My 7 Year-old Son Keeps Having Accidents in His Underwear.
May 20, 2008
Corpus Christi, TX
I have a 7 year old son has always had loose stools ever since I can remember. He was effectively potty trained at 3 1/2 years old. About a year and a half later he started having poop accidents in his underwear. Ever since then he has an accidental BM probably twice a week, sometimes more in a bad week. He seems to be just as surprised as I am when I take him to the restroom. He has no aversion to the bathroom or issues with laziness, I truly think he doesn't realize he has leaked until it is too late. He never has any urine accidents. I am truly at my wits end with what to do about this. We have tried rewards, punishments you name it, to make him more aware of his need to go early if he feels an urge, but they just don't work. It's gotten to the point that he doesn't want to pull down his underwear for fear that he might find that he's soiled and we might get angry. Has anyone had any experience with this and what worked? I am unable to put him on any fiber supplements to bulk up his stool, because he is allergic to wheat.
My assistant's son was having a similar problem and they even kept him back in kinder a year. Finally, they decided to take him to a pediatrician and found after a lower GI that he was impacted and probably had been for a very long time. After a weekend of enemas and a week of watching everything he ate he was cleaned out and hasn't has a problem since. See a pediatrician.....
Hi C.. I haven't had to deal with this problem, but as an otherwise experienced mother of two, I would advise you to talk to your pediatrician about this problem. There is no reason at all to ever get angry with him about these accidents. As you already know, he is not happy about it himself. In addition to a talk with the pediatrician, I would check into exactly what he is eating. Sugarfree foods, candies, etc. may be to blame. I would keep a diary of what he eats each day and also when the accidents seem to occur. Get him to go to the bathroom whether he feels the urge or not every hour and check himself and also try to go at those times.
Looks like other responders have said what I would think it is. My 8 year old son has encopresis. He has many other physical problems as well as wasn't considered potty trained until he was 5, so it took us awhile to figure out the underwear soiling was not a potty training thing. We took him to a pediatric gastroenterolist who confirmed the encopresis. Since he has a feeding disorder, his diet contributes to his "functional" constipation. He truly isn't aware of the "skid marks" (some of them Big Time!) until he pull his pants down to pee. He doesn't see aware of the need to poop until "the turtle head is poking out"!
How we manage it most of the time is to provide a "toilet sit" each evening within 30 minutes after dinner. He gets to sit with his Gameboy on the toilet and give his body an opportunity to go. Something about sitting on the toilet opens your bottom up, gravity helps it along and much of the time this does the trick and he goes fairly quickly. If he goes more than 2-3 days without a BM, then we do a week or so of Miralax. I don't keep him on this all the time because then we get the opposite effect! This helps to greatly reduce soiling in the school/daycare setting. And believe me, these entities just don't know what to do with an 8 year old who "poops in his pants" and it is embarrassing to all involved.
Good luck to you in finding a workable solution to your child's problems.
Mother to 8 year old Caleb and 5 year old Weston and wife to Wayne
The biggest issue here is how you deal with his situation and it should be only with love and compassion...no more threats or punishments. He obviously isn't in control of his body any more than you are when you blink your eyes (wouldn't want someone to punish you for that).
I would wager that it is probably another food allergy...If you have an allergist already, I would talk to them.
If not, sometimes the liquid bowel can be a sign of an intestinal blockage and the only thing that can get through is the liquid part of the stool. You would need to have him seen by a gastroenterologist who can do a lower GI series (not pleasant at all, but can rule out blocking cancers or tumors of the GI tract).
Either way, treat this as an illness, not a behavior and do what you can to help him get the treatment he needs.
I had a similar situation with my son. Like yours, he was completely potty trained for a few years with no problems, and then, the accidents started. You need to discuss this with your pediatrician. We eventually ended up seeing a gastroenterologist who determined that my son was very, very impacted inside, and what happens is that stuff starts leaking out around the impaction and the child can no longer control this or even know when it's going to happen. My son's rectum was all stretched out inside due to this problem, and it takes a long time for everything to get back in shape. I felt absolutely horrible when I learned what was wrong because like you, I had tried everything from all types of punishment and rewards and couldn't understand why he wouldn't cooperate when in the end, it was something that he couldn't even control. Please, talk to your doctor. Good luck!!!
Maybe call your pediatrician to rule out any health issues...especially since it seems to surprise him.
I had issues when my daughter was much younger. The doc helped me out with advice (no health problems.) But once she learned, she never went back to soiling her underpants. I wish I could help more...but I would definitely call the doc.
I'm curious if you have enlisted the advise of your pediatrician? There are other medical issues that can cause these problems. Before any further worry or problems I would definately ask your doctor. Good luck and let us all know how it's going.
Hi C. ~
My son, who is now 9, had the same problem. It started around the age of 5, and we tried the same things you've tried (punishments, rewards). We finally took him to the doctor and she diagnosed it in about 5 minutes! He had a blockage in his intestine (something I wouldn't have associated with loose bowel movements). The doctor could actually feel it when she pressed on his belly! What happens is the new poop doesn't really form because of the blockage, and then leaks around the blockage and out! Really gross, but they can't feel it! After 4 days of laxitives, and then daily doses of MiraLax the problem was solved! I wish I had taken him to the doctor earlier! He was 8 when we took him in. We felt terrible about all the punishments when we found out he really didn't know he was going! He still takes MiraLax about twice a week. Good luck.
This truly sounds like a medical issue, not a behavioral one. If his stools are continuously that loose, I have to assume a food allergy or digestive issue. It sounds like her truly can't control his BM;s regularly. I would not punish or berate him in any way, I would take him to your doctor, and if you don't get anywhere there, try alternative medicine, a dietician, herbalist, etc.
This sounds so frustrating. A couple of questions for you- first- does he eats lots of fruits and vegetables? Our youngest boy had a similar problem because he loved to munch on fruits and veggies alot and we just had to limit what he ate. Also- cheese is a good way to bulk up his stool. Question two- have you taken him to the doctor? This could be a physical problem. My sister is a school teacher (2nd grade) and she has had more than one child who have had similar problems. Hope you find something that helps!
If it's diarrhea or unusually loose stools I would talk to his pediatrician or a pediatric gastroenterologist. Celiac disease or lactose intolerance are just two of many conditions that can cause loose stools, at can develop at any age.
As many others have stated, I would definitely make a trip to the doctor's office. It sounds like it could either be a blockage or additional food allergies. Our 15 month old has many food allergies and I have since learned that even the smallest thing should not go unmentioned to the doctor. There are so many things that do not have a clear-cut diagnosis, or symptoms that I would associate with the actual problem.
My sister recently had to take my 5 yr. old niece to a specialist for what sounds to be the same issues. They learned that she has severe blockage in her intestines and she truly doesn't realize when the leakage occurs. She has no control over it since it truly is "leakage". She's had anenemas and medication but doing what they can to resolve this. So far what they are doing is helping quite a bit. Not only physically but emotionally as well.They too tried rewards, punishments etc but nothing worked. You might need to see a specialist to resolve this one, or at least put any questions to rest as to why this is occurring with your son. Best wishes!!
I'd be curious as to what your pedi has to say on the matter. I'm wondering if its not an issue with the muscles/sphincter in his large intestines, maybe they are not functioning correctly. Also, you may want to try the BRAT diet, bananas, rice, apples, and toast (I believe that is what it stands for). This is what pedi's recommend to combat loose stools. It tends to bulk them up a bit. Try not to get angry or use any type of punishment, this might be prolonging the problem. Have him go to the restroom more frequently throughout the day. Good luck!
Go to the doctor! Make sure it is not something more serious like celiac disease. I was 18 months old when I was diagnosed with it. If he has it then he won't be able to tolerate gluten which is found in bread, crackers, cakes, etc... anything made with wheat, barly or rye. Gluten is unfortunately in EVERYTHING! It is frequently used as fillers and thickening agents in many of the foods that we'd think were gluten free. Poor kid! If he has it he is in for a strict diet that is difficult to adhere to but will definitely make a difference in his gastrointestinal everyday life. Please check out this website for more info: http://www.celiac.org/
Food allergies can be a cause of this. Just be patience with him. School may be an issue if it happens there. See if you can recall what he had eaten before this accident happens and try to stay away from that food. I know some soft drinks cause that as well as different foods. I hope you can figure out which food may be doing this.
My daughter had a problem with loose stool and her wheat allergy ended up being celiac disease...which usually comes with some food allergies unique to each person. Once we cleared the offending foods from her diet, her stool returned to normal. Now the only time she has a problem with this is when she inadvertantly eats something she is allergic to.
I would definatly take him to the Dr. I'm not familiar with the wheat allergy, but I would be concerned at this age and this often. I wouldn't punish him. This is obviously something that he can't control. At this age it is tabu enough that he wouldn't still be doing it if he could control it. Best of luck.
I am a 2nd grade teacher. I come across students like this every couple of years. It is VERY embarassing to them and their self esteem seems to drop. This is serious for his age, I have always suggested to my parents that they see their pediatrician for help.
I am sorry this isn't much help but I hope you are able to find help for him.
Bananas have a lot of fiber in them so you may want to try one of those per day. I have IBS and find they work well for me. Does he hold on to the to go to toilet a lot? Sometimes the bowel can stretch and that causes problems. Also if children are constipated lose stool can leak around the blockage and they are unable to control that coming out. Personally I would take him to his Dr and maybe look up on google which fruits and vegetables are high in fiber. But like I said he may actually have a constipation or blockage problem that is causing him to leak.
Have you looked into the cause of his loose stools? Maybe he needs some medication to make them more normal or has something physically wrong. Maybe his muscles down there aren't developed properly? I would take him to a doctor and have him thoroughly checked. If he can't tell when its happening then something is up.
take him to the doctor, maybe he has no control over his bowel movement maybe incontinent. let him sit on the toliet for a long time to empty properly may have a full bowel that trickle down at times. keep asking him to go every few hours grt him into a more frequently routine after every meal and before bed time and even first thing in the morning. give him privacy in the bathroom, do not hurry him give him enough time to feel relax each time, he need to empty his bowel he might be holding it back. encourage more water and fruits.
My first thought, too, was that maybe he doesn't feel the urge to go soon enough? Can he tell when he has to go? If his stools are loose, could it be that he thinks he has gas but finds out too late that it's not? Just a thought.
It may be useful to see a pediatric gastroenterologist. If there is no attention issue, such as ADD, there may a physical issue. They could also recommend/prescribe something not wheat based to bulk up the stool.
Have you tried introducing yogurt into his diet. My son had loose stools and had accidents all the time and the yogurt helped. It has a good bacteria in it that the intestines need. His stool became solid and the accidents stopped.
I agree with the others, there is something going on. I do not know what his wheat allergy symptoms are, but as a dietitian, celiac disease was the first thing that came to mind when I read your post. Take him to the doctor and have him tested for celiac, lactose intolerance and other malabsorptive syndromes. He may be lacking in one or more of his pancreatic enzymes which facilitate digestion and absorption. His digestive tract is not functioning properly for a reason. No one should always have loose stools. Good news is it can likely be control with avoiding the offending food or taking supplementary enzymes if he is lacking in them. Good Luck, I hope your little guy will have some relief soon.
Consider other food allergies or sensitivities. I suddenly become very sensitive to lactose in milk products at the same time as my daughter. We both have to be very careful about taking our lactose enzyme, or very similar problems happen to both of us. Funny, my lactose problem has gotten better since I cut wheat out of my diet, although I've not noticed any particular sensitivity to wheat. (I've cut it out for dietary reasons.) There might be some other strange interaction going on with him.
I definately sympathize with you, my son is 11 and was potty trained at 22 months, but at the age of 4 he started doing the same thing; we are, after 6 1/2 years, just finding out that it could be something called encopresis. You definately need to consult your pediatrician with this, it can cause major damage if not dealt with properly. You can research encopresis on web and find out more. I hope this information helps.
I would get him checked for encopresis, by a gatroenterologist, not a pediatrician, if I were you and right away.
My son had exactly the same symptoms you are describing. We had been asking the pediatrician for years about the problem and she kept giving us something that we later found out you give to babies with consipation problems...not 5 year old boys. I became wigged out and decided to take him to a pediatric gasteroenterologist, against the advice of my pediatrician. When they xrayed his intestinal tract, they found that it was entirely full and impacted and probably had for years. The accidents were actually seepage from around the sides of the obstruction and he had lost all feeling in his colon, which was distended to twice its size. I burst into tears when I saw the xray. My poor boy.
He has been on medicine for eight months now and is doing so much better. He went so long that it took him a while to learn what it felt like. Our doctor told us that she has seen kids in high school who are still having accidents because they never got diagnosed. We are lucky. He will be completely normal after about a year...should not have recurring problems.