4 yr old potty training problems

[kevin3272us]

My son is now 4 yrs old.  He has been successfully urinating on the potty for 1 1/2 yrs now and wears normal underwear 24 hrs/day.  Unfortunately, he still only wants to have a bowel movement in a pull up.  There was a period about 8 months ago when he was constipated due to him holding it in.  I know that he associates pain with bowel movements on the potty. My wife and I disagree on what to do in this matter and the real issue at hand.  I believe that this is an issue in his mind, while she thinks he has a medical issue and needs to see an Upper GI specialist.
He can have a bowel movement with no problem in a pull up.  He actually had 3 successful bowel movements in the potty several weeks ago, but now insists on having a pull up again.
I have tried offering rewards, talking to him, making him sit on the potty daily--nothing seems to work.  When he did have bowel movements on the potty, we even had little parties for him with cake, etc.  I am tired of trying to force him to sit on the potty and the everyday battle.  Any ideas?  Please help!

[artieg09]

A related discussion, 4 year old potty problem was started.

[lmroswell]

My daughter was 4+ years old when she finally stopped using her diaper for bowel movements.  She was a 'withholder' when confronted with using the toilet.  Her pediatrician had her on stool softeners and we also tried laxatives, which eventually gave her bloody stools.  What solved my problem was letting her use the diaper for her bm's.  Yes, at age 4, that gets really old for us parents, but it was best for her.  What I think finally resolved the issue was age, and peer pressure.  She just wanted to be like other kids and do what the other kids did.  Bottom line is every kid is different and you have to figure out what will work best for yours.  Good luck.  And Happy New Year.

[Kevin Kennedy, Ph.D.]

Be sure to obtain the opinion of his pediatrician re: referral to a specialist, but there's no indication in the description you offered that this behavior represents a medical condition. Do continue with your plan for a schedule of sitting on the potty. At the same time, under the guidance of the pediatrician, a regimen of stool softener (and perhaps, but not likely, mild laxative) can be a great assist in having the child overcome the fear of pain often associated with avoidance of the potty. Overall it sounds like you're doing fine. Consider altering the routine the way I mentioned, and perhaps, down the road a little, dispense with the option of using the pull-up - it only contributes to avoidance of the potty. But you needn't make that change right away.