Encopresis in 7 Year Old

My 9 year old son has the same problem with Encopresis since shortly after he was potty trained. He was diagnosed ADHD when he was five. I've talked with other parents who have ADD/ADHD children (both medicated and not) and it seems to be a common problem. My son also doesn't seem to care that he smells or that it's in his pants.
I work with my son to make sure he takes time out to try and go, especially if he hasn't gone for a while, to help avoid accidents. I keep a pair of clean underwear and pants with the nurse at school, and I make sure to let his teacher know whats going on at the beginning of the school year. We do use Miralax too.
Thankfully this year things are getting better for us. We use less Miralax (almost none) and have been having fewer accidents. Just hang in there, encopresis is tough, but I've learned that things do get better.

One thing it could be is nerve damage or even absence (can't remember the medical term right now). Runs in my fam, and we suspect that's what's wrong with my daughter (had problems until almost the age of your son). She simply can't tell when she needs to go, so she has to make an effort regularly to avoid getting backed up.

The way we solved hers is to have her poop every night, without fail, after dinner (she usually had accidents at night while asleep). She would earn a treat if she did. This was after years of trying literally everything to fix problem. Worked beautifully! Of course, we had to make sure she had plenty of fiber, water, etc so it would be easy for her, and she does still have trouble with constipation on occasion. We don't usually let her skip more than a day since she gets constipated so quickly when she does -- sometimes she says she can't go without really trying because she wants to do something else instead. If it's been more than a day, I usually send her back to try again, and if it's been more than two days, she HAS to go before she can do anything else. It always works.

It took until my daughter was a little older to really "get" the whole process. She was on miralax for a long while to help with the constipation but that would sometimes make the encoparesis worse, since she still wasn't making an effort to go (and couldn't tell how badly she needed to -- she really didn't know until she'd had an accident). Now that she understands the issue, it's so much easier.

And yes, it was extremely difficult at first with the fears of it hurting from the constipation. Took a few months of coaching and coaxing and tears, but it was worth it! Once we got past that part and she realized there was no pain when she went every day, it was relatively smooth sailing. She has accidents rarely, usually due to her skipping days without telling or (one time) due to antibiotics.

Don't know if this will help but figured it was worth mentioning just in case. Good luck! I know how incredibly frustrating it is!

(Also, ADD/ADHD runs in my fam too, and she's shown signs of it -- wonder what kind of correlation there is? Interesting.)

hi -
although I don't personally have experience with this, here are a couple of great sites:
http://www.mayoclinic.com/health/encopresis/ds00885
http://www.cincinnatichildrens.org/health/info/growth/dia...

from http://www.mayoclinic.com/health/encopresis/ds00885 - see website for more info:
Causes:
* emotional
* constipation

treatment:
* Stool softeners, such as lactulose
* Colon lubricants, such as mineral oil
* Rectal suppositories
* Enemas
* More fluids

Once your child has been treated for encopresis, it's important that you take steps to encourage softer stools and regular bowel movements. The following tips can help:

*Focus on fiber. Feed your child a diet that includes plenty of fruits, vegetables and foods high in fiber. Offer whole grains, which are brown — not white — in color.
* Push fluids. Encourage your child to drink plenty of water.
* Limit dairy products and fats. These can inhibit bowel movements.
* Set a schedule. Adopt regular mealtimes and bedtimes.
* Arrange bathroom time. Have your child spend three minutes alone on the toilet after one meal each day trying to have a bowel movement. This applies only to children who are toilet trained and are at least 4 years old.
* Stick with the program for several months. The relapse rate for encopresis is high.

FROM http://www.cincinnatichildrens.org/health/info/growth/dia... - see website for more info:

Treatment for encopresis will be determined by your child's physician based on:
* Your child's age, overall health, and medical history
* Extent of the condition
* Cause of the condition
* Expectations for the course of the constipation

Treatment includes:
* Cleaning the hard stool out of the lower intestine
* Keeping bowel movements soft so the stool will pass easily
* Retraining the intestine and rectum to gain control over bowel movements
* increase exercise
* dietary changes
* Proper Bowel Habits (e.g. "Have your child sit on the toilet at least twice a day for 5-10 minutes, preferably shortly after a meal. Make this time pleasant; do not scold or criticize the child if they are unable to have a bowel movement.")

Good luck!

my son is also ADHD (combined type) and deals with encopresis regularly. This did not start until he started on medication and we know it is due to constipation. I have a friend whose son has this as well and also has ADHD. I don't really have any tips for you... my son takes Miralax daily for it. He has a BM about every 3 days... good luck with all this!

There is a great nutritional supplement designed for kids which can help with the ADHD too by eliminating some nutritional imbalances. Lots of great help from other parents in this. The same company makes a fiber product which can be added in small amounts - the combination of soluble and insoluble fiber in the same serving will probably make the difference for you. He already has a high fiber diet so the other posts suggesting you increase it may be insufficient - there are so many people who take benefiber or miralax and don't have these results, not to mention they don't like using too much of that stuff. Two friends of mine have this problem in their infants, and they've seen a whole change in their kids. I'd be happy to help you make this much easier for your son and for you.

Our 7yo son also has the wonderful combination of ADHD (combined type) and encopresis. Honestly, after a couple of years dealing with encopresis, what seemed to resolve it was having a set time each day when he had to poop. To get over that first "it's going to HURT!" hurdle, we offered a major bribe ... something like $20. It had to be "wow" or he simply wouldn't go because of the fear. After that initial awful poop, things got better going each day. We offered small rewards each time, like TV time, and then gradually phased out all rewards. Now, he just knows he has to go every day and since it doesn't hurt, it's no big deal.

On a side note, medications for ADHD have made a major life-changing difference for our son and I can't recommend them highly enough. However, being on them didn't help the encopresis at all.

Never did figure out what causes the encopresis, but it's pretty common. Good luck!