Daughter struggling with Encopresis

[maryfran2010]

My daughter will be 8 yrs old in June and our struggle with Encopresis continues.  I'm looking for any advice, information and/or suggestions that may help us conquer this ugly monster.  She has a prior history of constipation.  We've worked with our Pediatrician and Gastroenterologist who have both ruled out any and all  physical issues.  We tested her for Celiac and ruled that out.  Our family has attended Behavior Clinics and complete numerous reward charts which she knows how to work them!  We've tried the mineral oil, myralax route with minimal success.  She was on exlax for almost two years also with minimal success.  We are currently working with a Family & Child Psychologist and have been keeping progress logs, earning points to then earn rewards.  We've had a few stretches of about 3 weeks of success, but then she regresses.  Sneaky behavior...hiding pants.  Denying she has soiled pants.  I feel so bad for her as she gets older, the children at school are noticing the foul odor more often and asking questions or making comments.  Any information or new ideas would be greatly appreciated.

[Rachael1985]

I have a son who "had" encopresis. It started shortly after trying to potty train when he was 3 yrs old. I put potty training off for a while and then when he seemed ready again, we accomplished it. But then started the holdings. Mainly to do with the fact that he had more important "things" to do ~ like playing. Well I did some research and started with flaxseed in all-fruit smoothies, totally changed his diet to much more healthy, but to no avail. He still had encopresis. I found dairy products to also be a trigger to set him off. So I switched him to soymilk and watched his dairy intake, though he loves cheese. This helped somewhat and I was now giving him flaxseed oil in all-fruit smoothies. We've also gone the route of glycerin suppositories which also didn't work. When I took him in for his 5 yr well check, his Dr chided me for switching him to soymilk and told me he could develop osteoporosis if I didn't give him milk. I told him about his encopresis and he told me to put him on Miralax. I researched Miralax and Dulcolax and decided against it. But I did go home and gave him milk. He immediately got plugged up again, confirming the fact that milk is a major culprit besides him training his muscles to "hold it." We would spend SO MANY hours in the bathroom when he would go for 2-3 to 5 days without having a BM. I switched him back to soymilk. My sister suggested YoPlait YoPlus yogurt since it had probiotics. We tried it and it seemed to work and get him regular. Well, he tired of having to have a yogurt everyday, so I did more research about probiotics and found a chewable probiotic children's pill that he now takes once a day, at bedtime and it's NIGHT AND DAY in the difference. He is now regular and has been for 1 yr. It is such a relief to know our problem is solved. The pill is made by Nature's Way and is called Primadophilus Kids and it's carried by Sprouts and SunFlower Market where I live, but you can call them and find out if they sell it near you. 1-800-9NATURE begin_of_the_skype_highlighting              1-800-9NATURE      end_of_the_skype_highlighting. I thought he was going to have to live with this problem for the rest of his life but thank goodness I found out about this after only 3 yrs, which is still a long time to have to have dealt with it. I'm hoping this information helps someone else out there besides resorting to a drug that doesn't really treat the problem but just makes a person have to go to the bathroom. I am in no way affiliated with Nature's Way and I'm sure there are other probiotic chewables out there for kids. Just hoping someone else reads this and gives it a try if your child is suffering from this problem. It worked for us and hopefully it will work for you.

[therese83]

My son was very bad at this age, the pediatrician gave him a non habit forming laxative, that held the water in the stool.  He was on it for three months, end of problem. He forgot the whole thing, forgot hiding, forgot me asking, we got on with our lives.  It was a very good solution,

Fill her diet with fibre roughage , treat her diet wise as if she suffers from constipation, this helps

[Kevin Kennedy, Ph.D.]

Most children who are encopretic are OK from a medical point of view - i.e., their physical organs are fine. If your daughter is not now constipated or having impacted bowels, the strategies you are using (i.e., primarily behavioral approach focusing on rewarding successful days) is the correct strategy. Having several weeks of success is no small accomplishment. One thing you might want to add, if you have not already, is a rewars for cumulative days. That is, she should receive the reward every day she is clean and uses the toilet, but in addition she should be rewarded as the days of success accumulate.

[Kevin Kennedy, Ph.D.]

I really cannot speculate on that. You can pretty much rule that out, though, if she has not always been encopretic.

[maryfran2010]

Thank you for your response.  We actually have a point system with rewards for staying clean, pooping in toilet and cleaning her own soiled underpants. When she earns a certain number of points she chooses rewards which are non-material...ie extra TV or Wii time. This reward system is ever evolving and changes based on what will motivate her in any given week.  Just this morning she's been asking if we could go out to dinner...I said sure let's use that as this week's goal...she agreed. Do you think there could be any neurological issues?  We can't figure out if she gets a "feeling" to go or not.  

[maryfran2010]

Thank you for your response....I'm curious about the Non-habit forming laxative you mentioned...can you provide the name?  Her diet is very rich with fiber...this is a kid who actually likes broccoli and who will eat prunes like candy when I offer them.  At this point we're dealing with peanut butter consistency stool. Once in a while she will pass a normal formed stool.  She has been off laxatives almost a year now.  If I ignore the problem, she just continues to soil her pants and it doesn't seem to bother her.  She'll even try to go to bed with dirty pants if I don't force the issue of her cleaning up.  I'm really trying to drive home the "personal responsibility" angle based on our work with the current therapist.. She cleans out her own dirty pants and still  doesn't seem to mind.  I still can't figure out if she gets a "feeling" to go or not. Ruled out the anal fisure also.  I'm wondering if it could be neurological.

[therese83]

all this focus on it is only making the problem worse, say nothing about it and get her on the treatment, have you had her checked for 'anal fisure' that is how my son started, it hurt when he went to poo.  then bad diet .  keep the stool as soft as possible.  She is probably leaking around hard stool

Sincerely

very experienced mother !