Holding Bowels

[Hazel30]

Hello Doctor. I  have a son 2 yr 3mth old.  We started to potty train  him 1 month ago.  He showed many signs that he was ready  so I tried.  Within 2 days he was trained num1, standing sitting and even aiming himself as  well.  He loves it.  With num2 we never realy were as good.  He occasionaly had accidents but ever  since  2 weeks ago things changed for the worse.  It started off when one day I saw he didnt go num2 at all and the following day started to be afraid of going and his stool was hard.  Ever since he's been holding in his bowels through out the day and  struggles but eventualy  goes at  night before bed because I guess he  cant hold  it  in anymore.  I  give him 1 tsp a day of metamucil just to keep his stool soft because now Im just afraid his stool will harden up and scare him off again.  I know its a phsycological thing but  Im so afraid he will ruine his bowels if he keeps doing this much longer.  I even tried to put  him back in pull ups and he stays dry all day, he hates it.  We  do the  reward system, happy dance we do it all.  He understands very well the whole potty thing but just afraid to let it go  when he feels an urge.   Through  out the day he asks to go num2 and starts to hop around the house (thats how he holds it in) but once we sit on potty hes  done and the urge to go passed through.   Is it me over reacting or is this a serious matter.  

[Kevin Kennedy, Ph.D.]

It sounds like the main problem is that you rushed the toilet training. Relax your expectations; he's got plenty of time to get this accomplished. And be sure to consult with your pediatrician about the use of any OTC medications or preparations, such as the metamucil. You are correct in thinking that, if he associates bowel movements with pain, he will likely try to avoid bowel movements.

[chickster]

Hi my son is 4 and half and he has been toilet trained for a hwile now but not with poos, he used to have trouble when he was little with hard and big round poo's and now for the last year or so he will not poo, he will be playing happily then all of a sudden get up and hide behind the sofa and make a noise as if straining but he is NOT constapated he is straining to hold it in. We have taken him to the hospital and he has had unltra sounds on his bowels, special medicine, enemas twice a day for a week period, and still nothing. we have tried to take his most loved toys away from him until he goes on the toilet and stopped tv and so on, we are just at our witts end with him, everything it says in books etc to do we have done but it does not work. we have asked him why he does it, he says nothing. we have also tried to leave him in it to see if he then decided to go to the toilet because of it being horrible but no he just sat in it for ages. his stomach looks as if it is going to burst sometimes where it is so full. he has also gone a whole month before with out going properly, and sometimes he leeks poo rather than a proper one where he is straining so much. but all test show nothing wrong!! any help would be great please. we are so afraid he is going to be picked on if he does not start pooing properly.

[VLW1]

My daughter (now 8) went through this for about 2 years. We tried everything from her regular doctor, colace (stool softener), mirulax, colonoscopy, endoscopy, homeopath, physical therapy, massage therapy, behavior modification... on and on and on it went.
She would honestly go 14 to 15 days between bms. It was a night mare. I understand what you are feeling. I can tell you - the only thing that finally worked for her was mineral oil (1 tablespoon am and pm), a sticker chart that we made and she placed a sticker on every time she went (we made a big deal about this - a special trip to the craft store for supplies, and got her pediatrician involved in checking her chart once a week), and prizes for every so many stickers. I think the part that really made this work for her was being held accountable by someone other than me - that was the reason for getting the pediatrician to help.
She was afraid to go and fear is a powerful motivator. I don't hink this would have worked if she wasn't ready for it.
By all means seek out a pediatric gastroenterologist - we had one with our local Children's Hospital. That was aslo helpful in actually getting her cleaning out so that she sisn't develop megacolon from holding. Good luck - you have my thoughts and prayers.

[chickster]

Hi thanks for your reply but we have tried everything like that he has been to see everyone imaginable, the next thing i think might be a child psycologist, he seems to have got worse, i feel awful i cant even take him swimming in the fear that he might leak in the pool from where he holds it in for so long he ends up leaking, i really am at my whits end with it, i just know that if he poo'd normally he would be so much happier and i would be too. he also doesnt speak clearly either does any one think this might be related because as i say he is 4 and 1/2 and i am just so worried about him. if anyone has any ideas please tell me.
Thank you

[Sportymom]

Hi my nephew has the same problem and his doctor diagnosed him with Encopresis. Encopresis is a complication of chronic constipation, and it is fecal soiling with the loss of semi-formed or usually liquid stools, which may be foul smelling, into a child's underwear. Once a child becomes constipated and has hard and painful stools, he will then begin to hold in his bowel movements to prevent it from hurting again. This creates a cycle that makes the constipation continue and become worse, eventually leading to a large fecal impaction and rectal distention (which can make the rectum less sensitive and unable to hold even small amounts of stool). Stool behind the impaction begins to leak around it, and eventually leaks out of the rectum, without the child noticing it or being able to hold it in. You may want to ask your doctor about this and its treatments.

[onroute]

I am not a professional here but definitly go to a Children's Hospital and check out his speech and the bm and the likely "fears" related to the bm.  

Talk alot about this for your own sake so you dont build up stress in yourself.

Hopefully you  have some friends to help "YOU" as well.  My prayers are with you as well and for all the children with this probably actually.

See your child as 16 and having overcome...it helps to see the positive and not live in the problem all the time.