How to deal with poop issues in 5 y.o. - holding it then pooping pants?

[RedSuedeShoes]

My sister called this morning and was super frustrated with the longstanding poop issues with her son, who will be 6 in a couple months. Sounds like he never wants to go, so he tries to just hold it. And ends up pooping in his pants. She thinks he doesn't ever want to stop what he's doing to go poop, but by now (it's been 3 years!) there's definitely some degree of power struggle going on too. They try to watch and remind him when he looks like he needs to go, but he doesn't want to be told that he needs to go.

They have tried pretty much everything they can think of. Including rewards of all sorts, which never work bc as soon as they make something into a reward, he stops caring about it. Or maybe if he really cares about it, it'll work for a week or even a month but not forever. They also have many times built into his daily schedule for him to sit on the potty, but he says he never feels like he has to go then. Then he might poop his pants 30 minutes later. And maybe again 30 minutes later. She thinks his system might be so screwed up by all the holding it that it's not functioning properly. He is pooping his pants multiple times a day!

She said she read online that parents should take a step back and put the kid totally in charge of the whole process, which they did for a week. But it totally backfired because it was like she gave him permission to never use the toilet again! Which seemed perfectly lovely to him. He just filled up the laundry sink with poopy pants. Ugh!

Anyone BTDT and have any tips or useful info to share? She has mentioned it to the ped several times but always felt like she was getting brushed off ("eh, he'll get over it"). It's been driving them crazy for a long time now, and they are out of ideas.

[marymoo86]

If she wanted to relinquish control then I would have given a choice - pullup or pants. If he refuses to poop in the potty then he needs a pull up so there are no dirty pants.


You can't force him to do it and could result in really bad problems if she does.

[cmo]

Has encopresis been ruled out? If it has, perhaps he should participate in the clean up of the poopy pants!

[lalasmama]

I'd take him to the doctor to rule out encopresis. Essentially, poop withheld stretches the lower colon, resulting in constipation and a decreased "need to go" sensation. Then, when the body rebels and pushes the poop out, if often occurs at inappropriate places/times just because the kid never felt the need to go. Of course, the vicious cycle is often started by a need for control (though not always!).

At any rate, here I am, mid-to-late 30s, still dealing with the effects of encopresis since early elementary school... It's MUCH more common than people realize!

[WatchingThemGrow]

Sounds like encopresis to me. We have one whose colon got superstretched and really can't feel it. It is a miserable dealing with it.

[elephantmeg]

I think they need to look into a miralax cleanse. I'll bet he is super duper constipated and his colon is way stretched out. DS went through this, we did miralax for a long while and now do colace

[Simon]

Sounds like encopresis to me. We have one whose colon got superstretched and really can't feel it. It is a miserable dealing with it.

:yeahthat: ITA it sounds like he would benefit from a cleanse, and if they need to be convinced then they should get an x-ray of his abdomen. I agree with pp it will likely show evidence of constipation and encopresis. If it is, then this goes way, way beyond a power struggle and some or even all of the accidents might be out of his control.

[gatorsmom]

I think they need to look into a miralax cleanse. I'll bet he is super duper constipated and his colon is way stretched out. DS went through this, we did miralax for a long while and now do colace

:yeahthat: DS3 had poop issues until he was 6yo too. We started Miralax to slowly clean him out (I don't like doing drastic cleanouts but that's just me. Our ped said it was fine to stretch out the cleanout to a week). We also started a regular schedule of sitting on the potty. We were trying to establish a habit because he used to refuse to sit on the toilet. He would only poop in a diaper. We allow DS3 to have the iPad on the potty with him and we had a reward chart for sitting in the potty. We were religious about celebrating with a star EACH time he SAT on the potty. We were trying to get him in the habit of sitting, just sitting at first, 3 times per day because of the power struggles we had had before. Once in the morning, after school and befire bed. He started to be ok with sitting on the potty with the iPad (at first with his clothes on, gradually with his clothes off). The miralax softened and forced the poop out. He got so into his iPad games he just let it come out. And we continued to celebrate his achievements with rewards, songs and dancing and stars on his chart. It took 18months for him to regularly poop on the potty. But we started with a child who was terrified of pooping in the potty and terrified of the potty.

It it is so hard. Best of luck to your sister!

[essnce629]

I think he needs to see a GI doctor and have an abdominal x-ray. Sounds like severe constipation that is leading to the accidents. A Miralax cleanout and then Miralax daily for a year or so is probably needed to get his bowel back down to normal size. It's what we had to do for DS1.