5 1/2 year old pooping his pants

[puetz]

My son is 5 1/2 years old.  We have always had a problem with him using the toilet for bowel movements, but it was usually when he was playing outdoors, and he never fulled pooped his pants.  They were more like streaks in underpants.  He started Kindergarted two weeks ago and things have only worsened.  He had an accident everyday in school and they are not little accidents.  I have spoken to his teacher and have wet wipes and an extra set of clothes in his book bag.  I must also mention that there are times when he will ask us to wipe his bottom because he simply doesn't want to.
We tried to taking things away where he would have to earn the fun rewards back etc.  We TRY not to get angry, as we don't want him to be afraid to come to us in the future, but it is HARD.   When we take things away we usually try to say things such as, " Oh, I'm sorry you can't have ice cream tonight.  I'm sure you'll have it soon though." trying to encourage him to use the potty and implying that we have the faith in him to do it.  
My husband and I are feeling a bit helpless.  We don't know what other stratagies we could use.  I believe this is a choice for my son.  BUT, could it be something that we would need to take him to our ped. for?
Thanks for your help.

[Rebecca Resnik, PsyD]

Hello,
   your son's condition is known as encopresis, and yes it is absolutely something to bring to your pediatrician's attention. Encopresis is often caused by a combination of medical and behavioral factors, so your first stop should be your pediatrician. There are some medical conditions that need to be ruled out, though most encopresis happens after a child stops emptying his bowels routinely for a period of time. This often happens when children have constipation, because the stool grows harder and more painful to pass. When a child equates toileting with pain, he may avoid it and retain stool, thus making the situation worse. The child's colon can become stretched and he may no longer get the sensation of having to go. It does not take much in a young child to throw off his bowel habits, which can lead to stool being retained with leakage occurring around it (the streaks you have been seeing).

   Punishing him is very unlikely to help, as you have already seen from your attempts. Punishing him is most likely to make the situation worse and increase his anxiety (counterproductive when you need to perform an activity that requires the body to relax).  I recommend you ask your pediatrican for a referral to a pediatric psychologist with expertise in this area. The psychologist can help you manage your son's behavior in a positive way by teaching him healthy bowel habits and rewarding him for the desired behavior. I am sure you are frustrated by this situation, but keep in mind this is probably not manipulative behavior, rather a little child who is struggling to control his body.

Best Wishes
Rebecca Resnik

[mommyof2247]

A related discussion, My 5 year old son poops in his pants was started.

[puetz]

Thanks for the insight. We did take him to our ped. and sure enough he was constipated!  With a little help of MiraLax and Exlax, he is a new boy.  He is already showing more confidence in the bathroom.
Thanks again!