My 10 year old stepson still poops his pants

[Stepmom19]

My stepson has been through a lot in his life, and I'm wondering if that has anything to do with his lack of bowel control.  His mother used to leave him with strangers so she could be free to drink and do drugs, she even sank so low that she was living in a car with the children at one point (when my stepson was around 4 years old.)  She cleaned up her act when we filed for custody, but now my stepson (who is 10 years old now) is soiling his pants on a regular basis when he is with her.  This all started a few years ago, and when we took him to the doctor he was diagnosed with encopresis and immediately put on Miralax, which helped at first - but doesn't seem to now.  Everytime we pick him up from his mother's house he has soiled pants.  I'm afraid this is going to cause even more emotional damage with the embarassment and humiliation.  When he is at our house we have him on a schedule, he has to sit on the toilet about 35 minutes after he eats and try to go.  If he doesn't, then we wait 2 hours, then have him try again.  He says he doesn't know why he has accidents, and is very embarassed and sad about it.  I have tried to talk to his mother about it and she just wants to shove more medicine down him - blaming it all on encopresis - but I don't think this is the answer.  I am frustrated and worried about my stepson's emotional health, and his own mother doesn't seem to care.  He is fine when he is at our house because we keep a close eye on him and remind him to go, keeping him on a schedule really helps.  On the label of Miralax, it says "use no more than 7 days" and his mother has been giving it to him for more than 2 years (he doesn't take it when he's with us.)  Does anyone have any suggestions?

[Brooke050870]

I think it may be an emotional issue.  I say this because I knew two children when I was growing up who had been abandoned by their mom and weren't treated very well at home, and they had issues with going to the toilet, and at one point one of them was wearing diapers in his teens.  I do not think he had any physical problems that would have interfered with normal bowel function.  It seemed that he wore them because he wanted to go in his pants as opposed to using the toilet.  Long story short, it is very possible that your stepson's problem is an emotional issue.

[nlavh]

I have known children older then this having similar behavior. It was very much related to emotional health. As the family situation improved, so did the condition. The difference was, the children I knew were not always ashamed and would sometimes take it further to smearing or hiding their soiled clothes around the house--more so to prevent getting into trouble.

[mom@homenow]

It's possible that he doesn't feel it coming, that is not an unusual residual effect on a child who had encopresis for a long time. The muscles get stretched and the nerve endings don't always signal properly. He is having to re-learn the signals from his body that he has to go to the bathroom. The emotional stress he's had in his young life doesn't help, and this whole thing may not be a top priority in his mind... so he may not be trying very hard.

It's unfortunate that he doesn't stay on the same type of schedule when at his mother's house, of trying after meals. Unless he wants to take responsibility for going and trying on his own after meals, there isn't much you can do about it.

You can check with a pediatrician, but I don't think there's too much to worry medically about being on Miralax long term. When a child has encopresis or a fissure, doctors often prescribe it for 6 months or more. However, if the Miralax is making his stool very soft, that may also be adding to his inability to feel it coming in time to get to a toilet.