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ADD / ADHD (Expert Forum)
Rectal Problems
Answered by
Rebecca Resnik, PsyD - Parenting Instruction, Developmental Disabilities, Psychological Assessment
MindWell Clinical Psychology
Chantilly - VA
Questions in the Attention Deficit Disorder (ADD–ADHD) forum are answered by Rebecca Resnik, Ph.D.
Rectal Problems
by rschadt, Nov 29, 2008 06:34PM
My grandson goes to the bathroom about 10 times an hour. He just wipes the stool which has oozed (or dug) out and leaves the tissue. Then he changes his underwear which may or may not have stool on them. He does not make a bowel movement until he cannot prevent it. Nothing we have tried has stopped this habit. We are unaware of any medical condition which is causing this odd behavior. His physician said this is not an unusual problem and we give him poly.. something each morning, but it soesn't seem to help. Do you have any suggestions. This behavior is driving us nuts!
Doctor's Answer
by Rebecca Resnik, PsyD, Dec 01, 2008 09:50AM
, Dec 01, 2008 09:50AMTo: rschadt
Hello,
though the physician is correct that it is not an unusual problem, I agree that it is far from acceptable! Nobody wants to deal with poopy messes, and I am sure your grandson is upset about it too. The technical name for what your grandson is experiencing is encopresis. I am glad you have consulted the pediatrician, as it is important for him/her to rule-out physical factors that could be causing the difficultly eliminating. Encopresis is often caused by a combination of both physical and psychological factors. If a child is having trouble passing stool, bowel material can leak around the older stool (causing the oozing and smeary underpants). Laxatives should help him pass the impacted stool, but this is where the psychological factors can interfere with the physical.
Children can become very anxious about eliminating because it feels uncomfortable or painful. They can also get very worked up about fears of soiling (especially if they are criticized or punished, but even if they just know that it upsets you). Your grandson may be oversensitive to the sensations of eliminating, which may make him very distressed about what his body is doing. Any time a child is stressed, it is harder to let the body relax to pass the stool. Your grandson will need to learn to relax, listen to his body and dispose of his waste products appropriately.
If a week of laxative use and having him sit on the toilet for 10 min each hour (particularly after meals) does not help, I would ask your pediatrician for a referral to a pediatric psychologist or at least a psychologist who has experience in dealing with encopresis (many do of them do). The psychologist can help your grandson learn relaxation techniques and coping strategies. The psychologist can help the boy's parents (or whoever is doing the parenting) set up a positive behavior management plan to help him regain healthy toileting habits.
Best Wishes
Rebecca Resnik
Disclaimer: This Medhelp post is for informational purposes only. It is never intended to replace face-to-face psychological or medical care. This Medhelp post is not intended to create a patient-clinician relationship, nor to give or rule-out a diagnosis.
though the physician is correct that it is not an unusual problem, I agree that it is far from acceptable! Nobody wants to deal with poopy messes, and I am sure your grandson is upset about it too. The technical name for what your grandson is experiencing is encopresis. I am glad you have consulted the pediatrician, as it is important for him/her to rule-out physical factors that could be causing the difficultly eliminating. Encopresis is often caused by a combination of both physical and psychological factors. If a child is having trouble passing stool, bowel material can leak around the older stool (causing the oozing and smeary underpants). Laxatives should help him pass the impacted stool, but this is where the psychological factors can interfere with the physical.
Children can become very anxious about eliminating because it feels uncomfortable or painful. They can also get very worked up about fears of soiling (especially if they are criticized or punished, but even if they just know that it upsets you). Your grandson may be oversensitive to the sensations of eliminating, which may make him very distressed about what his body is doing. Any time a child is stressed, it is harder to let the body relax to pass the stool. Your grandson will need to learn to relax, listen to his body and dispose of his waste products appropriately.
If a week of laxative use and having him sit on the toilet for 10 min each hour (particularly after meals) does not help, I would ask your pediatrician for a referral to a pediatric psychologist or at least a psychologist who has experience in dealing with encopresis (many do of them do). The psychologist can help your grandson learn relaxation techniques and coping strategies. The psychologist can help the boy's parents (or whoever is doing the parenting) set up a positive behavior management plan to help him regain healthy toileting habits.
Best Wishes
Rebecca Resnik
Disclaimer: This Medhelp post is for informational purposes only. It is never intended to replace face-to-face psychological or medical care. This Medhelp post is not intended to create a patient-clinician relationship, nor to give or rule-out a diagnosis.
