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4 Year Old Son Refuses to Poop
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4 Year Old Son Refuses to Poop

I read some of the other questions, but think this is a little different.
After an incident at daycare that is still unclear, my son now refuses to poop after being fully potty trained for about 6 months.  We know that he went in his pants and some comments were made such as "That's icky.  That's gross."  He will let a little slip and then hold off--causing him to need multiple underwear changes throughout the day.  He has now started going in his sleep.  I have watched him and he is truly unconcsious while pooping.  He doesn't even wake up when his pants get changed.  To make matters worse, he is also refusing to eat anything but bread and butter, apple juice and milk.  We have tried suppositories, laxatives, bribery, and nothing seems to be working.  Please help.  He is not the same child.  All of his energy is spent on holding in his bowel movements, so he refuses to play.  He only takes part in sedentary activities so he can control himself.  When I ask him why he won't go, he has told me everything to that his tummy hurts to he is scared.
We have been encouraging him and asking him every day if "today is the day?".  He always says yes.  Lately, he has begun ignoring us any time we bring it up.  I have not made a big deal out of him going in his sleep.  I am just happy that he is going at all at this point.  What can we do to help get him back on track?  Thank you!!!
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One thing to be sure to check is if his bowels are now impacted. Schedule an appointment with his pediatrician to pursue this. It would explain the circumstances you are describing.
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I forgot to mention that he has had trouble with constipation and hard stools in the past, but since he is going in his sleep, I'm not sure this has anything to do with what is going on now.
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There is a name for this, but I don't know what it is. In any case, the reasons he tells you he won't go are the reasons he's holding his poop. You may need to send him to see a child therapist who can help him out. As you know, health problems will arise if he continues to hold his poop. His pediatrician will probably be able to recommend a therapist for you.
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I think I can help a little. My daughter has always had problems pooping. She is 5 now. When she was an infant we had to use suppositories to make hard round balls come out...when she got to be about two we went to a gastrointerologist...he told us it was psychological and she would grow out of it..well she is 5 now and streaking her underwear. She went poop at school once and clogged the toilet. She is now too embarrased to go anywhere because she doesn't want the toilet to overflow.....Like you, we go through many pairs of underwear. I understand what you mean about using the energy up holding it in. Standing up crossing the legs and holding on the things trying to pinch those little but cheeks tight. But the good news is we are steadily resolving this. I have resorted to adult fiber supplements. The best yet have been the benefiber orange flavored chewable tablets. She also really likes the Metamucil original texture regular flavor powder mixed with water. And now, though my child does not like chocolate milk, yours may...They make a chocolate flavored powder that you mix right in the milk and it tastes like the real thing. This really keeps the stools moving in a healthy way rather than trying to poop out something the size of an orange if you know what I mean. (and believe me there is no exageration on the size). I hope this was of some help to you. Pooping can be a positive thing for kids, she now tells ME when I forget to give her the fiber.
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Pooping should absolutely be viewed as a positive thing simply because it is. It is the way we clean out our insides. It is the way we stay healthy. Just use a positive approach on this issue. It does hurt when you are that constipated and it definitely can cause health problems. Hope you can get this issue resolved rather quickly.
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You might want to read:
http://medhelp.org/forums/ChildBehavior/messages/33081.html
(4 yr old with potty issues - refuses to do anything to help!!!)

I was part of this subject/forum from not so long ago and I have a son (5 1/2 yrs.old) who is still battling this most frustrating issue.  

You may have read it already, but just in case you haven't I highly recommend you take a look at many of the comments.  You might find many others going through very similar situtations as you!  Good luck!
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Follow up.  After reading everyone's comments Friday, I immediately made my sone an appointment to see the doctor.  He had an impacted bowel.  The doctor said they generally see 3-4 kids a month in the same condition.  It is usually when they start school or change day cares.  Anyway, he was given half of a fleet enema and it has worked like a charm.  The doctor told us to give him 1-2 tsp. of a stool softener daily to keep it soft so he can go easily. If he goes 2 days without a BM, we are to give him a suppository, if he goes 3 days, he is to get half of a Fleet enema.  All the while, he gets a "Good Job" sticker on the calendar for every times he poops on the potty.  He has been going on his own all weekend and is back to his old self again.
I wanted to post what the doctor told us for anyone else that may be going through this.  The enema wasn't as bad as I thought it would be.  He handled it very well.  And it was all worth it to have him back to normal again.
Thanks to everyone for their comments and suggestions.
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My daughter also began refusing to poop when she began preschool at 3 and she had an accident and some kids commented.  She started holding it in and it resulted in anal fissures that were painful so she didn't want to go.  We dealt with it for a few years with doctors prescribing Kondromul and laxatives, then I met a nurse who worked in a pediatritions office and she told me it sounded like she had classic signs of a milk allergy and not to give her milk for two weeks and see what happens.. All along I thought it was due to the accident in school, but sure enough, it was the milk.  I gave her chocolate soy milk.  She thought it was reg milk.  Her stools became softer and much easier to pass.  She is 8 now and I limit the milk she drinks to what she gets on her tray at school, and it's gotten soo much better.  She spent years in pain with bad tummy aches due to her constipation, and didn't want to go on playdates.  On the few occasions she drank too much milk without telling me, I've had to give her Milk of Magnesium per request of a new doctor, that seems to work well for those occasional times.  I definitely can relate to how you feel for your son on this issue.  Good luck to you.  Things will improve.
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I have 4 children. I have used a small 4 ounce bulb enema when mine get constipated or won't poop. It was suggested instead of using laxatives or supositories. It gets instant results each time.
The solution is just distilled water ( 2 teaspoons of table salt to 1 quart of warm distilled water ) Should be held for about 5 minutes to be real effective.
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I am a mom of 4 and really suggest the use of a small bulb enema instead of suppositories or laxatives. I received good information from a web site called doctorscotts. This was a few years back as I had a son with encopresis ( which is a functional constipation problem ) where a constant soiling of his pants everyday was the issue.
The enema is effective and instant. You can make up the solution at home. 9 two twaspoons of table salt to 1 quart warkm distilled water. I found no problem with giving this enema at age 5. This is just my opinion and something that has worked well for us.
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My last post should have read 2 teaspoons of table salt to 1 quart of warm distilled water. Sorry I was tired when I wrote it.
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I am in a similar situation! My son will only poop with an enema an then seems regular for a few days, and then holds in for several more. He doesn't show any discomfort or pain (except sometimes whit the enema) but then he refuses to poop because he is afraid it will hurt. His doctor gave me a prescription for a laxative and he has not went since he started taking it. He also takes mineral oil to help soften it. Is there anything else I can do??? Help!!!!
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Hi Kate:

You dont say how old your son is ?
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My son is 3 years old. I think we are working through this.  After posting my comment I read a lot of other forums and websites, I finally came to the conclusion that my husband and I were making the situation worse. In stead of insisting that he sit on the potty and try and stress him out. We turned it around and gave him the option. He went on his own yesterday (in his diaper), but at least he went. Then about an hour ago, he went on the toilet all by himself! I think our stress anc concern for the issue was weighting down on him, and once we let go and gave him time to take care of business he did. We made the whole thing positive and it really worked for us... Thanks to everyone who helped....
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My son is 3 years old and he is impacted. We have been dealing with his non-pooping issue since he was 19 months old. We have been on Miralax- Kristalose- Lactulose- mineral oil, benefiber etc................ We can not find his happy medium with any medication. I have done so much research on this my brain is about to explode. I just wish this was over with. I have to give me son a suppository every other night or he will be sooo impacted that it gets stuck (literally). He screams and screams like there is no tomorrow. He told me that "it's going to hurt" when he poops. He has been to a specialist from the Children's Hospital of Philadelphia and all of the test have come back negative. They have done Upper & Lower GI tests, sweat tests, ultrasounds, x-rays, etc.......... It's been a nightmare.
I have read in the messages that some children have soiled pants all day long. That is because your "vault" gets so full that their "butt hole" spontaneously opens up and poops. My son went through that phase for awhile. Now I see NOTHING at all until I give him a suppository. Every thing I buy for my household is FULL of fiber. There is a cereal that I recommend. It's called Kashi. They have granola/cereal bars & cereal. They are great. My son ate them for a little but refuses now to eat them. To figure out how much fiber you child needs daily- get your childs age and add 5 to it.My son is 3 + 5=8 grams of fiber.  That is the number of grams of fiber he or she should have PER day. I have tried everything under the sun to get my son to poop and nothing has worked. He is on kristalose right now. That does nothing. He is still able to hold everything in. When he was on Miralax, he whole personality changed. He was fatigued and tired and didn't want to eat and not talkative. As soon as I took him off the miralax, my son came back to life..... but still didn't poop. If any one has any suggestions for me, please email me.
judy.***@****
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This message is for BREESMOM-

Can you tell me what fiber supplement company makes a chocolate fravored fiber powder??? My son would love that.
Please let me know. Thanks!
judy.***@****
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Oh lordy! I can relate to all of this too. My son held his poop for a week after finally taking initiative to poop 3 times on the potty, by himself, the week before! I don't know what the heck happened to him but he is totally refusing to poop on the potty. He says it hurts his butt. But, (no pun intended) he can go and squat in a diaper and have NO trouble at all!

So his doctor said he has bowel blockage and prescribed a daily laxative called Polyethylene Glycol (generic for Miralax) and it is a powdered laxative that I give him once a day, 1 tbsp, in a cup of juice. I have cut back his dairy intake and this is gross, but his b.m's are the consistency of applesauce now.

He still REFUSES to poop on the potty. We are going back to the doctor and are thinking of going to a therapist because he has himself convinced that he cannot and will not poop on the potty. Oh, by the way- he is four years old (July 16) I feel like a failure right now with him!

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I assure this will eventually all work itself out.  I have three kids, 9,7 and 3.  Every single one of them has had severe problems with constipation and holding.  In fact...my three year old is in this terrible holding cycle right now.  (That's why I found this website...cause I need some redirection and reassurance myself).
  
From experience, I know that there have been several factors for my kids in becoming regular.  The primary issue is the pain from large BM's...which leads to a fear of pooping...which leads to holding...which leads to so much family stress...which leads to a power stand off.  Your child will win this one...they can hold and hold and hold.  (Isn't that the strongest muscle in the body?)

What worked for us...and I am hoping will work for my little girl is making certain she takes her daily dosage of Miralax so that her stools will not become impacted and they will stay soft and easy to pass when she decides it's time.  We also have given enemas to our kids if they reach 5 days of holding.  And the other big thing...and this is where our family needs to redirect our energy...is to stop being so stressed about it.  She knows we are all anxious about her holding.  She needs for me to just tell her it's up to her to listen to her body and help her body to push out her poop when she is feeling pain in her tummy.  And, things have been crazy here with my other two kids and our schedule...so  I think we all need to just slow down, breathe, and focus on some fun activities rather than the negative.  And finally, this afternoon, I am going to get some little rewards as incentives.  If I get even 5 I'd be thrilled to give them out in the next few weeks!

I hope this is helpful for someone.  It will get better.  You are not a failure...although I understand your feelings.  I must say, this is helpful for me to remember the struggle and the pathway out of it.
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I agree with "my three kidz" advice.  I have a 2 and 1/2 year old daughter who has been "holding it in" for about 4 months now.  We've been to the doctor several times for help and suggestions.  It is so frustrating to watch her squeeze her legs together.  Our doctor has her on Miralax and prune juice which is helping.  If we make her, she will sit on her potty chair and go, but sometimes sits for more than an hour and only a little comes out.  It's still in her nature to fight it.  What we've been trying lately is to stop stressing about it.  It was consuming our whole day and wasting so much energy.  My husband and I would rub her back and talk to her and bribe her with things when she was having an episode and I think that it was just reinforcing her behavior.  Now, we're viewing it as a control issue and so we ignore her when she grunts and holds it in (which is very hard to do because I feel like a neglectful mom!) and we give her a small reward when she finally does go.  My friend suggested that we see a therapist for this but our doctor said that this is common and since she's not even 3 yet, it's not necessary.  He agreed with us about ignoring the negative behavior and rewarding (in a small way) the positive.  With the help of a laxative/stool softener and a consistent schedule of sitting on the potty, he says it will work itself out.  I sure hope so!  It just feels good to know that I'm not alone :)
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It's nice to know I am not the only one having problem's getting my 3 year old son to poop.   There is one product that may help kids who are constipated and need more Fiber in there diet.  It is a juice box called Fruit plus Fibre.  It has 10 grams of fiber.  It comes in a few different flavors.  My daughter used to drink the apple and she liked it.    I hope this is helpful.
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Miralax worked like a charm for us too!!
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I noticed that some moms mentioned buying fruit juice with extra fiber in it.  I've been to the grocery store and Whole Foods and can't find it.  Is it in a special section in the store that I missed?  I can't seem to find it anywhere.  Thanks!
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I am so glad to hear that I am not the only one with this problem!  My son is 4 years old and after 6 months of being potty trained, he started 'holding it'.  This has been going on and off for about 3 months, I have made several calls to the doctor who just kept telling me to use a laxative and/or supository - which I did but still would have the same problem the next day.  Then of course with the staining of the underwear etc, etc, etc.  I ended up taking my son to the hospital yesterday AM because he hadn't had a BM in a week.   They just took x-rays and sent me home telling me that it was a common problem and to give him more fiber.  I ended up giving him a supository which produced a BM the size of a soda can (no exageration there).   I know that I've put too much pressure on him to use the potty, but it's so frustrating.

After trying bribery, sticker charts, incentive toys, ignoring the problem, even trying to get him to poop in a pull-up (nothing has worked)  I have a new idea. I have come to the conclusion that the bathroom is just not a fun place to be right now.  So I have ordered a hand held game for him to play ONLY while he's sitting on the potty.   I don't know if it will work - but it seems like a good idea.   I'll let you know how it goes.
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i am new to this forum and found it out of god awful depseration. it is nice to see i am not alone in this issue of the poop problems. i got on line just a few minutes ago after holding my daughter for 1 hour while she strained to release a softball sized bowel movement. this all started 5 months ago, when we had to take her out of the daycare she was in. when we found out she got in trouble for peeing on herself and was sat in the corner for over 2 hours in her wet panties and skirt. within a day or two she went from being fully potty trained to wanting a diaper or pull ups and always having accidents, and then came the poop problems, she started going 5-8 days without going and then when she would go it was be excrutiatingly painful and take a while to work out of her. we went to the doctor and they put her on miralax, i noticed a comment from another parent on here mentioning fatigue due to miralax. i noticed this too but she never had a solid bm for over 2 months, she had constant diahrea, and that never changed even with the change of the dosages and everything. i finally got fed up with her pedetrician suggesting every time i called about this, that it would take several months to get her back to normal. i took her to texas childrens hospital and they did exams and xrays and blood work all came back normal. i have an appointment wed, with the gastrenologist but i know she  is holding it and that is causing the problems, but i guess what confuses me, if our bowels are shaped a certain way and i was wondering if anyone had any insight on why my daughters are round and not long shaped like a normal bowel movement. why and how would they get this way in the bowel tract, since the bowels are not shaped like softballs, and i am not exagerating.
i do think it very well may be psychological due to something that i am unaware of at the daycare she used to be in. but i am worried that this is something more, like i am hoping she wasn;t abused or something but i have no way of finding out, she is 3 and 1/2 and it's been so long ago we moved her that i am thinking if the gi doctor can't find anything i am hoping a psycholigist might help.
any comments would be nice.
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My 4 yr. old daughter has had this problem since she was only 9 months old. I have tried everything all the other parents here have tried...meds., children's hosptal, diet. She has no accidents but if I wouldn't give her Babylax every 2 days she would never poop. I really feel like I may go crazy with this. I have always been a stay at home Mom, I have no other children, my life is consumed my poop!!I will welcome any advice or new treatments: ***@****
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Please tell me what I am doing wrong!   I followed alot of your advice and am still having problems.   I have a 4 year old son who I had problems potty training - same thing, peed great, wouldn't poop.  After about 8 months of this, we finally succeeded.   He was fully potty trained for about 3 or 4 months w/o incident.   When he switched rooms at daycare (moved up to the next level) and started soccer instead of swimming, he started holding it again.  He has been doing this since mid September.  It was so bad that I took him to the ER on Sunday and ended up giving him a supistory when we got home - which produced one of those colossial poops that we all talk about.  On Tuesday, after reading all of your comments, I gave him an anema which produced yet another colossial poo.   So yesterday, again another anema just to makes sure everything was all cleaned out - which produced a normal sized poop - but staining of the underwear for the rest of the day.

I have also been giving him the Oil every night in his drink at dinnertime.   Even with the laxitive - he just holds it more - more times a day and spends more time concentrating on holding it.  Yesterday he called me a 'bad woman for giving him that medicine'.  It was just awful....I'm at my whit's end with all of this - HELP!
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In response to Koppadopa - I read this in another website - the reason our children have such huge bowel movements is because the instine actually streatches because they are holding so much.   Once our issues are resolved and they start pooping on a normal schedule - they will shrink back down to size -
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I gave my 4 yr. old the new concentrated strawberry Milk 0f Mag. I gave her the 7-11 age dose and 6 hours later she pooped. she usually spits it out...I bribbed her with a can of soda..she drank her medicine, though. The milk of mag. always works if I give her the biggest dose, but she hates the taste. If she would just take it everyday pooping would not be an issue!!!It is the only medicine her doctors recommend. You can safely take it daily for at least a year. when she was on Enulose, Lactulose, etc. she had "failure to thrive". she is now healthy and has energy.
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I have 2 questions for Hailey's mom...did you try Miralax and if so, what were the results?  And does she have diarrhea or solid poops with the Milk of Mag?  We're on Miralax and her poop is usually pretty soft.  I'd rather her have more "normal" ones.  Thanks!  Amy
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I read that honey is a natural laxative and was wondering if anyone has tried that.  I don't know if it's enough to do the job but I feel much better giving my child something natural...let me know of anyone has had success with it.
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I'm an educator in a daycare.  I work with the preschool (4 and 5) year olds.  I am stumped with one of the children in my group.  He will soil his pants anywhere from once to three times a day.  When he soils his pants at school, mom is called to change him.  Everyday he comes in from school smelling and the other children say he "stinks" and do not want to play with him.  I encourage him to wipe himself and offer wipes to get the smell off of him however, he will still have more 'accidents'.  I asked him if he knows he's pooping and sometimes he say's no and other times he say's he doesn't know.  I've seen him sit, playing with a toy and suddenly he smells.  I've tried not making a big deal of it to offering stickers for jobs well done (using the potty).  At times he gets so frustrated and cry's but when I encourage him to clean himself up, he complains he hates to bend down (to take off his shoes), to why am I alway's checking him.  I know his self esteem is affected and that's what I didn't want him to have to go through.  Mom is aware obviously and I think she is frustrated but how do I deal with this problem?
Help!
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I forgot to mention that I heard through the 'grapevine' that dad this too when he was little and outgrew it when he was almost in his teens!
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We have a 4 year old son who is holding it in and won
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To Koom -
I would definatly talk to the mother regarding this issue.  You see by all of our postings that until we find this website, we all feel alone and very frustrated.  If you let her know that there is a name for this and that she isn't alone, she may be able to cope a bit better and my read some ideas that could be helpful in these postings.
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My son is three, almost four (in Jan) and was potty trained over the summer.  He has always had "potty issues" since he was two and we introduced the potty.  When he was two, we didn't make a big deal of it, but he started holding it...mainly I think because he was not ready and putting soo much pressure on himself to poop on the potty when he just simply wasn't ready to do so.  He got into a holding it pattern and we had to give him an enema after five days of holding it.  He fought us physically with this but we had no choice!  After the first enema, he still continued to hold it for a couple hours. So, we gave him another...until he finally pooped (ALOT) It had to have hurt as it was really large.  Since then, we backed off and started giving him Myralax, which has helped with the holding a bit.  He still tries to hold it for a day or two, but by the third day, he usually goes ahead and poops in his pull up.  Finally, over the summer he was totally trained, pooping and peeing in the potty normally.  He got set back after a death in our extended family, which the only way he was affected was that I was completely busy with trying to help my family with arrangements, etc. and I wasn't around that week to keep him on schedule.  Since then, he's back to his old ways.  He refuses to go on the potty and raises a huge fit when I ask him to go sit on the potty when he seems to have to go....HELP!  I feel like it's never going to happen and I just don't know what else to do....
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***********EVERYONE PLEASE BE VERY PATIENT*******************

I BELIEVE THE KEY IS TO FIND THE RIGHT FIBER SUPPLEMENT (for my son it is 1/2 t. benefiber 1x/day in his juice) TO KEEP THE STOOL SOFT AND YOU WILL HAVE TO ASK THEM TO SIT ON THE POTTY AT LEAST 1X DAY FOR 5-10 MIN.

***THESE CHILDREN DO NOT FEEL THE SENSATION OF HAVING TO POOP.
***THEIR COLONS ARE SO LARGE & FULL OF STOOL AND IT LEAKS OUT.
***THIS IS WHY THEY HAVE SOILED UNDERWEAR SO MANY TIMES A DAY.
***EVENTUALLY THE COLON WILL SHRINK BACK DOWN AND THEY WILL
   REGAIN THE SENSATION.
***ACCORDING TO MY SON'S GASTROENTEROLOGIST THIS PROCESS CAN
   TAKE UP TO A YEAR FOR THEM TO REGAIN SENSATION.
***THAT IS WHY WE MUST BE PATIENT - THIS IS NOT THEIR FAULT!

OH, THIS IS CALLED "ENCOPRESIS".
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I understand that it's not their fault and that they are just plain scared to poop (I would be if I had a bowel movement the size of theirs)  But what I don't understand is when people say they don't have the sensation to poop.  My son will run into the other room and hide, squeeze his butt cheeks together, cross his legs etc. just to hold it in.   Doesn't that mean that he is feeling the sensation?
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molly's mom- The milk of mag. gives ger very loose stools. But she can't hold it in. we have been on the miralax for 1 week and she is now pooping regularly. Normal size~something I have never seen her do before. I have been giving her slightly less than half a capful because she was having explosive diarrhea. But my doctor only gave me a months prescription of the miralax~ I had to beg for it. The milkof magnesia is safer she says, you can take it for a year. It is gross and kids hate it. the miralax is tastless. I would love to hear from Mom's who have kids on mirlax and how it is working long term.
***@****
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I am so relieved to find this website.  I have 3 kids pooping in their pants!!!  Well, my 4 1/2 month old is allowed.  My 3 years old REFUSES to poop in the the toilet.  I let her go in a pull-up to not stress her out or else she would just hold it and I would have the same problem as my 5 year old........My 5 year old has the distended bowel, and has had for months now.  She's on Miralax everyday and seems to do the trick.  My doctor told me to hold off on extra fiber for now.  I'm hoping to get her off the Miralax and onto more natural stuff in the next little while.  I think I forgot to give it to her the other day because she's been holding it the last few days and complaining that it hurts and today..... let's just say I've been in the bathroom at least 10 times this morning cleaning up smears.  I've been putting a liner in her underwear which catches the worst of it.  another problem is her skin down there is so red and excoreated it's been agony for me to clean her up.  I had to keep her home from school today because of this.  I feel like I'm up to my elbows in poop.  It's so hard to be patient and because I've already been dealing with this for months, I don't see an end in sight.
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I found a wonderful website - everything you ever wanted to know and more....
www.aboutencompresis.com
They have a great forum going with so much advise.  It's been extremely helpful to me...
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sorry - I spelled it wrong:
www.aboutencopresis.com
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A related discussion, 11 yr. old having trouble pooping was started.
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A related discussion, my son refuses to "poop" was started.
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My daughter does not hold her poop. But she is so extremely constipated right now. We have done a pediatric laxative,  MOM, and prunes. She was still unable to go and could not walk or lie down without crying from pain. We took her to the ER and they gave her a suppository and a enema and still no results. She has sat on the potty a couple times.and pushes with all her might, but nothing....what do I do know?
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A related discussion, my 6 year old son is too rough with children at recess was started.
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A related discussion, 4 yr old who holds her poop in was started.
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Ok. My nephew is four and still poops his pants and will sometimes use toilet. I just found out he used toilwt and reached inside and grabbed hand fulls and threw it on thw wall smearing it in .  Urinating in his brothers room and thwn his parenta room because he got in trouble for his brothers room.  I know this is acting out. Anyone have suggestions besides seeing a psych.  Seems like something deep seeded to me
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