Fecal Incontinence

[CatLover9886]

Hi! Newbie here! I need some help please, here is a bit of background. My son is a healthy 14 year old and had no complications at birth. Until he was around 4 he was using the toilet absolutely fine. But then he started soiling his pants and fast forward to today and 10 years on he still does it. We have tried absolutely everything. We've been to CAMHS, he's currently under a gastro clinic after being hospitalised last year, they didn't actually find out what was wrong with him, they just put him on a drip and discharged him within 3 days with movicol. The Gastro nurse has tried him on Senna tablets, movicol and although the movicol does get things moving, that's not the problem, the problem is that he doesn't actually know that he's doing it. He goes to sit on the toilet to no avail and then he will go again and it's in his pants and he had no clue. His diet is very healthy and he is not dehydrated. We're at our witts end, it's ruining his life and it's heartbreaking to watch! Please if anyone can offer any help or if you have been through similar I would appreciate it so so much. I have a telephone appointment with the nurse later today but we just keep going round in circles

I'd bet money on it being this

https://journals.lww.com/jpgn/fulltext/2009/04002/functionalnonretentiveefecalincontinenceein.19.aspx

My teen DD has a functional neurological disorder and incontinence is one of the more embarrassing symptoms of this. She also doesn't know it's happening until it happens

@FuckingFabulous

I'd bet money on it being this

[[https://journals.lww.com/jpgn/fulltext/2009/04002/functional]]nonretentiveefecalincontinenceein.19.aspx

My teen DD has a functional neurological disorder and incontinence is one of the more embarrassing symptoms of this. She also doesn't know it's happening until it happens

Wow that's really informative, thank you. What help is your DD receiving? How have they helped her, if you don't mind me asking x

They haven't really helped too much to be honest. She's meant to have rehab physio for a lot of different reasons but that's been slow starting due to the second wave of Covid hospitalisations. She's under CAMHS, but it's not a psychiatric thing. There's very recent research showing functional disorders to be due to low grade chronic inflammation and a repeated error in the way our DNA is interpreted.

Anecdotal evidence has shown that some teens and young adults have improved their functional incontinence by taking an aspirin a day and following a stricter toileting regime, as well as adding bulk forming agents to their diet which would create larger stools and therefore are more likely to give a signal to the brain that the rectum is ready to be emptied. The body and brain can relearn when it's time to empty bowels in some cases. If there's a time of day when soiling tends to happen, you can build your routine around this for initial small successes. If he tends to have accidents between three and five pm, this should be the time he visits the toilet regularly. If there's no successful evacuation after five minutes , he should return within twenty minutes to try again. The idea is that with bulk forming agents, his brain and body will relearn what that sensation and signal mean and communicate effectively. Functional disorders are a repeated error with the central nervous system. They have no identifiable cause by current medical knowledge, although the study I mentioned earlier does show very strong evidence that it's inflammation which causes the error in interpreting the DNA, and research is ongoing.