Encopresis clean out

[SAHMIL]

I have to do a clean out again with my son. But more the bigger question is this. I know it's because he doesn't want to stop playing Minecraft on iPad or Xbox. Would it be wrong to take video games away and only give them to him if he goes to the bathroom and has a normal poop as a reward? He only gets Xbox on the weekend and iPad during the week ( and about an hour of it if that) thoughts??


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[schrocat]

If it works I would totally do it. I dealt with encoperesis with one of my kids too. You do whatever works. Besides, in our family, video games and ipad time is a privilege, not a right.

[jren]

I would take them away for a period. With my DS, I have seen how easily it is for him to become addicted to electronics, and especially Minecraft, in a way that my DD never was. It's a problem for him, and his behavior is worse when he's played it. Minecraft apparently has no end or stopping point. You can't pause and if you just walk away, you could get attacked and lose stuff (so says my DS). So he never wants to stop! I have gone through periods where I've had to say no more electronics. Particularly when he won't turn it off when I say to and won't do anything else I tell him to do! Then we'll allow it one day on a weekend and as the negative behavior comes back, we take it away again. He understands it's because he can't regulate himself on it, and it's not really a punishment (he doesn't perceive it as a punishment even though he's bummed he can't play for a while).

Edited to add: he's 7.

[AnnieW625]

If it works I would totally do it. I dealt with encoperesis with one of my kids too. You do whatever works. Besides, in our family, video games and ipad time is a privilege, not a right.

haven't had to do it with my kids, but I agree with the above.

[hillview]

I think it depends on why the child is having an issue. I could see it working but more likely if there are other issues it might make it worse or not make a difference.

[SAHMIL]

My son is 8 and turning 9 in 2 weeks


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[jren]

My son is 8 and turning 9 in 2 weeks


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I think at that age you might be able to talk with him and come up with a solution where he takes time away from the games. I'm sure he wants a solution too! Mine is only 7 and understands that the game can cause issues. But my 12 year old DD would not be one to understand. So it depends on personality as well. I know you don't want to withhold games as a punishment for his issue, but just to see if that's contributing to his problems. I think you'd be more successful if you have his buy in.


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[gatorsmom]

I think it depends on why the child is having an issue. I could see it working but more likely if there are other issues it might make it worse or not make a difference.

:yeahthat: We dealt with this with DS3 for years. He's 8years old now and letting him play the iPad while he's on the toilet is part of the solution (along with miralax everyday to make him poop). It was an awful ordeal. Now he looks forward to pooping! It's become part of his daily routine. There have been a few times his iPad was out of charge so he'd take a book in with him. Whatever- as long as he is happily sitting on the toilet.

Instead ad of taking his iPad away, how about letting him have it ON THE TOILET and then for a few hours if he puts something in the toilet? I'm make sure he's got some miralax or stool softeners in his system or he could hurt himself straining to pass a bm. My kids would spill blood to spend time on minecraft (or whatever is the game of the moment)!

[dogmom]

It also helps to have things set up so he can establish regular bowel routines. If he's 8 and he has this problem his bowels probably are in a good routine and his colon might actually be distended. Generally peristalsis is triggered after eating, which is the movement of the smooth muscles in the GI tract to move the food along. So for most people it's easier to have a bowel movement after breakfast because you've had nothing to eat all night and then you eat something. However since kids go to school and a lot of kids don't want to sit on the toilet for 10-15 min at school, that doesn't work. So plan to have him sit on the toilet about an hour after dinner for a good 15 min or so, whether he feels he has to go or not. You can help this along by giving a stimulate laxative around lunch. My provider had my son take 1/2 an ex-lax at lunch.

Most pediatricians tend towards "clean outs" with miralax because it's easy. But if it's a more chronic problem there really needs to be bowel retraining. Just taking away his video games without setting him up for success isn't going to help, and just make him hate the whole pooping thing more. You can certainly use the video games as a reward, but it should be tied to the behavior of toileting vs. having a bowel movement, because he might very well not be able to produce one on command. He's old enough to use a chart system for it. It might be worth it to see the pediatrican and get an abdominal XRay to see if his colon is distended. It will help guide management.

[Simon]

It also helps to have things set up so he can establish regular bowel routines. If he's 8 and he has this problem his bowels probably are in a good routine and his colon might actually be distended. Generally peristalsis is triggered after eating, which is the movement of the smooth muscles in the GI tract to move the food along. So for most people it's easier to have a bowel movement after breakfast because you've had nothing to eat all night and then you eat something. However since kids go to school and a lot of kids don't want to sit on the toilet for 10-15 min at school, that doesn't work. So plan to have him sit on the toilet about an hour after dinner for a good 15 min or so, whether he feels he has to go or not. You can help this along by giving a stimulate laxative around lunch. My provider had my son take 1/2 an ex-lax at lunch.

Most pediatricians tend towards "clean outs" with miralax because it's easy. But if it's a more chronic problem there really needs to be bowel retraining. Just taking away his video games without setting him up for success isn't going to help, and just make him hate the whole pooping thing more. You can certainly use the video games as a reward, but it should be tied to the behavior of toileting vs. having a bowel movement, because he might very well not be able to produce one on command. He's old enough to use a chart system for it. It might be worth it to see the pediatrican and get an abdominal XRay to see if his colon is distended. It will help guide management.

I think this is all very, very good advice. I have only two thoughts to add.
First, it may be a very long time before his bowel is rested enough to have regular normal poop, so I wouldn't use that as a reward. Until he retrains himself and his body heals, things may vary for a while so the reward/punishment may feel arbitrary to him and he may give up on trying.

Second, I would seriously reconsider family rules about electronics as a separate issue from toileting. I'd first lean towards and all out break for a set period of time (one month, three months) with new rules after. If not a total break, then tie the reward to stopping play and going, or as Lisa (gatorsmom) said above, I'd only let him play on the toilet and use a timer.