# 4 1/2 year old still poops in his pants all the time!



## AmieRenee1980

My 4 1/2 year old son has never been completely "trained" when it comes to pooping. He did reach a point where he would start going in the toilet occasionally, but has continued to go in his pants frequently. There is no pattern to it, some days he does it in the morning, sometimes in the afternoon, sometimes at night. He does it at home, at school, at the park, wherever we are. He will often tell me he didn't "know" he had to go until it started coming out. I believed him and took him to the pediatrician about a year ago, she said sounds like "Encopresis", told us to use Miralax and have him sit on the toilet several times a day. We did as we were told, and sometimes we would go for a week or even two with no accidents, he would run to the toilet when he had to poop and all would be well. Then suddenly he would fall back into the habit of pooping in his pants. He has never seemed constipated and has never gone more than 1 day without pooping, so I never understood the need for Miralax, but we continued it anyway. The thing is I don't think it fits with Encopresis completely, I mean sometimes it sounds just like it, but sometimes I think Matty poops in his pants because he is too lazy to stop playing, or doing what he's doing.

So here we are at nearly 5 years old, he has been in preschool all year, and because it is through the public school system they have rules about the teachers cleaning the kids up. This means every time he poops in his pants at school they have to call me to come clean him up. Here's the thing, the other kids are already teasing him about pooping in his pants, and he doesnt seem that bothered by it. My husband and I have tried EVERYTHING! We have bribed him, punished him, told him how disgusting it is, coddled him, praised him, etc. I finally went to a psychiatrist because of this and other behavioral issues and we were given a diagnosis of childhood bipolar, but the psychiatrist had no suggestions on the pooping issues. I even recently took him 4 hours away to a pediatric gastroenterologist and they are still in the midst of various tests to rule out medical conditions that could be causing this, but the Dr feels like he will probably end up sticking with the Encopresis diagnosis. He had me do a colon cleanse on my son which consisted of 8 mega Miralax doses in an 8 hour period and let me tell you it was a nasty couple of days after that, but we did it so the colon should be good and clean, yet he continues to poop in his pants.

I am at my breaking point today. Recently, over the past week he has begun to not only poop in his pants, but then not tell me he did, he will go right on playing for up to an hour with poop in his pants!!! I don't know it until I smell him! I am baffled by how he could just not care that it's there, not feel disgusting and uncomfortable. Well today I get to school to pick him up and they inform me he has just had an accident, actually what happened was another little kid ran up to the teacher after suddenly finding poop on her shoe, then the teacher discovered poop all over the carpet. She checked my son, and he then admitted that he had pooped in his pants, and it had somehow fallen out of his underwear and to the floor and he had stepped in it and tracked it all over the room but not told anyone!!! I was mortified and I have no idea what to do with my child! How could he suddenly not care about having poop all over him? At least in the past he has always come to me right away to tell me.

Help!! I do not know what else to do, I can't let him start kindergarten in the fall still doing this!!


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## straighthaircurly

Wow, tough situation. I don't have much advice or experience to offer. But your son's comments about not being able to tell when he has to poop reminds me of my DS who has sensory processing disorder (SPD) and was saying the same thing up until age 4. We did 3 things that helped. #1 We stopped all blaming or negative thoughts/comments, etc. #2 We started talking about the sensations when he was pooping...what does it feel like, how did it feel right before, what does it feel like after. #3 We let him pick out a special treat that he could have only after he had pooped in the potty. Then we started putting the focus on the treat. Start with "Whenever you sit and try to poop, you can have a treat." Then move to "Whenever you feel poop coming and run to the potty, you can have a treat (even if some poop ends up in the pants and some in the potty)" And finally move to only getting a treat if the poop is in the potty. He needs to be the one requesting the treat, not you standing there bribing him with the treat (although to start this it is okay to remind him about the treat system). The treat needs to be something he never gets normally. If it is candy, then he should not have candy available any other time. Once he has gotten the hang of it consistently for a few months then you will notice that he will stop asking for a treat every time and you can let the treat side of things fade away.


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## nextcommercial

It really does sound a lot like encopresis. Have you done a big google search on it? Maybe what the doctor told you works sometimes, for some kids... but, maybe there is someone out there who has better advice that will work better for your son.

I know a boy who was still doing this in fifth grade. Every single day, in school. But, he didn't have a big bowel movement... it was just a lot of small ones.


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## Violet2

My brother had problems and ended up needing minor surgery at 6 to correct a congenital defect in his rectum.

I would get a second opinion and aggressively push to rule out any medical problems.

I know we were awfully hard on my poor brother







and it wasn't his fault.

V


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## LauraLoo

Another avenue to consider -- Have you checked out any food allergies or intollerances? This is a broad area. Some children do not tolerate certain foods well because their body doesn't digest them properly or they are having an allergic reaction to them. This can create a lot of gastro-intestinal pressure and discomfort (even pain) that is present *all the time* among other behavioral issues due to the allergies. Dairy and gluten seem to be the big offenders, but there are others.

If you think this is something to consider, I'd suggest that you pop on over to the allergy forum in Health and Healing.

Also, after a major colon cleansing, have you followed up with any probiotics to re-establish the good bacteria in the intestines?


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## fairejour

Have you discussed what it feels like BEFORE you need to sit on the potty? That is what took our girl some time to figure out. The feeling of needing to poo, not actually waiting until it starts.


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## bl987ue

It does sound like encopresis, because the colon gets stretched out and loses sensation. Does the ped recommend remaining on the Miralax for several months? That's usually the suggested routine.


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## leahrain

I think you have gotten some great advice. The only thing I would add is to do a potty schedule with him, where at certain times a day it is potty time, whether he thinks he needs to go or not. Best times: after meals, before going out and after returning from a car ride, every 1-2 hrs from last elimination, before/after sleep. I really like the first advice given regarding not making anything negative. I don't think shame or guilt are going to be effective in this case and will probably only lead to insecurities and self doubt.


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## Subhuti

I am going to tell you about our situation, although it doesn't seem your son's is the same. Just in case there is something helpful.

My daughter refused to train to poop in the potty. She said she was scared. I think she was scared in a performance anxiety way and also an unfamiliarity way. Once she was out of diapers (I am going to say finally by aged 3 and 3/4), she would just poop in her underpants. She'd almost always do it at home. It was a daily mess we didn't enjoy and we'd fume. It was hard to stay patient.

We got tired of this (it went on for about two months). Then one day my friend said, her boy had liked to poop standing up, and she just let him do so w/a diaper until he was ready. I realized, why not offer this option to her.

I told her she could ask for a diaper to poop in. This worked well. She did this for about six months. She never once pooped in her pants again.

Recently, (she's now 4 and 3/4) I suggested to her that we would put a diaper in a potty, and she could sit down and poop on that. When she felt ready to do so. She finally felt ready, and hasn't looked back. After a few times, she spontaneously said she would like to have no diaper in the potty, and is just using a potty the way God intended!

Anyway ... it sounds different from your situation, but I wanted to post because I wondered if there is anything in our story... perhaps the fear around sitting on the toilet? That is helpful to you.

Liz


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## claras_mom

Quote:


Originally Posted by *AmieRenee1980* 
sometimes I think Matty poops in his pants because he is too lazy to stop playing, or doing what he's doing.


Quote:


Originally Posted by *CatskillMtnMama* 
I am going to tell you about our situation, although it doesn't seem your son's is the same. Just in case there is something helpful.

My daughter refused to train to poop in the potty. She said she was scared. I think she was scared in a performance anxiety way and also an unfamiliarity way. Once she was out of diapers (I am going to say finally by aged 3 and 3/4), she would just poop in her underpants.

Dd (4-1/2) has been known to say the first--more along the lines of "too busy." We counter with the idea that it takes less time to go to the potty than to make a mess that has to be cleaned up.

She is still in the process of learning to consistently poop in the potty. On the plus side, her habit was to ask for a pull-up when she needs to poop, which meant that messes were contained. Then she went in the potty the first time and we had a string of pee and poop accidents.

Finally resorted to a reward system. For the very first time only she got to choose a toy. Then five times, and I chose a toy. She then had a couple of accidents at daycare, which made me very unhappy, because the whole mess, clothes and poop and all, just gets bagged for me to deal with. At least she gets her clothes changed. Now we're on 10 times without any accidents or pull-ups (we start over at 1, in that case)...and then she'll choose. We've already started over twice, mostly due to pull-ups. The next phase, if needed, will probably be 20 times without accidents, and then hopefully she'll be enough in the habit to stop with the presents already.









I don't know if any of this helps. Key things - she does know perfectly when she has to go, so it's just been a question of getting her comfortable going in the potty instead of in the pull-up. And she doesn't like the feel of dirty underpants, so she's unlikely to just sit in it.

ETA My daughter also said she was scared, though like the PP, I tend to think it was performance anxiety. Sitting on the potty in a pull-up never worked for us--I wanted her to try to learn the feeling of pooping sitting down, but with the "safety net"--but it is something we tried.


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