Seeking Help with Encopresis

Hi A.,

A few months ago I saw a show on Dr. Phil about kids with encopresis and help for them. Thought it might be helpful for you too. There is a message board there and here is a link to an article on the website: http://drphil.com/articles/article/533/

Hope that is at least a step in the right direction for you.

A.

A.,

I went through the same thing with my son and my daughter. My son had this problem until he was about 8 years old. After trying Miralax (among other things) and seeing a specialist - the best advice I got was to not respond positively or negatively to his accidents or successes. No more charts to reward him or losing my cool and yelling about having to clean poopy underwear. Just take it in stride, and don't give him attention one way or the other for it.

At first I felt like "yeah right - like THAT is going to work." But after awhile of not giving the situation so much attention (negative or positive) my son's encopresis improved and we finally got to the point that he did not need Miralax in order to have a bowel movement.

Now that he is 10, I notice that if he gets really stressed about something, he tends to hold it in. (I note this in his underwear when I do the laundry.) But I think overall - he has improved and no more laxatives!

Good luck. I know this problem is more prevalent than most people realize and is SO, SO frustrating!

Maybe because you are trying to control it so much. Try making it a game where he gets to go when you are least expecting it. Act all surprised and say he tricked you by going alone or something. Try not emphisizing pooping, but ask him to sit on the potty for 10 minutes to read a book after each meal. The tummy being full as well as relaxing will be the best circumstances to get him to go. My son will only go if he is alone, so you may need to get out of the bathroom and let him go alone. Find something he like to do (video games, reading, etc. and let him do that for the 10 minutes he sits on the pot. Eventually, he will establish a routine and the idea is to get him to go every day. Just try to take the emphasis off the product, and focus on just getting him to sit (ie. don't tell him to poop, just to sit and relax).

My son is nearly 7 and we have gone through this too. I hear it's really common in boys. (??) Anyway, we've gone through his not wanting to just stop what he's doing to poop off and no for several years and we did all the rewards and meds and everything too and here's what finally worked for us. My son is more schedule oriented than most boys, so we just have certain times that he is expected to sit on the toilet. It took a few weeks for him to get used to the routine, but now he knows that if he doesn't go on his own then he will be sitting on the toilet at a certain time. And we try to set him up for success too- about 30 minutes after eating or a bath, not when there is anything else fun going on like a favorite TV show or favortie visitor. And now that he's old enough, there are no excuses "I don't want to. I don't have to go" - none of those excuses fly. And we try to frame it as just something that he has to do because this is the way his body works. "Mama has to wear glasses; dad isn't very tall; some kids need special help from a teacher- this is just your thing that you need to do to keep your body healthy." You'll get some resistance at first, (lordy, did we), but since he's 6 now, it won't take him very long to get with the program. Good Luck! Hey, and lets both hope that our boys will be able to poop without our help by the time their in Jr, High... ;0

I'm by no means an expert on this. I believe my son has this as well, but didn't know until just recently, that it might be it. He's almost 10, but started having issues after potty training. We thought it might be food allergies or a different cause, but got no help from his pediatrician other than, "Here, give him Miralax." From what I understand it can be a control issue (subconscious), but other factors play a part as well. Check out this website: http://encopresistreatment.com/index.html

Hi A.: I really have empathy for what you are going through. My nephew suffered from this for years . . .all the way up through age 13. My sister was so exasperated that I took him into our home, hoping that things might be better, and then I had to deal with it. Here is what I learned. In my sister's particular situation, there were extreme issues of control going on in the parenting style in the household, and the last thing one wants in this situation is a power struggle. There were also marital issues. My nephew's encopresis was his own form of witholding, and controlling, as well as being the barometer of the household climate of overcontrolling. This may not be your situation, but from the reading I've done, it is related to power and control. When my nephew got into his teen years, the encopresis stopped but the rebellion continued, severely. It was so severe that it impacted the marriage, and then the marriage dissolved. I urge you to get some good help from a therapist. Don't try to handle this alone. It may be difficult. It may involve re-examining your parenting style, or some home environment issues. Just be sure you have a good children's therapist, and carefully interview them before you choose. My sister did get help, and it helped immensely with the immediate problem. I wish you the very best, and hope you can take action soon. Taking action early will be so helpful later on.

We dealt with this from the time my son was 3. He would have relapses every so often. When he was 9 yrs old we took him in for psychological counseling along with the diet, bowel training regimen. It helped IMMENSELY. It helped him deal with his own insecurity with the whole thing. The poor kid was so embarrassed over it he actually resorted to hiding his soiled underwear in the bushes outside!
The last time he relapsed was when he was 12 yrs old. He started Middle School and didn't want to poop in the restroom, where there were no doors. They apparently didn't trust what the boys were doing behind those closed doors! Quite a set up for a kid who has trouble pooping! He started holding at school and then would forget he had to go by the time he got home.
That time we had him drink GoLytley at home (nauseating!) and that motivated him to not hold anymore. At that point he was mature enough to be internally motivated to overcome the problem.
He's now 23 and hasn't had a problem since. It's a long road to full recovery, and he needs all the patience and love you can give him. He probably feels very out of control (hence the power struggle).
I heartily agree with the suggestion for the clinic. There is almost always a psychological component to the problem, and they can help you deal with it. Family counseling is what finally helped my son the most.
I promise you, he WILL mature and outgrow it......eventually. There are no quick fixes. My best to you in this struggle.

There is an encopresis clinic in Edmonds, Washington. The nurses there specialize in this problem. The telephone number is ###-###-####. Good luck! This is a huge problem.

They treated my daughter with mineral oils and laxatives to get her stool to soften up enough to "go".

The trick is to make it part of his routine. Have a set time every day when he spents time on the potty. Usually most sucessful if that time is after eating a meal. Have him take something in the bathroom to occupy himself while he sits and relaxes. My daughter use to play her gameboy during this time. Also depending on the age of the child, they can blow up balloons while sitting on the potty. This actions causes them to bear down and helps with the bowel movement. You want to make sure his diet consists of foods high in fiber, roughage, and water to keep his stools soft. Good luck. It is a power struggle, but it sounds like you are on the right track to helping him in managing on his own.

My son is just turn nine this month. He has also dealt with this since potty training. We have found using a routine has helped a lot. Every night/day he has to sit for 10 to 15 mins about an hour after eating. Also sounds kind of funny, but sometimes a book or something to read, breathing exercises help them relax. The right kinds of fruits(i.e.peaches)and foods can help if he is having hard stools.

our 3 year old has had this issue since she was 1.5 years old. I also had her on miralax. Her doctor said she needs to "re-earn" going poopy doesn't hurt. Somewhere in her mind, she relates having a bm to being painful whether she had some painful ones in the beginning and it's stayed fresh in her mind. Kids think that if they hold it in ,it won't hurt but they don't understand the more you hold it..it will hurt as it will compound and get hard. we had her on the miralax and even up'd the dosage so it her bm would be a little more on the runny side. (He'll need to feel no pain for months in order to retrain his mind it's ok). That's what we did and although I was getting impatient, it was starting to work when she would say.."mommy,my poopy doesn't hurt" so I knew we were on the right track. She then had a bout of 3 weeks severe diaherrea and that helped a huge bit as she battled loose stools for 3 weeks, she forgot about the holding it. She's now doing so much better but have the miralax on back up in case I start to see her fall backwards. Good luck and stick with it..maybe add more for a little bit.

Oh, man I feel your frustration. The thing to start with: he can't feel anything at this point. After so long his colon has lost sensation. he has no urge to poop. Even if a strong willed child- he is NOT doing it to make you angry - he really can't feel it at this point. Our doc put my son on sennokot every day and he has to sit three times a day for ten minutes to retrain his body to the sensation. We are having success with regular poops, sometimes helped a long by glycerine suppository. The most important thing to help his body HEAL and go back to normal is to GET THE POOP OUT. It doesn't matter if you have to do enemas or suppositories, but his body will not be able to heal if the impaction continues. Hearing this from our doctor was very helpful in getting my extremly willful 5 yr old to cooperate.

My daughter experience this as she entered school. It was not so noticable in kindergarden but by 1st grade her stool was 1 1/2" in diameter (larger than adults) and she only weighed 45lbs! She said she is embarrased and uncomfortable to go there. I saved a sample and took it to the doctor who proceded to explain of the present complications as well of the colon effects if it was to continue. This scared me and, well, I simply put it to her that she will become very sick and possibly "explode" if she doesn't try to get it out. Within time, she was able to come home from school and POOP on her on. What a relief for both of us!

I'm so glad you asked for help with this issue. I had no idea so many other parents and children were dealing with this bm problem. My daughter is just turned 4 and has had this problem since we started potty training. We have been on Mirilax for over a year. It worked, but I hate being reliant on it. So we've sort of weaned her off it. Every day we tell her she has to go poopy some time that day... she can pick when. She knows she will be forced to sit after dinner for as long as it takes, so now she can decide to do it before then. I think this has given her some control over the issue and she usually goes before being force too. We have done the glycerin and she hates it, so this is another motivational thing. I'm thinking we may need counseling with her over these control issue, since reading everyone's responses. Maybe we all need a little help. Thanks again for everyones responses.

I know the frustration and worry - our son has been hospitalized because he gets so backed up he can't keep food down - the biggest thing is to make sure it doesn't become a power struggle by "riding" him - we have two set times a day where our son goes to the bathroom and sits with a book - feet on a footstool so he doesn't become too "sore" from sitting and maekes himself go - routine seems to be the best advocate we have - we are also working with the specialty clinic at Mary Bridge - have they done testing to determine if there is a physical problem - sometimes the rectal muscle doesn't funtion properly and sometimes they get so backed up for so long that the muscle no longer has the sensation to feel that they need to poop - good luck and know that you are not the only one out there - I have felt like we are

Maybe sprinkle ground flaxseed into something he eats. This has a natural laxative effect and is healthy to boot. You may want to start with a small amount and increase as necessary

I didn't know what encopresis was and so I looked it up on the Internet. Here is a site that seems helpful to me.

www.medicinenet.com/encopresis/article.htm.

I doubt that discipline techniques would work because his problem is physical and may also be emotional. His bowel and anus no longer tells him when he needs to poop. You may also be in a power struggle which makes the condition worse.

Try being loving and undestanding. Yes, praise him when he poops but don't set him up for failure by making pooping something to earn rewards for. Tell him you know it's difficult to poop. You are there to support him; not punish him. Express your frustration as your problem, not his. Reassure him that you will help him and will stop "making him poop." Do provide a schedule so that he regularly sits on the toilet for 15 minutes or so 2-3 times/day. Make that as pleasant a time as possible. Don't push him to poop. Help him to relax. Perhaps give him something to do while sitting. Provide him with books, crayons and coloring book, markers and paper or something else that he enjoys. There is something to the old description of the bathroom as "the reading room."

I also advise taking him to the doctor and a counselor. Taking him to a encopresis clinic sounds hopeful. They can provide answers and support.

I suspect one reason for your frustration is that you are concerned about his health but feel helpless to help him. Having to deal with soiled clothing is not fun. And not understanding why this is happening might cause you to focus on the problem instead of the child.

Think how frustrated he must be that he can't conform to you expectations. Remember when you were a child and felt embarassment.

My grandaughter, who is 7, will frequently not let anyone into the bathroom when she's on the toilet. When she's at my house she does want me to go in with her and we play silly games while she waits for the poop to come out. I think she wants me to come in with her because that was a part of potty training and she is working out jealousy of her younger brother, who she still calls baby even tho he's 4, by returning to some parts of being a baby. She also asked me to call her baby and rock her as if she were a baby. She stopped the baby stuff awhile back. She has just begun to use the bathroom once in awhile at my house without me.

I tell you about my granddaughter to illustrate how emotions are involved in pooping. And how accepting the situation as the way it is instead of adding more pressure to perform helps.

Because you asked this question I think that you are a caring mother who has done the best that she could. I think that some professional involvement will help you to feel success and thus less frustrated.

Oh boy! I went through this with my first child who had a kidney condition that made her susceptible to urinary tract infections. We think she started associating pain with going to the bathroom and so started holding everything in. But just as in your case I think it eventually turned into a power struggle. Can't tell you how it pushed my buttons!! We also have a child who will be 5 in March and JUST finally potty trained about 4 months ago. He was just super stubborn/resistant about it and once again it was a power issue. If there are two things they can control it's what goes in and what comes out! In both cases what it finally came down to was being painstakingly consistent with taking away privileges AND with making them responsible for cleaning up the messes they made. You may have to do this over an extended period of time. I would have them get into the tub, take off their pullup or underwear and put it in a bag for disposal, clean themselves up in the bathtub, walk the bag to the trash, and redress themselves. I refused to touch the poop! They got so tired/disgusted with having to do so that they eventually came around. It may be as hard on you as it is on them, but it pays off in the end. The key is not to let it push your buttons (this was SO hard!) but instead just calmly and firmly enforce the consequences each time. When we would go out in public (restaurants, parties, etc) I would warn them ahead of time that we would simply have to go home if they had an accident. This was a pretty good motivator, too!

Best of luck!

Hi A.,
I need advice from you as well. I have a five year old daughter that has had multiple urinary tract infections. She also holds her bowels and will not go even if she knows she needs to thus resulting in an accident (not exactly accidents anymore). Sometimes she will not tell anyone and sits in it for who know how long...unles you smell it you would never know. The urologist also has told us to use mirilax as well. We think the urinary tract infrections are coming from the whole poop thing (holding then accident). What exactly is encopresis? I understand your frustration with this, unfortunetly with my daughter I have reverted back to the potty training age and have to constantly make her go sit on the toilet. I know it is hard to do since your child is 6 beleive me I understand. I think you have hit it right on the head, it's a power struggle. I hear everything from the potty hurts my legs to I tried and I just can't go...then an accident 2.3 seconds later....uhg....FYI I aslo have a nephew who is going through a similar situation and he is 6...same personality trait as well. Does your son have the accidents?

Until I read your story, I didn't know it had a name to it. The doctors didn't seem to know either, kept saying he was constapated. My son will be 5 in May, we have tried everything, I am so sick of poopy underware.
This started shortly after he bagan to walk because he had gotten constapated and it had hurt him to go, so no matter what we did it wouldn't work either. My mother-in-law- sent me an artical from her newspaper, it said each morning take all clothing off your child, put him in the bathroom and tell him he must stay there until he poops, each day it will get easier (no fits) and within a few days he will be going on his own. This man who wrote this has never meet my son, it's not going to work, already been there.
So my son had not gone for about 3 days, and knowing it could go on till he was so sick from not going that he was throwing up and not eating, I went to the drug store and got a box of
Fleet Babylax liguid suppositories ( these things are great) after dinner we let ourselfs relax for a while then we went into my sons room (my husband was a big help) I layed a large towel on his bed, had him take off his pants and underware, I explained to my son I was going to help him feel so much better, I was going to give his bottom some medicene that would make the poop just slide out, all he had to do is lay there and be still, then popa would lift him up and carry him to the bathroom. When I started inserting the little thing in him he started wimpering, but through the whole process as hard as it was for us we never lot our temper are threatened him, it was hard but we stayed claim, my husband leaning down on one side of the bed and I on the other telling our son a funny story. as soon as I was done ( it only took a couple mins.) my husband picked up our son, carrying him like a baby, I think he said our son was a rocket ship coming down to earth , landing (being sat on the tolet) and now dumping it's used up fuel. We walked away, a bit, and the next thing we heard, was, Look mommy, it came out, Boy did it, then he was done and we praised him, telling him how good he was and how wonderfully happy it made us that he went poop in the potty.
This was not a quick cure, by all means, but it was a start.
Our rule is he can't wipe or flush till we see it.
So for a few days all was good, then we went right back to where we started. Altogether we had to use the Babylax 4 times. But the problem started again , I have a bucket of poopy underware in my tub socking and I am so fed up I didn't know what else todo except to buy stock in Babylax.
My husband who is always home first with my son, started noticeing a pattern, at 4pm or so he would catch David trying to hide and hold it in. So now everyday at 4pm David is sitting on the tolet pooping. He crys and asks why, and that it sticks in the bathroom, he wants to use the other one. He is told the reason he has to sit on the pot is to poop, the reason it smells is because of the bucket of poopy underware, that are his, within 15 mins. he goes now.
So this is what is working today, yes we even had him washing out his own underware, all we got from that was a mess.
These little guys are funny the way their brain works and explaining to the is so hard, But don't give up some day it will just click and it will be like he never had a poopy pair of underware.
I would like to hear more from you about you progress, maybe we will be able to help each other and our sons.
Good Lucj
R.
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