Encopresis - Help!

We really needed help from a pediatric gastroenterologist and a nutritionist. My daughter was withholding because for her it was partly an issue relating to Sensory Integration Disorder as pertaining to her Autism. She was having additional pain issues and gastric problems related to Lactose Intolerance which were tested and confirmed with the gastroenterologist.

This is why I'm suggesting you get help from a specialist. There could be more going on here than you realize, such as an actual dysfunction in the gut that needs to be discovered and dealt with.

My daughter had a lot of trouble going when she was younger too. I put her on probiotics (once a day) and had her sit on the toilet right before her bath each night. I set up a table in front of her with some toys (now she likes to read a book).

This took some time she would go for a few days without pooping. I only gave fiber gummies a couple of times, I would rather give her foods to help her go.

I think in my case it was more about her having control over when she went. Once she realized that all she had to do was sit in there without me she started going regularly. Try not forcing her do something to make it fun for her. Offer a toy to play with or get some dollar store toys as rewards.

Remember that some people don't poop every day, some only go a few times a week. As long as there are no other health issues than let her go a few times a week. I am sure your ped will tell you the same.

Routine is the most important thing I think. Sit on the toilet after every meal (breakfast and dinner I suppose since you don't have her at lunch), eating triggers the the whole elimination process. I prefer breakfast anyway to try to send the kid to school empty, you know? Absolutely give her a book or activity to do on the toilet, put a stool beneath her feet to try to keep her knees bent at 90-degrees for comfort, then set a timer or 5 or 10 minutes. Keep every ounce of emotion out of it, this is a new routine we are trying and that's that. It's OK if it doesn't happen every time, but she has to try and has to stay for the whole timer. You need to retrain her body basically, and as the previous poster said occupy her mind so that she can't think her way out of it.

We did see a gastroenterologist, who only helped by assessing the xrays, which showed (lo and behold) that he was indeed backed up with stool. It was important I suppose to rule out genuine medical issues, but ultimately it was up to us to deal with it. We found some success with miralax to empty him out when he was impacted, but I agree it's not a long-term solution. The best success we've had has been when we are in charge of his bathroom visits, and they happen consistently and predictably, without shame or stress or frustration.

If you haven't already, do a search on this site for Encopresis, I for one have had multiple conversations about it here and have found good advice from a lot of people who have gone through it. You're not alone, it'll be OK!

I have helped a lot of people with digestive issues, including children. I have a friend whose child had severe encopresis all the way through high school - she did the gastroenterologist and the behavioral therapist, and it helped some, but even at age 13 her daughter was having the problems yours is (soiling before bowel movements, urgency, multiple accidents, and so on). It's a long road and a difficult one, not to mention very expensive.

I would question the fiber gummies - if you put most gummy vitamins in a dish of vinegar for 20 minutes, see how much is left. (probably most of it!) how much is left in the child's stomach after the customary 20 minutes food spends in there. The rest is likely wasted. Gummies are a great marketing gimmick but hardly anything in a regular pill form has more than 25% absorbency (often less), and the gummies are much tougher to digest.

A good comprehensive supplement with soluble and insoluble fiber (almost impossible to find), with a patent, and with many years of clinical data is what you need. Comprehensive means digestive herbs and enzymes on top of the 2 types of fiber combined. This can help heal the digestive tract and, for all of my clients who use it properly and consistently, has enabled them to get rid of all their symptoms of IBS, constipation, diarrhea, colitis, diverticulitis, acid reflux and similar conditions. This is not in pill form and can be added to water or any liquid she will drink. If you don't know of a source for this, I can help guide you.

My son will be 10 in August, he has battled encorpresis since potty training. He was stuborn about going #2 in the potty as well. He has had a long road, we have tried miralax, diet changes, and routine potty sits.... he has seen the ped. gast. and last year we were blessed to be enrolled in the encorpresis clinc at U of M in Ann Arbor! It is the first time ever that my son has not had to wear pull ups to school and had a sucessful year! They started him on 2 tsp of senexon at 3pm and he started with 3 bathroom sits, as he has continued going every 2 mths to the clinic they continued to adjust his schedule and praise God his last appt. they took him down to 1.5 tsp senexon and we are adding 1/2 capful of mirlax in the morning to b sure he stays soft. He is down to only 1 bathroom sit in the am and the remainder of the day he is going when he feel he needs to. he still has some soils but NOTHING like what he use to deal with and it is getting better every month! If you need to ask any questions feel free to message me!!!! I would love to help you get where you need to be, it is heartbreaking as they get older and are dealing with these issues. BTW, at the clinic he sees a MD and a Behavioral Theropist (They work hand and hand) :)

I think once they get to the point of diarrhea with the Miralax you can reduce the dose or the frequency of giving it. It does help to get them going though but long term I would not want to do. I guess fruits, water not other drinks all day, exercise all help but also the main thing is to make a habit of going in and sitting until they go. We went through that with grandsons, twins, and now they go on their own and do great although one is still on the Miralax. I hope he is able to be off that medication soon though. They were very constipated and did the specialist, tests, etc. and were just holding it for some reason. The doctor a Children's Mercy said to do the Miralax and the only other thing they suggested was to do the colon testing and not for a little 2 or 3 year old! They said that was last resort more or less. I'd do the Miralax for a bit if you aren't afraid of it, then do prunes and fruit, not the juices.

I know this isn't what you want to hear, but the fact that she has diarrhea with the Miralax is helping to clean her out, the first step in getting her on track to poop regularly and not hold it.

Check this site out, I used it to help my guy before he developed encopresis, it offers lots of information to help with a child who refuses and holds their poop and to eventually get them pooping every day, to help you to help your daughter to be okay:
http://www.rogerknapp.com/medical/pottytrainingrefusals.htm

As far as your daughter seeing a therapist this is what the site has to say on that:
"If the child has significant emotional problems such as anger or depression, either as a primary condition or secondary to the encopresis, counseling by a psychiatrist or psychologist is indicated. A young child who is engaged in a power struggle with his parents in many areas also requires referral."

Hang in there!

Give her your smart phone or a video game. Something to occupy her brain that is a very very very big deal. Telly her that if she sits quietly and tries she can play with this item for a while. We let him play on it for some time so we don't have huge messes to clean up.

It keeps him on the toilet and keeps it from seeming like punishment. He will sit all day if we let him and he will pooh several times. We also give a reward for actual feces. He has to show us the stool though if he wants any tiny M&M's or other small candies.

This has helped him to sit and try much better. He is all about playing on my phone. If he is playing a game with someone else in the house he will even sit there longer.

The goal of him sitting for so long is so that he has to "go" and has to stay there until he does. If you figure out about what time of day she is going most often then you can time this just right where they need to go and will produce feces.

You have a lot of great advice here. Our son was finally diagnosed about age 7 and was considered cured by age 12. We saw a Ped Gastroenterologist. once, at the beginning. He had the full course of exams, barium enema, etc...
We did Miralax and regular "sits" on the toilet. We had it written into his IEP at school that he was never to be denied bathroom access. I threw out so much underwear those first few years. I remember the first time he came to me with "my stomach hurts!" and I remembered what the doctor said and replied "Go sit on the toilet!" as it was the first time he could actually feel the urge to go, which meant the nerves and colon tissue were healing. And then the day he came to me with the realization it had been three months since his last accident. That, according to the docs, meant he was totally healed. You are welcome to contact me here to talk about it. It was an emotionally trying time for our whole family, and taught us about empathy, tolerance, and most of all, patience. Remembering it now brings tears to my eyes, really.

Metamucil Clear and Natural got my son back on track. this was recommended by the pediatric gastroenterologist.

Have had the same issues with my DD. Finally found Fiber Gummies at Wal mart and that has helped a lot. I did not liket he Miralax. Could not seem to keep from getting diarrhea with it.