Almost 5 YO DS STILL having accidents. Please help!

[sewarsh]

My son will be 5 at the end of August.
He's been potty trained since he was almost 3 - 2 full years now!
In the past 6 months he's been just letting a little bit of pee out to relieve himself because he doesn't want to stop what he's doing.
In the past month, its gotten worse...like EVERYDAY he's got some damp underwear. Last week he had a full blown pee accident.

At first I ignored it and didn't make much of a deal about it becasue I figured it was a phase and would stop. But its been like 6 months here and its fricken gross!

I've told him he's goign to have to wear Pull-ups if his underwear gets wet and he does NOT want that, but of course he just takes the Pull-up off when I'm not around and puts on underwear so I have no idea.

I've also tried a reward chart whereas if he gets 7 stickers in a row then I'll take him to the toy store and he can pick out a toy. He was excited about that but still hasn't even gotten ONE sticker yet (I came up with this about 3 days ago but its clearly not effective).

And at this point, I blatently ridicule/belittle him and I'm not proud of it. I'm just very frustrated.

Any ideas PLEASE!!

[crl]

First have you ruled out any medical causes? Is he constipated? Or could he have a UTI?

If there are no medical causes, maybe the reward needs to be more immediate for now. Go half a day and get a Pokemon card or a matchbox car or whatever. Something he can have right away and at more frequent intervals.

Catherine

[brittone2]

My two boys have trended toward constipation. FOr DS, that lead to some encoperesis (aka "skiddies' in his undies), but he never had issues with pee (day or night).

DS2 has much more mild issues with constipation. However, his manifests as pee accidents. If he gets backed up, we miss dosing miralax, etc. he will have teeny tiny pee accidents over the course of a day or two until he gets a few big poops out courtesy of miralax. That isn't uncommon if you talk to some of the parents here with kids prone to constipation. DS2 doesn't have any issues with nighttime wetting and has been pee trained at night since age 2, but we do see it during the day.

Any chance he's constipating? It can be deceiving, as my kids still poop pretty regularly and it isn't hard. A lot of people assume it isn't constipation if they see fairly regular, non-hard poop.

[megs4413]

We are going through the same thing with DS. I posted about it a week or so ago. I'm taking him to the pedi on Tuesday.

[scrooks]

My dd has constipation issues we control with Mirilax. Every once in awhile we get off track and she get backed up. She has pee accidents then.

[ABO Mama]

My DS has finally grown out of the damp pants phase...in first grade!

He still wets every. single. night. Talked to Dr, ruled everything out, it's just who he is (and DH was a late bed wetter as well).

[ZeeBaby]

DD is having the same issues. In our case it is behavioral. She told me she had an accident because she was playing with a toy and didn't want to get up because someone else might take it. I am over it. At this point I am helping her to clean herself up and change her clothes. I am very frustrated with it, but this week was a good week. I take it day by day.

[speo]

My DS1 has had trouble with this. It has gotten better overtime but every so often he can still have an accident. When he was in preschool he had so many accidents even though he was potty trained. If he has one now, he will say that he just didn't notice that he had to go. He also chronically holds his urine too long. I think we have fewer accidents because he can notice just a little better.

I recently asked our pedi about this. He said that for kids who hold it so much they have sort of wrecked their bladder and the signals temporarily. At times this confused bladder, will just let go. His suggestion was to put them on a 2 hour schedule. They need to go every two hours at the same time. They must sit and try to go. And even if they just went they still need to try at the allotted time. So if they need to go at 8 and 10 and they just went at 9:45, they still need to try the 10. He said even doing this only on the weekend can help a lot. And it didn't sound like it needed to be done forever. Just a little while to reset and give the bladder a rest. FWIW he has 3 boys ranging in age from 6-10. I have yet to do this, but I will if DS has another accident.

DS2 never has over held his pee and never has accidents.

And I definitely know how frustrating this is!!

[inmypjs]

Please consider that he may be constipated. Wet accidents and damp pants after potty training are symptoms that there is too much stool in the colon - it presses on the bladder. This can occur even if he's going regularly. Most people think, oh they're not constipated because they are pooping, but it's totally common. There are a lot of posts on this if you do a search. Check out the book It's No Accident and consider trying mirilax or extra fiber.

[azzeps]

My DD has this problem. In fact, just this week she peed while we were at the playground. She said, "mommy, I have to go potty!" And as I was saying "ok, let's go" she says "too late" and out comes an entire bladder full of urine. Sigh. I find it annoying but try hard not to shame her. Her teachers thought she had a UTI because of repeated accidents one week...but she didn't. She just has a case of "holdsittoolongitis". When we are home, I have her help with the clean up.

Just curious how one can be constipated if one is pooping regularly, which she does?

[magnoliaparadise]

Is there anything at all that might be a big transition or upset for your DS? My DD surprised me when, after I gave birth to her younger sister (she was 3.8 yo at the time), she started peeing alllll over the place - I mean, usually in the toilet, but I would sometimes find pee just on the floor of the bedroom or the bathroom. I couldn't understand it - this went on for about 4 months and a therapist said that it was not unusual after a big change like getting a big sister. She eventually stopped. I know that she was younger than your DS when it happened so not necessarily the same case, but just wanted to chime in that it might be related to transition/change/issues.

[dogmom]

Please, Please, Please take your child to see your pediatrician. Do not shame him. You can stool regularly and still be constipated. I don't have a lot of time, I will write later. But basically your colon/rectal vault expands over time so it takes more stool to fill it before the body empties it. It takes months to heal with treatment. The stool presses on the bladder and causes bladder spasms and might even impede complete emptying of the bladder. You need this worked up.

[123LuckyMom]

My DS1 has had trouble with this. It has gotten better overtime but every so often he can still have an accident. When he was in preschool he had so many accidents even though he was potty trained. If he has one now, he will say that he just didn't notice that he had to go. He also chronically holds his urine too long. I think we have fewer accidents because he can notice just a little better.

I recently asked our pedi about this. He said that for kids who hold it so much they have sort of wrecked their bladder and the signals temporarily. At times this confused bladder, will just let go. His suggestion was to put them on a 2 hour schedule. They need to go every two hours at the same time. They must sit and try to go. And even if they just went they still need to try at the allotted time. So if they need to go at 8 and 10 and they just went at 9:45, they still need to try the 10. He said even doing this only on the weekend can help a lot. And it didn't sound like it needed to be done forever. Just a little while to reset and give the bladder a rest. FWIW he has 3 boys ranging in age from 6-10. I have yet to do this, but I will if DS has another accident.

DS2 never has over held his pee and never has accidents.

And I definitely know how frustrating this is!!

This is what I was going to suggest. First, rule out constipation at the ped. Even a child pooping regularly can have a backed up colon. My DS did.

Then, put him on a schedule. Whatever he's doing, he must stop and try to go. If he goes, he gets lots of praise. Once he's enjoying success, you can start to relax the rules.

[inmypjs]

Yes, what the pp said! You can absolutely be constipated and pooping regularly. You can have a harder mass of stool lodged somewhere in the colon, while some softer poop will move around it and come out. But that mass remains and could be pressing on the bladder. You can poop regularly and just have your colon stuffed of poop - meaning it is not moving through fast enough and is chronically full - even though the child is going. What the pp is referring to is when poop is chronically held in the colon, it expands beyond what it should, becomes distended and loses its nerve sensitivity. Without that sensitivity the child can't tell when they have to go.

I would caution you that some peds really don't know much about this. Our ped thought our DD was fine (because she was going regularly). After reading "It's No Accident" I followed the author's advice and asked our ped for an x-ray. Surprise surprise, the x-ray showed her colon was full of poop. The ped was shocked - but honestly I wasn't. Our DD used to take 1/2 cap of Mirilax daily and still had a lot of accidents. I was nervous about upping that dose, but now she is on just over a cap a day, and no more accidents.

[123LuckyMom]

I just wanted to add that if you're concerned about Miralax, you should know that not every kid stays on it indefinitely. My DS used it for three months. He got cleaned out, got his habits down, and he's good to go (literally)! I was also concerned about the x-ray, but it was worth it to know and to address the problem.

[dogmom]

Yes, what the pp said! You can absolutely be constipated and pooping regularly. You can have a harder mass of stool lodged somewhere in the colon, while some softer poop will move around it and come out. But that mass remains and could be pressing on the bladder. You can poop regularly and just have your colon stuffed of poop - meaning it is not moving through fast enough and is chronically full - even though the child is going. What the pp is referring to is when poop is chronically held in the colon, it expands beyond what it should, becomes distended and loses its nerve sensitivity. Without that sensitivity the child can't tell when they have to go.

I would caution you that some peds really don't know much about this. Our ped thought our DD was fine (because she was going regularly). After reading "It's No Accident" I followed the author's advice and asked our ped for an x-ray. Surprise surprise, the x-ray showed her colon was full of poop. The ped was shocked - but honestly I wasn't. Our DD used to take 1/2 cap of Mirilax daily and still had a lot of accidents. I was nervous about upping that dose, but now she is on just over a cap a day, and no more accidents.


Yes, that. Remember the story that caused a fury a year or two ago about a woman who's child was kicked out of preschool because of urinary incontinence. I forget how it made the national press and there was this huge backlash saying she was lazy mother and schools shouldn't have to deal with this? She was contacted by a MD, who worked he DD up and found stool the size of a nerf ball in her colon. That was causing the accidents.

My son has problems with this and he has a genetic predisposition to nocturnal wetting from my DH and my MIL. He clearly doesn't concentrate his urine at night also, but I can tell when he's backed up even if he is going every day because he will wet the bed every night instead of 1 or 2 a week. Usually it turns out my DH and I have not been as good with his Miralax.

I did read an article in a British Medical Journal about treatment of chronic constipation in this various age groups from infant to teenagers. They postulated that may there was some natural selection towards holding in water and a tendency to constipation on past generations because so many children under the age of 5 did, and still do in some countries, die from GI illness and diarrhea. With today's diet and sanitation it's not such a good thing. Interesting theory, no idea how to test it. There is a theory that is gaining support that having the cystic fibrosis trait, as opposed to having the disease, may actually be protective against cholera and thus selected for.

[azzeps]

Sorry to make you all go TMI with your explanations, but I sure do appreciate it. I did not know I'd ever be so preoccupied with another person's poops and pees before I had kids!!

So is the only way to really diagnose the constipation to do an X-ray? And does this generally occur because they're holding in the poo to begin with? Or maybe not getting enough roughage?

[sewarsh]

wow, thanks to everyone for all the info. i can't believe what i'm reading. i've never heard of this and am going make an appt for my DS. thanks for all the info. the BBB never ceases to amaze me with your knowledge. :)

[dogmom]

Sorry to make you all go TMI with your explanations, but I sure do appreciate it. I did not know I'd ever be so preoccupied with another person's poops and pees before I had kids!!

So is the only way to really diagnose the constipation to do an X-ray? And does this generally occur because they're holding in the poo to begin with? Or maybe not getting enough roughage?

Sorry, just checking in late.

You can do an exam and if there is not too much fat in the way an experience provider can feel someone is backed up. The small intestines sort of loop around in your abdomen, but you colon, which is the last trip on the way out, goes up your right side of your abdomen (ascending colon) across the top (transverse colon) and down the left (descending colon) http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page1 if you want to see a picture

So when people are backed up you can palpate it up the left side, sometimes. For you to really see it well you need an abdominal Xray. Also known as a KUB my medical people for kidneys/ureter and baldder-which also covers intestines. If you have people good at looking at it they can tell if there is chronic distension of the descending colon which tells you that this is a chronic problem.

As far as the cause, diet contributes, certainly. But there are also probably genetic predispositions and habits. My DS always was prone to larger stools as a toddler that eventually lead to withholding, but what came first? The genetic predisposition or the behavior. My DS and DD have the same diet, but she doesn't have these issues.