# almost 4, poop accidents suddenly, can't figure it out



## Llyra (Jan 16, 2005)

My almost 4 year old has suddenly started having poop accidents. It's nearly a year since she started doing her BMs reliably on the toilet, and I can't figure out what's going on. I was hoping for some insight and advice.

She is doing tiny little bits of stool, sometimes stains and sometimes little soft poops, in her underpants. It's not runny, but it's not hard rocks either. Just little tiny soft stains. She's been doing them for about four days, during which time she's also had three normal big soft but solid BMs, all in her underpants.

At first, I thought she was ignoring the urge to go, and I guess I lost my patience and hassled her about it, and now she's upset about it. I've stopped that now, and after talking to her very carefully, I think I've got that she's really not aware of the staining when it happens, until it's already happened. I have no idea why. I wonder if she needs to see the ped.

The big poops, though, she knows she needs to go, but she'd rather use her undies to do it. She totally loses her mind and throws fits whenever she needs to do the big poops, and refuses to sit on the toilet, and then there's the poop. It's almost like she's afraid to do them on the toilet, even though she'll PEE there very willingly.

Her anal area is red and she says it's sore.

Is this just a simple case of constipation? But why is she staining and not aware that it's happening? I dunno. In the meantime, she's miserable-- the whole thing has become a stressful thing in the house, and she's upset and she thinks I'm upset, and she keeps telling me she just wants to wear a diaper.

Would it be wrong to just let her wear some training pants or something, for a few days? I don't want to send mixed messages.

And other than watching her diet, which we are doing, would you do anything like a stool softener or whatever?


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## harrietsmama (Dec 10, 2001)

She does sound constipated to me. My kids have had chronic constipation for a long time. I had it too and outgrew it prepuberty. I would start with removing wheat and dairy and see what happens. But for it to work, it has to be *all* gone, no cheating. Those are the most common reasons. Sometimes it goes in phases. My daughter did fine for about a year, then she started staining like you are describing and the kinesiologist said this was the cause. When I was young, my Grandma tried to remove stuff from my diet, but there weren't very many options. There are many many options now at most health food stores. I would go to a kinesiologist (Applied kinesiology) who tests for food intolerances which cover more than just allergies and see what shows up before trying laxatives because they often just make it worse imo. In the meantime, you could do epsom salts baths which have a mild laxative effect - helps bring more water to the colon - and be prepared for a little mess or some loose stools. I got a lot of practice using my doula skills on my poor little ones before we got solutions! Nothing shows on either of them for allergy testing or any other testing. The docs just want me to put them on Miralax which is not studied in children and if you look on yahoo, there is a whole group dedicated to talking about very serious side effects in children from taking it. I hope that gives you some ideas!


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## Teensy (Feb 22, 2002)

That does sound similar to my DS when he had constipation. The poop can be literally leaking out, with the child having absolutely no control over it (sorry for the TMI, but I got the idea that a big hard stool can be blocking the way, but soft, watery poop leaks around it). Our pediatrician prescribed some sort of powder (mixed with drink or food) to soften things up, along with an enema for the immediate problem (ugh, not one of my best parenting memories).

He had problems off and on for about three months, but hasn't had a recurrance in the past few years.

Good luck.


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## Llyra (Jan 16, 2005)

It doesn't make sense to me, though, that it would be food intolerance causing this, since it only started last week, and she's been pooping fine on dairy and wheat since she was a year old. There's no wheat or dairy in my diet, so taking it out of hers would be fairly easy, and it can't hurt, and I'm going to try it, but I really don't think that's it. Thank you for the idea, though.

The epsom salts are a great idea. I'm going to try that tonight.

But how do I address the anxiety? That's the worst part....


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## sbgrace (Sep 22, 2004)

This is classic for encopresis/constipation causing withholding and fear. The little accidents are stool leaking out behind constipation and/or her anal area is stretched too much.

The treatment is to make the stools very loose long enough for the tone to go back to normal and for her not to fear pain. Then you slowly lower the dosage of whatever is softening the stool until she is going on her own again--without fear causing her to withhold.

I've had two friends who dealt with this. Both did miralax for a while. You could try some other alternatives first...but you need the pain gone from her memory. Like you one kids just started all the sudden when she had been fine for so long. She just had a large/hard stool and then got anxious about the pain and so tried not to go and wham...in the same mess. The other had a child younger and I do think food intolerances were suspect there.
encopresis is what you're dealing with.
http://www.askdrsears.com/html/8/T081100.asp (bottom part...her muscles are stretched, hence the leaking and lack of control, so she does need softening until she's no longer afraid of pain) http://pediatrics.about.com/cs/commo...nstipation.htm

If you went to a pediatric gastroentronolgist they would place her on high dose miralax for a while. Whatever you use you need to get to the same point.


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## Llyra (Jan 16, 2005)

Quote:


Originally Posted by *sbgrace* 
This is classic for encopresis/constipation causing withholding and fear. The little accidents are stool leaking out behind constipation and/or her anal area is stretched too much.

The treatment is to make the stools very loose long enough for the tone to go back to normal and for her not to fear pain. Then you slowly lower the dosage of whatever is softening the stool until she is going on her own again--without fear causing her to withhold.

I've had two friends who dealt with this. Both did miralax for a while. You could try some other alternatives first...but you need the pain gone from her memory. Like you one kids just started all the sudden when she had been fine for so long. She just had a large/hard stool and then got anxious about the pain and so tried not to go and wham...in the same mess. The other had a child younger and I do think food intolerances were suspect there.
encopresis is what you're dealing with.
http://www.askdrsears.com/html/8/T081100.asp (bottom part...her muscles are stretched, hence the leaking and lack of control, so she does need softening until she's no longer afraid of pain) http://pediatrics.about.com/cs/commo...nstipation.htm

If you went to a pediatric gastroentronolgist they would place her on high dose miralax for a while. Whatever you use you need to get to the same point.

Thank you. This is really helpful information! I do think this sounds like what's going on. It explains why she's not realizing that she's staining, and why she's afraid to go. And you're right, at the beginning of all this she did have one time where she told me she'd done a "big poop" and that it hurt; I remember consoling her about it. She actually had some minor anal bleeding that day. I'll bet that's when this all started, and I just didn't realize.

I'm still deciding what to do. This morning I gave her prunes, and if that doesn't work to get her moving, I'm going to try maybe a suppository to clean out whatever's in there, and then move to something to soften her stools, for a bit, until I can deal with her diet better. I think that most of her anxiety is the worry about me being upset about the accidents, so if we can get her back on the toilet again, and stop the leaking, we'll be good to go. Her diet is terrible in terms of fiber-- she's a binge eater. She'll eat very little but cheese for weeks, and then switch to something like oh, I don't know, raspberries, and then it's pasta, and then she's on to grapes. We're in a yogurt phase right now, where all she wants is yogurt, and I'll bet that's how the problem started. My real fight, then, is to balance her diet a bit. That's a tough one-- I offer good food every day, but I can't make her eat it, and she's never been a good eater ever.

It's never easy, is it?










Anyway, thanks.


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## harrietsmama (Dec 10, 2001)

Quote:


Originally Posted by *sbgrace* 
This is classic for encopresis/constipation causing withholding and fear. The little accidents are stool leaking out behind constipation and/or her anal area is stretched too much.

The treatment is to make the stools very loose long enough for the tone to go back to normal and for her not to fear pain. Then you slowly lower the dosage of whatever is softening the stool until she is going on her own again--without fear causing her to withhold.

I've had two friends who dealt with this. Both did miralax for a while. You could try some other alternatives first...but you need the pain gone from her memory. Like you one kids just started all the sudden when she had been fine for so long. She just had a large/hard stool and then got anxious about the pain and so tried not to go and wham...in the same mess. The other had a child younger and I do think food intolerances were suspect there.
encopresis is what you're dealing with.
http://www.askdrsears.com/html/8/T081100.asp (bottom part...her muscles are stretched, hence the leaking and lack of control, so she does need softening until she's no longer afraid of pain) http://pediatrics.about.com/cs/commo...nstipation.htm

If you went to a pediatric gastroentronolgist they would place her on high dose miralax for a while. Whatever you use you need to get to the same point.


I agree. I got the same results by diet control. The miralax works, but it isn't worth the side effects imo and all the other options just had no results. Avoid stimulants like senna and cascara sagrada especially with this situation, it makes it worse according to our ped gastro doc. She originally prescribed the huge dose of miralax, but when I brought her the info I found about it she agreed to take him off and try something else.


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## Lovenest (Apr 12, 2006)

My son had the same problem.
I changed his diet, added fiber, reduced fiber and all he drinks is water.
Nothing changed his BM.
I finally took him to the doctor and he has been on Miralax since 5/28/2008 and he uses the potty everyday (














as before he was holding it in for 1-1.5 week at a time or even up to 2 weeks at a time. He was having accidents multiple times a day, like small runny water stools. Now he has not had an accident since about day 10 on Miralax (first week also on MoM), and has had no side affects. The first few days were a bit messy as he had alot of poop (blockage) in him. Now it has been smooth sailing. We also have a set schedule for him sitting after breakfast to try.

I would tell you to at least have your son seen by his ped to rule out a blockage and start from there. I am so happy we sought out help for our son. It is so nice not to have to change his underwear 5-10 times a day.
PM me is you need anymore info.

Erin


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## Ironica (Sep 11, 2005)

You've gotten lots of good advice here. I just want to add that your daughter's eating patterns sound VERY typical of food reactions. "Picky" eating is often the body's way of trying to cope with the constant low-level inflammation caused by reactive foods. Kids (and adults) also will have addict-like behavior with foods that cause problems, which will also cause them to reject other foods. Dairy is a big culprit for the addiction issue, since it produces a substance called casomorphin during digestion, which binds to opiate receptors... causing a literal addiction.

I'm glad to hear you know how to eliminate dairy and wheat (although I'd do all gluten to be on the safe side) and are ready to try it. I'd hate for this issue to recur for her after you get it sorted out!


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## harrietsmama (Dec 10, 2001)

Quote:


Originally Posted by *doriansmummy* 
My son had the same problem.
I changed his diet, added fiber, reduced fiber and all he drinks is water.
Nothing changed his BM.
I finally took him to the doctor and he has been on Miralax since 5/28/2008 and he uses the potty everyday (














as before he was holding it in for 1-1.5 week at a time or even up to 2 weeks at a time. He was having accidents multiple times a day, like small runny water stools. Now he has not had an accident since about day 10 on Miralax (first week also on MoM), and has had no side affects. The first few days were a bit messy as he had alot of poop (blockage) in him. Now it has been smooth sailing. We also have a set schedule for him sitting after breakfast to try.

I would tell you to at least have your son seen by his ped to rule out a blockage and start from there. I am so happy we sought out help for our son. It is so nice not to have to change his underwear 5-10 times a day.
PM me is you need anymore info.

Erin

Did you every find out the cause of the constipation?


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## Lovenest (Apr 12, 2006)

Quote:


Originally Posted by *harrietsmama* 
I agree. I got the same results by diet control. The miralax works, but it isn't worth the side effects imo and all the other options just had no results. Avoid stimulants like senna and cascara sagrada especially with this situation, it makes it worse according to our ped gastro doc. She originally prescribed the huge dose of miralax, but when I brought her the info I found about it she agreed to take him off and try something else.

Please let me know of this info you speak of...
I researched it and got on a few websites with other parents of kiddos with encopresis and 90% of them said the only thing that _really_ worked was miralax.
We have had not one single side effect.

We are not sure of the "reason" behind the constipation. Although my husbands sister and my niece (his sisters DD) had the same problem growing up and now as an adult he has to be careful not to get constipated, her DD is getting better at 10, still having some issues though. He rarely eats dairy so we cut that out about a year ago and no difference. We tried to cut most of the wheat out, and did not see any difference.
We think he has a slow digestive system?
We have been working on exercises for his trunk muscles as well.
He has sensory issues so I think that could be part of the problem with feeling the urge until the bowel was too full.


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## Beth F (Apr 19, 2006)

I agree with cutting out dairy. Our dd is constipated too, and we've been using prunes.

As for the toilet anxiety, have you asked her if she'd rather use a potty? If she embraces change, this may work. Our children will often be more receptive if we offer an alternative. Also, if the potty offers more of a squat stance, it may help with the constipation.


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## Llyra (Jan 16, 2005)

Quote:


Originally Posted by *Beth F* 
I agree with cutting out dairy. Our dd is constipated too, and we've been using prunes.

As for the toilet anxiety, have you asked her if she'd rather use a potty? If she embraces change, this may work. Our children will often be more receptive if we offer an alternative. Also, if the potty offers more of a squat stance, it may help with the constipation.

That's a good idea, and actually, she has a potty next to her bed, since she has trouble making it to the bathroom to pee during the night.

Good news. Last night, during her bath she suddenly doubled over and cried out, and said her belly hurt, and had trouble straightening out again. DH was with her; he says she seemed like she had a terrible belly cramp. He let her put on a pull-up, since she was obviously going to poop, and he didn't want to get into the struggle with the toilet. He says they sat and he combed her hair and talked to her, so she relaxed, and then suddenly she announced that she had pooped.

Anyway, it seems like the prunes and all did their work-- he says she passed the most ginormous (sorry, TMI) nastiest thing he ever saw, all dry and hard, and she hardly noticed it since she was so distracted. So whatever was blocking her up appears to be gone. Now we only have to deal with the ongoing constipation, which is the real battle, but still. And this morning she sat on the toilet awhile; didn't go, but didn't freak out at the idea, either. I think we're going to try to establish a regular "going" time twice a day.


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## harrietsmama (Dec 10, 2001)

Quote:


Originally Posted by *doriansmummy* 
Please let me know of this info you speak of...
I researched it and got on a few websites with other parents of kiddos with encopresis and 90% of them said the only thing that _really_ worked was miralax.
We have had not one single side effect.

We are not sure of the "reason" behind the constipation. Although my husbands sister and my niece (his sisters DD) had the same problem growing up and now as an adult he has to be careful not to get constipated, her DD is getting better at 10, still having some issues though. He rarely eats dairy so we cut that out about a year ago and no difference. We tried to cut most of the wheat out, and did not see any difference.
We think he has a slow digestive system?
We have been working on exercises for his trunk muscles as well.
He has sensory issues so I think that could be part of the problem with feeling the urge until the bowel was too full.

There is a yahoogroup with over 600 members discussing and sharing about side effects and alternatives http://health.groups.yahoo.com/group...ec=group&slk=1

It may not be clinical research, but I believe it when there are this many families getting together to try to resolve the aftereffects of taking Miralax, another drug that is not approved for children.


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## angela40 (Mar 25, 2008)

if she is more comfortable going in a pullup for now maybe put one on her and then sit her on the toilet or a potty w pullup on until she starts relaxing a little more.
my dd (just turned 5) had same problem about 6 mo ago for a month and just in past few weeks. both started when dh went out of town. i took her to dr (miralax) and to child psych bc she stopped the first time after i promised her a toy if she kept from pooping in her pants for a week and she stopped just like that. basically her main advice was not to lose your cool which of course was my main problem; cleaning up poop out of underwear etc right now just makes me ill. dr said she needs to keep rectum empty or it gets overstretched as explained in above post.hth! this too shall pass hopefully.


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## Lovenest (Apr 12, 2006)

Quote:


Originally Posted by *harrietsmama* 
There is a yahoogroup with over 600 members discussing and sharing about side effects and alternatives http://health.groups.yahoo.com/group...ec=group&slk=1

It may not be clinical research, but I believe it when there are this many families getting together to try to resolve the aftereffects of taking Miralax, another drug that is not approved for children.

I am looking into what else we can use.
My son has been withholding since around 2 and his colon needs the break so he can feel that he needs to go.


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## Lovenest (Apr 12, 2006)

Quote:


Originally Posted by *angela40* 
if she is more comfortable going in a pullup for now maybe put one on her and then sit her on the toilet or a potty w pullup on until she starts relaxing a little more.
my dd (just turned 5) had same problem about 6 mo ago for a month and just in past few weeks. both started when dh went out of town. i took her to dr (miralax) and to child psych bc she stopped the first time after i promised her a toy if she kept from pooping in her pants for a week and she stopped just like that. basically her main advice was not to lose your cool which of course was my main problem; cleaning up poop out of underwear etc right now just makes me ill. dr said she needs to keep rectum empty or it gets overstretched as explained in above post.hth! this too shall pass hopefully.


My son would try so hard for a toy and could never get 1.
He would try and try to go poop and say "I am trying!" and then he would get up and walk around and leakage would happen.









I would try making sure she also sits 15-20 mins after eating meals. I have read this is the "perfect" time for anyone to go and it will happen more naturally. It did not help my son without Miralax, with it it did.


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## Lovenest (Apr 12, 2006)

Can someone tell me how peds are RX this stuff to children when it says right on the FDA website it is not for children?


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## Coco Cabana (Dec 22, 2014)

If you or your child is having gastrointestinal issues that aren’t responding to the treatment your doctor recommends, please pay careful attention:

We have four children, ages 23, 19, 10 & 9. When our 10-year old son was seven, he experienced an abrupt change to his stooling habits; specifically, he suddenly began soiling his pants, and it was black and smelled toxic. My husband and I didn’t even know what to make of it, for he had been potty trained normally like the rest, and he was otherwise normal behaviorally. He also experienced episodes of acute abdominal pain and vomiting. I thought he might be constipated and gave him some chewable Pedialax, which had no effect.

I took him to our family doctor, whom we had selected from a list of providers based on proximity to our home; since he was in family practice, I selected him to be our family’s doctor, and I never had any complaints with him prior to this. When I told him what was going on with our son though, he said it was constipation, and suggested I give him MiraLAX.

So I did, and it affected no change other than making our son very nauseous. We continued with this for a time, and of course all the while, the warning label on the box had me worried: “do not use for more than seven days”, “not recommended for use in children”, “if this product fails to produce a bowel movement or causes cramps and pain, discontinue use”. Those types of things, and I wondered if I should continue to give it.

So, we went back to the doctor, who very breezily explained to me that our son had “childhood fecal retention disorder”, that he was “holding in his poop” because he had suddenly become “afraid to poop”, and he directed me to give our son a dose of MiraLAX in the morning and a dose of DulcoLAX at night. This diagnosis really irked me, and I just really knew that it was wrong. But I went ahead and did what the doctor ordered…again, with seemingly no effect, no change, no improvement.

I would bring our son back to the doctor several times; sometimes, I would take him to the urgent care facility, and no one could tell me what to do. The suggested remedies became more invasive as I tried suppositories and then enemas, following the doctors’ instructions — nothing worked. The soiling continued, requiring our son to wear pull-up pants every day. This basically went on for nearly three years, and when I questioned it, the doctor continued to ascribe a behavioral cause for our son’s symptoms. I, too, was told to increase the amount of MiraLAX, and that he might have to take it for the rest of his life.

My research indicated that the symptom of black stools is either because of an iron-rich diet, bismuth medications, or bleeding in the small bowel; it also indicated humans cannot exert any control over the small bowel. We asked our son to describe what was going on; of course, since the topic was all about poop, he was embarrassed and hesitant to talk about it…but also because it was difficult for him to find the words to accurately explain what he felt was going on inside of him…after all, he’s still a child, not Doogie Howser, MD.

My son and I are/were very close, I loved him so much, we had such a good relationship, we had a very close bond. All I wanted for our son was for him to feel better and to go back to how he had been before this suddenly happened to him. By now, he was getting ready to enter the fifth grade, and after that it’s middle school, and I just wanted him to be free of this health complaint. We agreed that the next time he had acute abdominal pain, we would go to the emergency room at the hospital so they could look at it with all their diagnostic machines and whatnot and figure out once and for all what was wrong and fix it.

When it happened again, I took him to the local “Childrens Hospital.” They asked, “what brought you here today” and as I began to provide the history and describe my son’s symptoms they began to look at me funny…quizzical and skeptical. They decided to admit him, and that was the beginning of 12 days in Hell. They ignored everything I said, putting him on a clear liquid diet and literally pumping Go-Lytely into him to “clean him out.” He got so sick, vomiting ceaselessly, and still no poop.

Occasionally, they would ask me what *had* worked, and I told them a “milk and molasses” enema. They jumped on it, and administered a rapid succession of enemas, and my son was in so much pain and so sick, and nothing worked to “clean him out”, there was still so much stool inside of him according to the x-rays. They decided to do a manual disimpaction, believing that a lump of hard stool must be blocking things up…but that was not the case either. They subjected him to an endoscopy that was just…I don’t know. It was so *aggressive* when they couldn’t get it to go down past this one section of his stomach, they just kept trying to force it through, and it didn’t work. My son got so sick as they poke and prodded him everywhere in every way, trying to force the laxatives down, even though I had already explained that none of the oral laxatives had any effect.

My son lost so much weight; the staff kept urging me to leave the hospital for some “me time” and I didn’t want to leave his side, I was just so afraid for him. The hospital assigned a “social worker” to us, a do-do bird who shadowed us everywhere we went. I did not fee free to take my son from the hospital. In the time we were there, my son was placed under general anesthesia four times. When after everything they did my son continued to “not respond to therapy as we had anticipated” they said he was going to be there for at least five more days and ordered the placement of a PICC line for direct nutrition.

This PICC line went straight to his heart. They placed in the after noon of day 10. In the early morning hours of day 11 a nurse came in to flush out the line, and my son cried that it hurt. The nurse rolled her eyes, commenting on his “anxiety” — she put in a call to the doctor, who gave her the go-ahead to give our son a dose of Ativan to calm him. And then she pushed the Ativan in and nearly killed him; she induced congestive heart failure, and my son almost died right in front of my face, and I will never forget the sight, I will never forget the moment.

I cried out that she had overdosed him and she denied that she had, and another nurse led me out of the room and told me if I didn’t be quiet and calm down they would prevent me from re-entering the room. I assured them that I was perfectly calm and that if my son was going to die, I was going to be sure to watch him go and take note of everything I saw. I spent the next several hours holding my son, so afraid; after three hours of babbling and seizures he finally fell asleep.
In the morning, those quacks walked into the room all smiles, remarking on how great our son looked, and that they felt it was just a stomach bug and as soon as he passed some stool he’d be ready to be discharged!! I couldn’t believe it. After some time, he passed a little orange-ish turd, and they shoved the discharge papers in my face to sign…but I recognized the smell, linked it to a smell I had detected on a stray kitten’s poop…we had taken in this little stray kitten three years earlier…

Long story short, my research led me to wonder if my son had something called Helicobacter Heilmannii — look it up, its a bacteria you can catch from your cat or your dog, and it causes all kinds of gastrointestinal disorder. It is treatable with a two-to-three week regimen of antibiotics and stomach acid reducers…but left untreated, it causes lymphoma of the gastric mucosa. I asked our doctor to test our son for it, and the test came back positive, and I was elated. Finally, a real diagnosis!

But the hospital had already started a horrible, nightmare train a’rollin…the doctors there claimed I had “medically neglected” my son, that if only I had given my son MiraLAX as the doctor had recommended, my son would never have had to come to the hospital at all; they reported me to child protection services and told them I had Munchausen’s Syndrome by Proxy, and that I had deliberately sickened my son because I enjoyed the secondary attention I got from the doctors from my son’s illness. CPS came and took our 10 year old son and our 9 year old daughter away. Two months after his removal, our son suddenly began stooling normally again, and everyone pointed to it like, “see, all we had to do was take him away from his mom, and he got better.” But it was because of the antibiotics he had just finished taking before they removed him from our care…

And that was eight long months ago…we get one four-hour visit with our kids every month, and two phone calls per week…the dependency and neglect system is so corrupt and evil…CPS told my husband they would return the kids to him if he divorced me…we’ve been married 24 years…we miss our kids so much…the hospital and CPS have destroyed my life, stolen my from me and my heart and my whole world are broken.


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## Asiago (Jul 1, 2009)

My thoughts and prayers go out to you and your family.


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