# I think my 7 year old has encopresis



## mamakah (Nov 5, 2008)

My 7 year old started first grade this year, and I noticed he was holding his bowel movements until he got home. Everyday, the minute we'd walk in the door, he'd go to the bathroom and have a bowel movement. 
Last week he was obviously constipated. He wasn't eating, his stomach was pushed out, and he kept saying it hurt to go. After speaking with a pharmacist, I gave him a laxative. Within an hour of having the laxative, he soiled his pants. Then again that night, and everyday for 4 days after. I called the pharmacist and explained what was happening and he said that's common when a child has been constipated for a few days.

The pant soiling stopped, and he had a couple of bowel movements in the toilet for about two days, and is now back to being constipated. Not wanting to give him the laxative again, we bought prunes, probiotics, and juice and talked about making sure we help his stools soften up so he can go. Last night I noticed him definitely holding in a bowel movement and took him to the bathroom so I could be there to help him get it out. He was unable to go. An hour later, he soiled his pants. He gets very upset when this happens. I don't shame him, just tell him we're going to get it all worked out, and that we just have to get his body to be comfortable going again.

This is very distressing to me. He never had problems potty training, and once potty trained, never soiled his pants, so obviously my 7 year suddenly going in his pants is freaking me out. I've also noticed that when he's constipated, he gets eczema like bumps on his elbows, which makes me worry that this is affecting his immune system somehow.

We have an appointment with a chiropractor this week. I might take him to his Ped too, though I worry he'll just prescribe laxatives and that's it. He's really good about fiber. Eats an apple a day, likes beans, oatmeal, fruits and veggies. The only possible stress trigger I can think of is that he will be switching schools next year (a choice he seems to be excited about). Maybe it was stressful for him for this school year to end, knowing he'd be attending a new school next year?

I think I mainly just need support right now, but would also love advice.


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## Linda on the move (Jun 15, 2005)

Water, water, water. In all the things you listed, you didn't mention water. Lots of it, all the time. 


As far as holding it at school, it could be a couple of things. First, it may just be that his natural timing of needing to go falls at a bad point in the day. Teachers tend to get pissy about kids wanting to go to the restroom shorting be leaving school, but then there is the whole getting ready to go, getting picked up or to the bus, the travel time home etc. I think some teachers think "but we only have 15 minutes of school left" and not "yeah, go, because it will be 45 minutes before you get another chance."


Or, it could be that he is uncomfortable pooping some place other than home. Or, he is overall OK going someplace other than home, but some other little boy in first grade teased him about going poop at school, and now it's an issue. (A lot of boys his age think poop is very funny). Have you tried just talking to him about what is going on? 


I'm sorry you are going through this.


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## mamakah (Nov 5, 2008)

Linda on the move said:


> Water, water, water. In all the things you listed, you didn't mention water. Lots of it, all the time.


Oh wow, you're right I didn't mention water! He already drinks a ton of water (really the only thing he'll drink regularly) which is also what's concerning. He really has no reason to be backed up. :frown: So frustrating.


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## newmamalizzy (Jul 23, 2010)

Yes, I was going to say water also. My DD(5) is struggling with encopresis right now. She had x-Rays and whatnot and is supposed to be on Miralax, although I don't give it every day. 

We've been doing a few things aside from the medicine. 
1. If I don't give her the medicine, I give her a drink in place of the medicine. It's very rare for my DD to drink 4 oz in a sitting, so I make it a point.
2. She sits with books and a drink on the toilet for at least 5 minutes after each meal. Ped says after eating is a natural time to go. It's definitely been helping to have that dedicated time. 
3. Search YouTube for a video called "the poo in you." Sounds ridiculous, but it's a great description for both child and parents.
4. Naked Berry Veggie drink seems to work almost as well as Miralax for my DD. if you try it, don't be alarmed by the crazy poop color.
5. Like you said, reassurance that we are working together to solve the problem. My DD is defiant about the whole thing, but her relief after seeing the doctor betrayed how much she cares. It's been so good for her to understand that she's not just failing.


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## japonica (May 26, 2005)

We've BTDT and could buy a whole rack of T-shirts. DS PTed late, had issues learning to poop on the potty, then all was fine (we thought) until we started with these soiling episodes when he was five and again at six. Turns out he was withholding because he didn't want to poop at school, and it was backing up, and then the stool was leaking around the impacted stuff. We saw the GP, got an X-ray and it confirmed the encopresis, and we had to dose him multiple times to clean him out and then basically re-train him to learn proper bowel function again since all that time holding it and ignoring it meant that he couldn't tell when he had to go.

The episodes when he was five years old were pretty awful. Let me just say that we spent a fortune on new undies for a while there and we had two occasions when I had to scoop and disinfect the whole bathtub. Enough said.

We got it under control but then when he was six it flared up. Again, same thing, not wanting to use the toilet at school. Back to the GP for laxatives to clean him out and back to focusing on good bowel habits.

So far, we've been flare up free for almost a year. We remind him that he has to go regularly, even if it means at school. Right now he seems to have a schedule where he either goes in the morning before school or right after he gets home in the afternoon…either way, we don't let a day go by without a friendly reminder that he needs to grab a book and sit there. Hang in there. It does get better. Honest.


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## mamakah (Nov 5, 2008)

newmamalizzy said:


> Yes, I was going to say water also. My DD(5) is struggling with encopresis right now. She had x-Rays and whatnot and is supposed to be on Miralax, although I don't give it every day.
> 
> We've been doing a few things aside from the medicine.
> 1. If I don't give her the medicine, I give her a drink in place of the medicine. It's very rare for my DD to drink 4 oz in a sitting, so I make it a point.
> ...


Thank you for this. I just pulled up "The poo in you" video for him to watch and he watched it 4 times!
I also bought some of the Naked Berry Veggie juice you suggested. Does your daughter drink the whole bottle in order to get things moving?


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## mamakah (Nov 5, 2008)

japonica said:


> Turns out he was withholding because he didn't want to poop at school, and it was backing up, and then the stool was leaking around the impacted stuff. We saw the GP, got an X-ray and it confirmed the encopresis, and we had to dose him multiple times to clean him out and then basically re-train him to learn proper bowel function again since all that time holding it and ignoring it meant that he couldn't tell when he had to go.


I think this is exactly what's happened with DS. He was retaining at school, and even though he was still coming home and going, he got backed up.

Is the miralax hard to come off of? I've read a lot of protocols for clean out, but I always worry that he'll become dependent. Is that not the case?

Thank you!


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## newmamalizzy (Jul 23, 2010)

My DD always went every day as well, so we were surprised about the diagnosis. She would hold it when she didn't want to stop playing.

We definitely don't do the whole bottle of juice. I'm guessing we do 4-6 ounces a day. It's been her favorite special drink for years, so we knew it had the side-benefit of moving things along. It can't hurt to try it.

I'm not keen on using a lot of Miralax, but I do think she needs some help with the initial clear-out. We did three days in a row with 2 doses, then dropped to one a day. I had to skip doses strategically to avoid having accidents during inconvenient times. We're trying a half dose for a while, but I'm hoping to drop it pretty quickly and substitute more natural methods.

Glad your son liked the video. It's pretty great.


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## blessedwithboys (Dec 8, 2004)

http://www.judytsafrirmd.com/spotlight-finally-on-miralax/

http://thinkingmomsrevolution.com/can-kid-cant-know-go/

Miralax is bad stuff. Above is the TMR page with a couple dozen alternatives.

To that I will add the suggestion that if you ds is holding it all day at school , the simple solution is to make him go in the morning. My ds2 was a morning pooper, my ds2 was an after school pooper. It killed him to have to go at school bc he refused to sit on the toilet, he thought (and I agreed) that it was just too gross and dirty. He never became constipated, but it became a daily joke that he would bolt out of the car and run for the bathroom.

What if you gave your ds something at night that would work slowly and produce a movement first thing in the morning? Maybe a bath in epsom salt, followed by a drink containing aloe juice or a tiny bit of senna tea? Just be careful not to OD the senna as it can cause painful cramps.

Cascara sagrada is a pretty decent softener. I take it when I am doing hardcore low carb. It doesn't make me go, but it does keep the BMs from becoming rocky.

Then when your ds gets up in the morning (you might have to wake him up earlier than usual to accomplish this), have him drink a big glass of water and keep him moving. Take him for a walk. Get that peristalsis going. After 15-20 mins, have him sit on the toilet. Let him be late for school for a couple of days. Get his body trained to move the bowels in the morning. Then he won't be holding it at school and causing the compaction which leads to encopresis.

Best wishes to you both!


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## blessedwithboys (Dec 8, 2004)

http://www.judytsafrirmd.com/spotlight-finally-on-miralax/

http://thinkingmomsrevolution.com/can-kid-cant-know-go/

Miralax is bad stuff. Above is the TMR page with a couple dozen alternatives.

To that I will add the suggestion that if you ds is holding it all day at school , the simple solution is to make him go in the morning. My ds2 was a morning pooper, my ds2 was an after school pooper. It killed him to have to go at school bc he refused to sit on the toilet, he thought (and I agreed) that it was just too gross and dirty. He never became constipated, but it became a daily joke that he would bolt out of the car and run for the bathroom.

What if you gave your ds something at night that would work slowly and produce a movement first thing in the morning? Maybe a bath in epsom salt, followed by a drink containing aloe juice or a tiny bit of senna tea? Just be careful not to OD the senna as it can cause painful cramps.

Cascara sagrada is a pretty decent softener. I take it when I am doing hardcore low carb. It doesn't make me go, but it does keep the BMs from becoming rocky.

Then when your ds gets up in the morning (you might have to wake him up earlier than usual to accomplish this), have him drink a big glass of water and keep him moving. Take him for a walk. Get that peristalsis going. After 15-20 mins, have him sit on the toilet. Let him be late for school for a couple of days. Get his body trained to move the bowels in the morning. Then he won't be holding it at school and causing the compaction which leads to encopresis.

Best wishes to you both!


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## japonica (May 26, 2005)

mamakah said:


> I think this is exactly what's happened with DS. He was retaining at school, and even though he was still coming home and going, he got backed up.
> 
> Is the miralax hard to come off of? I've read a lot of protocols for clean out, but I always worry that he'll become dependent. Is that not the case?
> 
> Thank you!


We're in Australia. We were given Movicol, which is probably along the same lines as the Miralax. He did not stay on it and in our case, it wasn't really necessary after the initial clean out. Without the clean out being done, or done thoroughly, the leaking would continue. We used it per the GP's instructions to get the backed up stool out, and then perhaps for a couple of days afterwards while we focused on retraining and getting him to go when he needed to and not ignore it. But in our case, he was not on it long term or anything. After about a week or so, he was fine.

We went through the episode again the next year, repeated the whole protocol, and again, he was fine and we didn't need laxatives long term. I think the biggest thing is recognising the signals to go again and being consistent with good bowel habits. Things have been fine with us so far *touch wood* and no need for laxatives, prunes, whatever.


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