4 Yr Old Won't Poop on Potty

I'm not sure whether he's still feeling frightened/traumatized by his painful event. If so, get the book It Hurts When I Poop, which has reportedly been helpful for a few of the kidlets in my life.

Also, check out this website describing a detailed approach to dealing with delays and resistance. The principles seem sound to me (I've never actually applied them, but everything syncs with what I understand about children's thinking that DOES work for me). http://www.rogerknapp.com/medical/pottytrainingrefusals.htm

Best of luck!

Once they are constipated, pooping is very painful.
It then becomes not only a biological thing, but an EMOTION based, problem. It is painful. Thus the child 'fears' pooping. Thus, they 'withhold' their poop. Hence, the poop becomes harder and blocked up and impacted... more. Hence it gets more painful internally and when exiting.
Thus a vicious cycle, ensues.

My daughter, at 2 years old, even if we did not force her to poop on a toilet, simply had ANXIETY and stress, about the idea of it.
Hence she got constipated... and all those problems I mentioned above. Hence we saw a Pediatric Gastroenterologist. Hence he said, EVERYDAY he sees children like this. That it is a biological AND emotion based, issue.
Hence it takes, a long time, to overcome.
And to just let... the child poop... for now... even if that is in a diaper.
ONCE the problem is resolved, medically and emotionally and biologically... the child, on their own, will poop, on a potty, when ready.

IF constipation... is worsened by whatever reason... things like "Encopresis" can occur. This is not good. It means, they get an involuntary leaking... of feces which they cannot control, because their innards are all stretched out and blocked up. Internally.

Don't force the issue.
No rewards or punishments... will fix it. For now.

Do check out the site Peg recommended. My guy was the same, (now 2 years, 7 months) he was scared after being constipated so was holding it in. He knew when he had to go so I tried this approach and it worked. Your son can still use his pull-up, the key is the "power incentive," YOU own it, not him, he earns the privilege of using it 30-60 minutes. Only took my little one a couple of days to lose his fear, yaaay!

Poor child. Is he on medication? Don't medicate him yourself, without a doctor's directive. He needs to drink water and eat a healthy diet too and eat high fiber snacks. Have him sit for 5-10 after each meal. You need to take him to a different doctor, to get better results. Not all docs are created equal. It's money out of pocket but you get some results, well worth it. He needs get used to sitting and the hardened stool needs to be softened.

He's not pooping his pants. He's leaking stool, that bypasses the hardened stool. It's encopresis. He has no control over it. He cannot feel it, until it is too late. It's a medical condition and it's not his fault.

Again, you wouldn't be seeing a GI unless he was constipated and had a blockage. You and the doc are not on the same page because he has chronic constipation and has a blockage and he cannot feel the stool leaking out.

It's frustrating but he's young. Deal with it now diligently, and effectively, so he doesn't suffer for years. Educate yourself and ask the doc a lot of questions. Have any invasive treatments been done, or a clean-out from the top-down? That's what you want but either way, you need a good doctor.
http://kidshealth.org/parent/emotions/behavior/encopresis...

I had issues with this with my daughter. I found it extremely helpful to get her the Poopie book. It's written by a Japanese writer, I think, and has pictures in it of animals and all of the different kinds and types of poop. And it shows the different places animals go poop, and then shows humans and how, after one is done being a baby (and pooping in a diaper), that as we grow up, we poop on a toilet. She loved that book, and it was our favorite bathroom pottie time book for quite a while. She had issues with constipation as well as overactive bladder, so getting her to regularly go on a toilet took some serious work. It's also a book for younger children, but might still work for an older child.

As far as how to entice him to go on the potty when he equates the potty as the place where he had unbearable pain/constipation--you need to find something he loves to do and use that as the reward for going on the potty.

I feel for you, especially since he will need to use the potty at school. MAKE SURE he is drinking enough water for his age/weight; most people are dehydrated (don't drink enough water/fluids), and dehydration makes constipation issues worse.

Ah, yes, I am at the tail end of it myself. I spent about 9 months giving my son laxative suppositories because a week would go by and there would be no poop at all (toilet or otherwise). Fun. I was getting so anxious about it myself that I'm sure it was rubbing off on him. The pediatrician kept saying it would resolve itself and to feed him oatmeal, and I didn't believe her. I insisted that she see him and got a referral to a GI. Wouldn't you know it -- he started pooping on his own the next day. Luckily he didn't have serious medical problems so we could try some solutions on our own. The best -- if he poops on the toilet he is allowed to play the angry birds video game (at the beginning of toilet training he couldn't watch TV until he pooped on the toilet. Not that he watches much TV, but that worked as an incentive for a while). He has had a couple of setbacks but in general is back on track since the doctor visit. So for my son, the pediatrician was right, but it was a long trek. This isn't exactly advice but sometimes it helps to know that others have gone through it and are on the other side.
Good luck,
B.

Poor guy - he's just scared of the pain even though it's not there anymore. I think he's kinda lost control of it since he had the constipation problem. Have you tried talking to him about how he's feeling, how his body feels, how he's scared, etc.? Maybe helping him feel like he has some control since it doesn't hurt any more might help him relax and get some of the control back.

Good luck!