September 12, 2008,
J.B. asks from Middletown, OH on August 23, 2008
6 Year Old Having BM Accidents
One day a couple months ago My 6 year old son starting having BM accidents in his underwear. He's never had a problem with this before, and suddenly it's happening 3+ times a day! I'm not talking about a few skid marks - he's filling them with chunks that have to be pick out and scrubbed before I can put them into the washing machine. His stool is soft like play-doh, not the hard pellets you would expect with constipation. He says he can't feel that he has to go, and is often surprised when we notice it and take him to the bathroom. A few times he described it as feeling, "numb."
A week or so after the BM accidents started he began wetting himself too. He is going through 6 or more changes of clothes a day and my house stinks! I am so frustrated!!! We think this is probably just laziness or attention seeking behavior. We've tried rewards, we've tried consequences, we've tried taking him to the bathroom at set intervals. We've tried a stool softener. We've tried giving him more attention and one on one time... nothing is helping at all. Hoping desperately to hear from anyone with some advice! School starts again next week and I'm afraid for his self-esteem.
S.D. answers from Indianapolis on August 25, 2008
I don't have advice on how to stop it, but I do on cleaning. I'd get a second diaper pail for his room (a cheap used one would be great) and after flipping his poo in the pot and maybe rinsing the undies in the toilet, put them in the pail. Every few days, wash them all together. You don't have to scrub them, just treat them like cloth diapers and wash them together - actually, I know people who wash their CD's with other clothes, it's safe, I just have enough diapers that I do separate loads of them.
Most people pee when they poop, so that's probably why he started wetting at the same time.
J.B. answers from Columbus on August 25, 2008
Did he have a fall that might have thrown something out in his back? I've heard of this happening to small children, and then they can't feel when they have to go to the bathroom. If you take him to a chiropractor, they can put things back in place so he can feel it again. I have a couple friends who swear by their chiropractors and have taken their kids to see them for this very problem (usually in the potty training stage, though).
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K.V. answers from Indianapolis on August 24, 2008
I think you have hit it on the head with the attention thing. He is only 3 yrs younger than his older brother, while he is a 6 yrs older than the new baby. The older one probably adjusted a little easier to the "new" baby because he was younger. Are there other changes happening this year such as school? He may just be needing some one on one time with especially you. He used to be the baby up until 6 mo ago!
L.H. answers from Cincinnati on August 24, 2008
I am not sure if this is it but this sounds like a condition that young children get called encoparesis (sp?). It is when children get absorbed in play or some activity and usually put off going to the bathroom to have a BM. This usually has been going on for a while. What happens is that the lower colon gets distended from stool being there. The stool builds up causing an impaction (harden stool) but soft stool continues to ooze around it. The constant pressure of the impaction on the rectum then causes that "numb" feeling which in turn the child is not able to sense when they have to go to the bathroom. This then leads to the incontinence that you are describing. It is a very reversible condition but does require you seeing the child's physician or a gastrologist for children to get certain medications to help and to establish a regieme to establish bowel tone again.
What is fustrating is the incontinence and the child not able to understand why it is happening. I would advise to see the MD asap to get him on a bowel regieme soon to prevent embarassment for him at school and peace of mind for you guys.
Will say a prayer for quick resolution for you all.
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L.H. answers from Dayton on August 24, 2008
I have a 9 year old that did the same thing. Get him into the pediatrician. It could be medical if he says it is "numb". My son would hold it and then his colon quit working correctly. I took him to the dr. and we put him on a stool softner and it took a few weeks, but he is now able to tell again when he has to go. I also remind him every morning to try and some days he is surprised that I am right and he does go! Hmmm, I guess he isn't old enough yet that he looks at me as knowing nothing......
Best of luck and let me know how it goes.
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D.T. answers from Indianapolis on August 25, 2008
That sounds EXACTLY like encopresis. You need to take him to your ped ASAP but then also to a pediatric GI. Most peds are pretty clueless about this. It's a very common condition, especially in boys ages 5-10, but most people have never heard of it because it always gets misdiagnosed (aka lazy boy). It's a legitimate medical issue. He has no control over his bowels at this point.
Basically, he got constipated, the stool got backed up and now loose stools are flowing around the backed up stool. He's lost all sensation due to being stretched out and no longer has control over the muscles that 'hold it in'.
The standard treatment is an X-ray to determine how much he's constipated. Then 3-5 days of 'cleaning out' which is basically massive doses (like 6 or 7 capfuls a day) of Miralax and/or a few doses of exlax. Then another x-ray to confirm there's no stool left. Then put on a maintance dose of Miralax (1/2 to 2 capfuls a day, depending on your child) for 6-12 months (yes MONTHS) until things get back to normal. During this time, he needs 'timed toilet sits' which basically means he needs to sit down for 10 minutes 10-20 minutes after every meal to take advantage of the bodies natural instinct to poop at that time.
Many people, including pediatricians, seem to think that simply giving a capful or 2 of Miralax a day is sufficient when in most cases it is not. That makes the problem WORSE. It just makes the new stool soft but it's not enough to loosen the mass so it's more likely the newer softer stool will just leak out. As long as the hard mass is in there, it'll never improve.
It's a long battle but like everything else the sooner you catch it the shorter time it takes. My son just turned 6 and we didn't have a diagnosis until he was 5 even though the problems started right after potty training at 3.5. We followed our ped's advice for 9 months before finding out about ped specialists and insisting to see one. We saw no improvement with our ped but after just 1 visit and 4 weeks after seeing the ped GI we saw vast improvement and are now down to one soiling incident (don't call them "accidents"... he can't control it and calling them accidents makes it seem like he can!) a week. It used to be several a day.
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K.S. answers from Cincinnati on August 24, 2008
please go to your doctor and do not let him/her blow you off. i have a friend with a six year old with this same problem. he has some colon issues that are being addressed and are not medically dangerous but causing that same numbness and bm/wetting problems you mention, and are certainly effecting his mental, emotional and physical health. his wetting issues have become a problem because the colon issues are effecting his bladder.
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K.B. answers from Cincinnati on August 25, 2008
I remember in nursing school we learned that any time a child has been completely potty trained and then starts having accidents that there is 95% of the time an underlining cause that warrents a doctors call/visit.
Are there any other changes in his life right now that could be adding extra stress of any sort? Does he have any other health problems? I would be more than just a little concerned especially since it has gone one longer than a few days.
J.F. answers from Elkhart on August 25, 2008
My son had the same problem. He could have what is called encoprisis. When had stool becomes impacted whch stretches the anal cavity and softer stool leaks out. My doctor had me give our son an enema at night and then in the morning to get the impaction removed and since my son had this happen chronically, my son takes a stool softener (Miralax-now availalbe over the counter) to keep him more regular. The Miralax is very mild and has no flavor and is not gritty- I mix it with some juice and he drinks it with his evening meal. After the enema releases the impaction, he may still have some accidents until the anal cavity regains it's shape. My son worn pull-ups until the accidents stopped. Since they have trouble feeling the loss of stool, encourange him to try to "poop" within 15 minutes after each meal. My doctor said that is when the bowels are most active and will be more likely to "poop".
God bless, I know it can be frustrating, My son is now 7 and we have been dealing with this since he was 3. We've even gone to a specialist in another city to try to find a solution and it all boiled down to the same solution after months of diffrent tests, and special meds.
Just an FYI, but boys tend to be more likely to have this problem and especially boys with ADD tendencies.
God Bless, My prayers are with you, I know your frustration.
C.H. answers from Youngstown on August 25, 2008
My son use to do that. We found he had a disorder that caused him to BM in his pants he finally straightened himself out. They do it when it hurts to go you can look it up on mamma.com thats how we found out about it. Also has anything changed in your house that might be causing him destress? He might be afraid of getting older and not being the baby. Is he going to school? Hope this helps....
M.P. answers from Indianapolis on August 25, 2008
I would take him to a doctor, make sure everything is OK. Have you tried to catch him doing it? What was he doing at the time? Is he just too involved in something that he doesn't want to stop and go to the bathroom?
If everything checks out OK, it is time for punishment. Make him responsible for rinsing the undies in the toilet and then putting them in the wash machine. Make him mop up any messes. Then, spend the rest of the day in his room- or start with an hour, then add an hour each time. This will work!
(My son started the #2 thing when he was around 9 yrs old, so I have been through it.)