Encopresis for a 5 year old going to school

[Ayushma]

My daughter has just turned 5 and we have moved to a new city at the same time. Since then she has been suffering from constipation followed by encopresis. The pediatric gastroenterologist had put her on stool softeners (Duphalac) which didn't work and I had to give her enema every third, fourth day to remove feces. Then he switched to Milk of Magnesium. This resulted in diarrhea after a few days and now soiling her clothes twice-thrice a day has become a routine though I had to stop the medicine. She feels bad when her clothes are soiled in school as helpers in school change her clothes everyday after cleaning and other children notice. Also, the helper scolds her every time she has to wash. Would it be advisable to put potty trainers on her to save her from embarrassment till she is cured or will it further complicate things.

[Ayushma]

Thanx Annie. I appreciate your suggestion

[AnnieBrooke]

I don't think she will stop trying if you put her in potty trainers.  And at least she will stop being punished for needing to be cleaned up, during the day.  Frankly, it sounds like the school she is in is very problematic, for that reason (adults should not scold kids for being out of control with their potty habits) and also because it sounds like her anxiety at being there is what started this off in the first place.  Some kids are bullies in the bathroom.

[Ayushma]

Thanks for your detailed response Annie. I am consulting a pediatric gastroenterologist currently who has put her on the stool softeners I mentioned above. He said it'll take 6 months to a year before she regains her confidence to use the toilet on her own. I think that using potty trainers is a good idea but was wondering what if she gets used to them and stops using the toilet altogether.  She has never had this problem before though she has been in a playgroup and kindergarten. But when we got posted to Thailand 6 months ago, she started having hard stools followed by encopresis. What really worries me is what happens when she starts her school in August.

[Ayushma]

Thanks for responding RockRose. She has been going to a kindergarten since she was 3 and doesn't like to be kept home. Proper school starts in August and I just hope she gets better till then though the pediatric gastroenterologist I take her to says that it takes 6months to year to cure it. I am having sleepless nights

[RockRose]

I don't know what your school system is like in Thailand,  but in the US,  she wouldn't be in school at this age.  So here,  she would lose no ground whatsoever if she were kept home until this problem can be solved without embarrassing her further.

Is this daycare you're talking about or is she actually in school,  and she'll be held back a year if she misses time for a medical issue?

[AnnieBrooke]

I think you should put her in potty trainers so she won't add an embarrassment load to the problem she already has.

In my son's school, there is a lot of teasing around going to the loo, and the kids are in the children's bathroom together with no adult to supervise (at least, the boys are, because there are only about two male staffers in the whole school).  This causes him to be unwilling to go the bathroom at all, and he "holds" it so he won't have to.  I'm encouraging him a lot to go to the loo immediately on coming home, and also have talked to the school's principal about the whole issue.  In other words, shyness or feeling bullied in the bathroom, some kids just handle by not going.  They don't think of telling anyone, they just think it's their problem to solve by avoidance.  Did your daughter begin to have this problem when she was first in a group with kids?

I don't know what products are available to you, but Benefiber is a good powdered (and tasteless) stool softener, much more gentle than Duphalac, it goes in the juice every day to keep things soft and moving.

Your poor daughter, between the enemas and the scoldings and the embarrassment and the trauma, this needs to be solved.  Ask your pediatrician to recommend a pediatric gastroenterologist.