My daughter is almost 3 1/2 and she has been going on the potty for about 9 months. About a year and a half ago she started getting constipated. There was no change in her diet, eating habits, etc. Her Dr. told me to give her Benefiber to get her regular again. We did this for about 6 months and during this time had to give her enemas on occasion. Her Dr. finally sent her to a pediatric Gastro Dr. last Aug. The gastro Dr. tested her thyroid and for gastro-intestinal diseases and found no problems. He believes it is all mental and that she associates going with pain. He instructed us to give her Miralax every day so that she goes regularly and it's soft. We go to see this Dr. every 6 wks.
Here is my problem.......we give her the Miralax every day but she still doesn't go every day. She will go 3-4 days without going then she will have little "accidents" in her panties every time she farts. She NEVER has diarrhea, it's more of an oatmeal consistancy. I believe she tries to hold it because she doesn't want to go. We have adjusted her diet (less diary, more fiber) to try to correct this. We go to the library weekly to get books to read while she sits on the potty. It's really frustrating when we are away from home and she is having "accidents". She is embarrassed when we have to change her clothes and sometimes doesn't want to tell us because she doesn't want to draw attention to it. Does anyone have any suggestions of other things we can try?
if i was you i would get a second opinion from another doctor. it would never hurt to see what another doctor has to say. i had to get a second opinion on my daughters ears so i know what its like to know that something is wrong and the doctor says that there isnt.
I'm not sure when her accidents started – if it was last year when you took her to the gastro Dr., then he may have ruled out encopresis. But if the problem developed some time after seeing him, she may have developed encopresis, which is not uncommon in the potty-training years, and often evolves after the child has had a painful bout of constipation and begins withholding.
The condition is caused by a backup of stool in the lower colon, which eventually numbs the local nerve endings so the child may not even be aware of a need to pass stool. However, softer, fresh stool squeezes past the blockage and leaks out, causing "skid marks" or small accidents. There are also emotional implications, because the child may feel embarrassed or ashamed, and not know how to deal with it.
Again, the kidlet may not realize she has to go, but may only become aware of passing poop afterward, by smell, irritation, or in your daughter's case, she may notice when she farts. She may not be able to help the situation, because the local numbing of encopresis makes that impossible. (In some kids, the numbing extends to the bladder and makes pee accidents happen, as well.)
So, if all this has become an issue since last August, I'd check again with the gastro doctor, or perhaps take her to someone who specializes in pediatric cases. If it is encopresis, she may need an extended period of stepped-up treatment with Miralax and/or Benefiber, and possibly enemas, that allows her to get completely cleaned out, shrinking the colon and allowing the nerves to function normally.
If that turns out NOT to be the problem, here's a very specific program that makes a lot of sense to help kids take responsibility for their own elimination: http://www.rogerknapp.com/medical/pottytrainingrefusals.htm
Wishing you and your daughter success!
Google encopresis for lots more information.
Probiotics is a good idea. Someone else mentioned it too below. What if has to do with the nerves in the gastro area. I think it is sad they always want to believe it is psychological but I don't like to put a young child through unnecessary procedures that could scare her more. My daughter has some health issues and she was seen by a combination. One doctor was a neurologist and the other was a gastro. They were a team approach and I loved that they were looking at my daughter as a whole not just each symptom. unfortunately they are no longer here in the Cleveland area but I wonder if there is s family doctor who would approach this a little differently. If you are open to ostepathic doctors, there is a wonderful one in Richfield. Dr Cheryl Leuthauser. She works with a lot of kids with food allergies and intolerances and she does it safely without any need for some of those invasive procedures they use at the main stream hospitals. She could help you rule out any problems. She has helped me and my two kids.
What you are describing sounds as if it is encopresis, but only her doctor could say for sure:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002537/
Check with her doctor, it sounds as if maybe her dosage of Miralax needs to be increased, so she can't "hold it." (She hopefully is drinking lots of water with it to help it work properly, it won't make it looser, just easier to go and harder to hold.) This should help her go more often, at least every 2-3 days (the aim being every day.) She more than likely did experience pain at some point while constipated (fairly common with poop holders) and it is now a mental thing. Check out this site for info to help her, along with her doctor's recommendations:
http://www.rogerknapp.com/medical/pottytrainingrefusals.htm
hang in there!
Probiotics? They make some for kids that are can be dissolved in water and also chewable ones. If she is holding it because she doesn't want to go, maybe there has been too much focus on it? If she goes regularly and her bowel movements have a good consistency, then maybe it's time to let up and just let her go whenever she needs to without worrying about it? If it is mental, maybe she needs to have more control/independence over the process?
