12-Year Old Grandson Still Soils Pants

My son has a 12-year old stepson who still soils his pants. In many ways he is a loving, intelligent boy (his IQ is well over the genius level), but his behavior is putting a strain on my son and his wife. They've been married for two years and also have a year old baby son. The older boy (a premature birth) was born when his mother was 15 years old, and the boy lived with his grandmother until the last two years. His grandmother largely ignored the problem and just quietly washed out his underwear and cleaned up after him. This is a huge problem. Today is Christmas Day and my son and his wife awoke this morning to find that the boy's toilet (he has his own bathroom) was plugged up with several days worth of poop. He can't spend the night anywhere, since poop drops out of his pants constantly. They are always finding it on the floor. I'm very worried about the baby getting into it and getting sick. Last week my daughter-in-law found several of the baby's diapers in this boy's closet -- soiled. They recently took him to a medical doctor and he had an MRI. A physical reason for this has pretty much been ruled out. Also, I forgot to mention, the stench is terrible. Please respond. We are at our wits end. Thank you.

[HVM M.D. - EV]

Dear Karen -
    Thank you for your Email.   You are right to be concerned about your son's stepson.  Leaking of stool ("encopresis") is a very real problem - and does need a full medical evaluation.  Generally these patients - and many are boys - have underlying issues with constipation, bowel training, diet choices, and/or emotional concerns.  I would suggest your son take this child to the child's doctor for a visit focused specifically on the stooling.  I would recommend a complete review of the child's bowel habits - starting with infancy.  Then, with the doctor - and maybe even with a specialist trained in these issues - a plan can be worked out to establish regular bowel habits.  Often this requires a real commitment from the child and family - with regard to diet and toilet time.  Often laxatives and/or stool softeners are needed to assist - and these may be needed for long term treatment.  Also - emotional counselling/support can be  very helpful. Medically - it is important for any child to have regular bowel movements. And then socially - foul odor from leaking stool can have a great impact on a child's self image and social acceptance. So - as per above - I would encourage your son to take this child to his doctor to begin evaluation and treatment.  Good luck  - Dr. EV

[Melissa]

Dont allow them to rule out physical problems just yet.  My (now 8 year old daughter) has several problems, and one was bowel and bladder trouble.  As an RN, I was convinced that her worsening bowel and bladder problems were neurologic, and after some pressure, was sent to a pediatric urologist, then to a pediatric neurosurgeon for tethered cord syndrome.  The first 2 MD's missed the diagnosis.  I urge you to have your MRI, or CAT scans sent to a qualified specialist to look for subtle symptoms such as: left lateral scoliosis, spina bifida occulta, and possibly the tethering of the conus of the spinal cord.  A very simple surgery corrects the problem, if it is caught before irreparable damage to the nerves is done.  It is appearing more and more that we waited too long to help my daughter,...please have this possiblity checked out right away to spare you son the same.  Good luck!

[cae374]

A related discussion, child pooping in pants was started.