6 Year Old Defecates Pants

[MelPet]

I have a six year old son who on a daily basis poops his pants.  This has been going on since late summer and at one point he was completely pooping his pants and at other times he just does not wipe well.  He is not discriminatory about it, he does it at the sitters, his father's, and my house (I spoke to his teacher and she has not noticed anything so I am not sure if he does it at school)- so it is not either of those situations causing it.  I have talked, yelled, punished, and cried with him about it.  I ask why and I generally get "I don't know", I ask if he likes smelling bad he says "no" and I ask him if he is comfortable and he says "no."  I have made him clean his own underwear thinking maybe this would work, but he now comes home and washes them out like it is part of his daily routine, and quite frankly it has become so.   His father has talked to him, his grandfather has talked to him (as I mentioned I have as well).  I am really at a loss for what has caused this sudden change, he was 38 months old when he was potty trained so I do not feel it is because he was trained too early.  The only thing I can think of is possible stress.  His father and are divorced but have been for 5 years and have an amicable relationship.  His father did get re-married this past summer approximately when it started occuring, but the woman he married he has been with since shortly after our divorce five years ago.  I work 50+ hours a week and go to school full time and am a single mom.  The issues started prior to my hours becoming long and stress becoming next to unbearable, but has not gotten any better since.  I am working on trying to reduce my hours and regain control of my personal life in hopes that this will help us, but since this occured prior I do not feel it is a contributing factor.  I cannot think of any thing else that could have and still has such an affect on him.  I thought maybe it was a phase and lately I have tried not making a big deal out of it, but again to no avail.  Can you please help me to determine a cause and possible solution.  I am at a complete loss... thank you!!

[Kevin Kennedy, Ph.D.]

The most immediate need is for his pediatrician to examine him and see if his bowels are impacted. That is the single most frequent cause of encopresis in a child of this age. While encopresis can occur as a result of stress or trauma (e.g., sexual abuse), it generally does not occur because of psychological reasons. The medical exam is the priority.

[eniko]

I had the same experience with my son, but I can tell you: yelling, punishing, etc... won`t make it any better, only make him feel guilty about something he might not even have control of.
I hope he is going to get better as soon as possible, especially for his sake.

[things3]

My Son (6 1/2) has been having a similar problem (on and off) since June '05.  We were charting on the calendar (with "skid" for accidents and "YEAH!" for successful bm in the toilet) and that worked for a while.  We had one totally poop-in-the-toilet-only month (August).  We were also using a token reward system...every time he went in the toilet, he got a token, didn't make it, lost a token.  When he got to a certain amount (I think we started low, like 3) then he got a prize (like a special lollipop...reserved only for rewards).  This was successful, but after a time, interest waned.

We too went through medical testing...I think it made matters worse.  We were giving him fiber (Dr's orders) because he wouldn't poop for days, then he would start to skid in his pants...it was A MESS!! heheh...

Anyway, it really became a matter of will...there are a few things that kids can control; eating, sleeping and pooping.  They all become problems at one point or another.  For us, we KNEW he had to go, but he wouldn't.  He would just sit there on the toilet.  So I told him, it is his choice to make.  So, then the problem was pretty much gone for about 2 months, then...boom!  Back again.  And washing the underwear didn't phase him either, in fact he kinda seemed like he wanted to do it.  It was a little freaky.

We have found that it has to do a lot with attention.  If he is engaged in an activity he will poop.  He doesn't even realize he's done it (which I will never be able to comprehend).  Then when I ask him he'll say "Oh yeah, when I was playing with my cars".

So, while I don't have a ton of successful advice to give you, I can only let you know that you are not alone.  Good luck.  Post whatever you learn!  Thanks.

[momof3boys]

You may want to check out this thread:
http://www.medhelp.org/perl6/ChildBehavior/messages/33081.html

I was a part of this thread quite some time ago...and have a son with encopresis.  If anything you will find that you are not alone...I was at my wits end until I found this website and learned that there are so many others going through the same frustrating situation.

It is quite long, but you may find it helpful.

[beenthroughit]

Please, please, please do not punish your child for this. He truly cannot help it. I went through the same problem with my son for about 2 years before we discovered that this is a horrible problem called encopresis.

I finally took my son to a pediatrician (rather than a general physician) who knew exactly what the problem was and how to fix it.

He said that when a child stops having regular bowel movements, the rectum can become too full and stretch. The rectum will become numb and the child will not be able to feel the sensation to go to the bathroom. This is why the soiling occurs. When the child finally does go, he will have a very large and painful bowel movement.

To fix it, the doctor said I should first give him an enema, give him Lactulose twice a day (a prescriptive laxative), and mineral oil once a day. He said it would take a few months of keeping the bowels empty until the rectum returns to normal and he can feel the sensation to go again.

I hope this helps. I know how frustrating it can be.

Good luck and God bless!

[MelPet]

Thank you all for your advice.  Let me put your conscience at ease and advise you that after a very abbreviated period of time I ceased to punish him, sad to say it was a desperate, and unsuccessful, attempt at rectifying the problem.

I have since read about encopresis and your comments and the one area where my child differs (and a rather critical area it is) is that he is not constipated.  The last time we dealt with regular and prolonged constipation was when he was six months old.  He goes almost every day and sometimes multiple times per day.  He has no pain and his stools are firm but not hard and are of normal appearence.  It literally appears as if he has not wiped afterwards.  Due to the lack of constipation I have held off on a physician's visit.  At this point I have decided to take him in regardless as I am unsure if this can result from any psychological causes.  He eats well, sleeps well, and is ill rarely. All in all he is, and for the most part always has been, a physically healthy child.

If anyone has any other comments or suggestions I am aching to hear them.  Thank you all once again for taking the time to read my concern and to reply.  That was very kind of you.

[nursemom]

Dear melpet,

I have pretty much the exact same problem with my 6 year old... He has all the symptoms of encopresis except he is NOT constipated. I honestly can't remember a time that he has ever been fully in control of his bowel movements, but I just kept thinking that he would eventually "grow out of it" and gain control. I finally did make an appointment with a pediatrician for next week. If I find out anything, I will let you know.

I did know a girl (about 12) who had a problem with her anal sphincter and was unable to sense or control when she had a bowel movement. She wore a pull-up to contain the stool and cleaned herself up when she went. I'm concerned my son my have a similar problem.

[2-my-ah]

I have a 8 year old son who does the same thing. I tried the $.25 reward for everytime he doesn't do it but it still has  not worked.  I even have him clean his underwear out and he still does it.  We have probably went from having 50 pair of underwear to 20 and once  or twice a week we have to wash them.  It's very frustrated.  I took him to the doctor and she told me to change his diet.  water, fresh vegetables, fiber.  I gave him laxatives and some mineral water stuff, but he still goes on himself.  Sometimes it's seems as if he's not wiping himself good to sometimes going on himself.  The doctors say he's constipating, but he goes all the time.  I'm at an Awww
I wish I had some good advice for you.
             Gob Bless
                   I'll be praying for you too.

[at lost]

I've been going through the same problem with my 7 year old son.  He is a very bright child and has made the honor roll since he started school.  I'm constantly reminding him and now it has gotten to the point where his older brother makes body gesture to him and that is his way of telling him to make sure he goes to #2. When he comes home from school I find his soiled underwear tucked away in the laundry basket. In the last several weeks it has gotten unbearable for me and I'm sure its the same for him.  I've been pushing my husband that he needs to get checked by our physician but he denies that it is not a problem.  I have tried the punishments but I know that is not working hence I have tossed away many many of his underwear.  I was able to locate this web page and I have read all that was posted and I will take matters into my own hand and have him checked as soon as possible.  One of his comments to me was that he was afarid to go to the toilet but I don't think that is the real problem. I was wondering if encopresis is hederity?  My husbands 10 year old nephew had this same problem but I believe he has since grown out of it. I will keep you posted on his situation, but if any knows the question to my answer please help.

[momex2]

I have the same problem with my 5 1/2 year old daughter.  We took her to the doctor and he said she has encopresis.  I too have read tons on information on the topic and also changed her diet.  The doctor gave us a prescription laxative that she takes twice a day.  The medicine is working the only problem is she is still not going to the toilet.  She not only does this at home but at school as well. It does not seem to upset her to do this.  At school when the kids have good conduct they get a bear stamp in their folder, if their behavior is not good there is a note in the folder.  Since school has started back (in 2006) she has been getting notes on days when she has "accidents"  this was not the case before Christmas.  Today she had 3 accidents.  I am beginning to get worried that this is going to be a problem at school.  Is not being able to take care of toileting needs reason enough to keep a child in kindergarten?  My daughter is very bringht is progessing well the only problem is the toileting issue.  We have tried everything to get her to stop, but nothing has helped so far. Her grandparents (my parents -- husbands parents don't really show intrest in the kids but that is a whole other story) have tried offering her rewards for stopping.  My 4 year old will ask her "why do you poop in your pants?  I go to the potty."  I thought that when school first started she would see the other little girls going and do the same.  The doctor even told us peer pressure may put an end to the problem.  The first time she had an accident at school she came home and was proud of the fact that she did it and the other kids didn't laugh or say anything to her.  Last friday she had an accident so bad the nurse had to give her a shower and I had to go and pick her up.  I talked with my daughter and explained to her that this was a one time thing and she should not expect to get to come home every time she has an accident.  Sometimes I wonder if she does this on purpose for attention.  How is it possible for her to poop all over herself without knowing?  Sometimes she won't change unless I mention it to her.  I hope someone has a suggestion that can help me.

[pottyhelpplease]

I am having a similar problem with my 5 1/2 year old son.  A few weeks ago, he began pooping in his pants.  He, too, is very regular with daily BMs.  He eats healthy and is a "normal" well-adjusted, bright child.  I have considered that maybe he is not wiping well, but have caught him under or behind his desk pooping.  Then he uses the excuse that he couldn't get to the potty in time.  

This is very frustrating and easy to get angry about.  I have caught myself punishing him, which I believe is a normal response.  I don't think he has a medical problem, however, I can't figure out how to get it to stop.  He gets plenty of attention, so I don't think it is that, but I can't figure out why he is doing it.

I am taking some of the previous advice and trying rewards, so hopefully that will help.  Any other advice would be great.

Also, MelPet, I think that you have been come down on pretty hard for punishing your child.  I think that most of us do the best we can, and try to be the best moms that we can be.  Good luck!

[oliver-jamie]

My son is almost ten and had a lot of problems with soiling.  I finally figured out that it was worse when he had any for of vitiman C or milk.  We stopped all vitiman C (everything has it, so check carefully)milk and cheese.  He now can have those things in moderation.  Still can't give him a normal vitiman tho.  He sometimes still has a problem in the bath tub that he seems to not notice until it is too late.  Try it and good luck.  Mine has ADHD too- so there is always something!

[frustrated girlfriend]

I have been dating a man for a little over a year who has a 9 year old who has been pooping his pants on and off for the past few years. He is also ADHD and is on Ritalin.  From what I understand , he was potty trained fairly early....around 2 or 3.  I also believe it was around that age that he began taking Ritalin for his ADHD.  After reading a bit more about ADHD on the web, he is definitely the hyper, can't sit still , always moving type.  I currently don't spend time with my boyfriend when he has his son because I don't know how to deal with this issue.  I feel critical, judgmental and would be completely embarrassed if this ocurred in a social situation.  He did do it once in front of me when he was caught up in playing a video game.  When his dad called him on it , he looked at me with sort of a giggle and said "I'm not potty trained" which I found to be a odd comment.   To have the awareness of what potty trained is to acknowledge that he isn't.  I said to him, "I know that you were potty trained when you were younger so why not now ?"  He just gave me an "I don't know" .  HIs parents split up a couple of years ago so this was going on prior to their split.  I get frustrated when I hear that Drs say "its just part of ADHD, or it could be due to the meds or whatever."  I feel like no-one is making this a priority to help this kid.  (mom, dad or drs).  I fear the permanent emotional scarring. I find it hard to believe that kids at school don't make fun of him and I don't understand why this doesn't embarrass him.  And I think it is wrong that my boyfriend cleans him up after these incidents. I think he should clean himself up but after reading some other comments how cleaning their own underwear doesn't seem to phase some kids and they might even enjoy it , I am more confused.  I've also thought of removing privileges..ie, video games, movies etc and making the day about focusing on how his body feels and when it tells him he has to poop.  I too am completely confused how a kid can not feel the need or the fact that it is happening. I have been reading some of the comments of things that don't work, i.e. rewards, punishment, peer pressure etc. Whenever I try to discuss with my BF, he is defensive, says I'm shallow, I need to get over it, I'm not a parent (though I do have many nieces & nephews taht I spend a lot of time with which I know is not the same but I do have some knowledge)  He loves his son and hopes it will work its way out.  I realize at times I feel like the militant approach is the way to get this kid into shape  But I'm just so confused, I feel guilty but I also know that there is no way I want to be a part of this.  Plus, my time with him is pretty limited to a few hours on the weekend so how much effect can I have if his parents aren't the ones setting the boundries/practices?   I just feel like this is my dirty secret (no pun) and would be mortified if my friends and family knew about this.  Which sounds selfish and about me.  Like I said, I'm frustrated and don't know what to do.  thanks for listening

[bossy]

Sympathy, sympathy with everyone here!

My 9 year old never really successfully potty trained.  We also tried EVERYTHING, and of course between trying something new, it's very easy to resort to the punishment, belittling, and yelling that you're so ashamed of afterwards.

I saw a child psychologist for this and other problems.  He was diagnosed with anxiety (for other reasons) which we thought medicating might have the beneficial effect of fixing this problem, but no such luck (that was when he was 6).

Then when he was 7 or 8, he was diagnosed and medicated for ADHD (the symptoms were mild enough that we might not have medicated, had we not had the hope that the medication would help with the encopresis).  The doctor said it was a good possibility that the encopresis was actually an ADHD problem.

Well, he was medicated for almost a year before we saw improvement.  A GOOD PART OF THE REASON WAS BECAUSE IT TOOK THAT LONG FOR MY BEHAVIOR TO CHANGE. For so long, my relationship with him had been too dependent on if he had kept clean that day, if he had pooped in the toilet that day (BTW, he did not have constipation problems).  It took me a long time to learn to back off, love him for reasons totally unconnected to bm's, and interact with him in other healthy ways.

He is doing great now.  He still will only do bm's at home, so sometimes he comes home from school with little skid marks, but nothing very noticeable.  Also, we've been able to take him off the ADHD med's for the last couple weeks, and he's still doing great! (we had tried taking him off a few times before, and he would revert right back to defecating in his pants)

Anyway, good luck, I totally sympathize with the frustration, the embarrassment, the "dirty little secret", etc.  YOU'RE NOT ALONE!

[witcher]

My 6 year old son started school last year and was doing fine until about October and then almost everyday he uses his pants instead of the toilet. I have tried everything to help him with this problem. I ask him why he does it and he says I don't know. I had problems potty training him and I thought that was over and done until it started again. He has never had a problem urinating in the potty. I have not taken him to a doctor because I really didn't know if I should. I have another child who is 4 years old and never once has he used his undies. He always uses the potty. My 6 year old uses his pants at school, his dads, my house everywhere!! His dad and I were never married and his dad came into the picture when he was about 2 years old so maybe that is the problem. He does have a stepdad and he tries to talk to him about using the potty but it does no good!! I really don't know what to do. If my son is playing he will not stop and go potty, maybe he doesn't know that he has to go! He uses his pants alot at school, so I called the school to see if maybe he was be bullied in the bathroom, he wasn't and now they let him go to the bathroom by his self (not in a group) this still is not helping. I go through so many underwear a week, it gets expensive. What do I do??? Anyone have a suggestion??

Please let me know if you have any thoughts on this- I thought I was alone on this!!

[momex2]

Since I last posted on here, my daughter (age 5) went through a period where she had an accident every day at school and sometimes more than once.  I talked to the teacher and nurse both said they allow Sara to go to the toilet whenever she asks.  My daughter did mention something that you may want to ask your child.  She said that she has trouble using the potty when there is a group of students in the restroom.   This is common and I even know some adults who experience this.  I told my daughter to ask to use the nurses restroom since she only has one toilet in her restroom.  My daughter has done so much better the past week -- no accidents at school.   She says she has been going to a teachers room next door (teacher apparently has a small restroom in her classroom) and using the potty there.  She is wanting to take swimming lessons this summer and I told her they didn't let kids who went potty in their pants take lessons.  By her knowing this she seems to be trying harder to get to the potty in time.  We have also made a calander and she gets a happy face when she does not have an accident.  At the end of the month if she has a lot of happy faces (we are going to allow a couple of accidents) she will get a special prize.  This seems to be helping this time - we have tried it before with no success.  Her teacher, the nurse, and other teachers who know her are also giving her encouragement at school which helps because she loves the extra attention.  Anyway, I hope everyone is having success with their child.  Don't give up because it will get better.

[dee1298]

A related discussion, 10 year old boy not making to the bathroom in time was started.