of shame that they're in. Anyway I really recommend Eric.

madwomanintheattic · 19/03/2010 21:08

zopiano - re 're-setting'

we have been told it can take up to 6 months for a similar issue with lactulose/ suppository as required - (impaction causing bowel and bladder incontinence)

also high fibre diet/ plenty of fruit and veg, plenty of fluids. and toileting twice daily, ten minutes sfter breakfast and evening meal (which should be accompanied by a warm/ hot drink to stimulate movement)

hth.

wraith · 20/03/2010 23:05

the strategy mentioned are good ones but the more immediate situation is dealing with the mess,and oder.

if the child is soiling then immediately changing pants consider wet wipe toilet wipes. not baby wipes as they clog toilets.

if not changing immediately you may consider, some sort of pull up type... disturbing as that may seem it does offer a short term solution especially if it is due to constipation and the soiling, if treated may lead to unexpected movements.

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