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376008 tn?1312484756

6 year old doesn't want to poop

I hope that I'm in the correct forum for this.  I have a 6 year old (7) in June of this year who does not like to poop.  He was potty trained fairly quickly when younger and had no real problems.  A few years ago, I noticed that he would go for days without having a bowel movement.  When I'd ask him about it, he'd tell me that he didn't have to go, though it was obvious that he did and was holding it in. If he was standing, he'd run to a chair or the floor and sit down and rock or shake his legs or something.  I took him to his pediatrician who thought that possibly he'd had a very large bowel movement at one time and it caused some pain. (He is rather small. At almost 7 yrs of age, he is in a size 4)He believed maybe this made my son apprehensive about going for fear of the pain.  He put him on a bulk stool softener.  This did help him go more often, but only because he can only "hold it" for so long.  For a little while it got better.  He hasn't been on the softener for over a year and half.  However, this is still a problem.  I can tell when he has to go, though he will deny it every time.  I've tried everything from trying to explain how it can hurt his body to hold it in, not allowing him to go places if he hasn't gone and I know he has to go, and even rewards for going. On the rare occasion that he does go without holding it, I'm always quick to tell him how proud I am that he isn't holding it in.  Every time he goes, I ask him if it causes him pain and he says no.  He says that he doesn't like the way it feels.  I've explained that he will have to poop for the rest of his life, regardless of if he doesn't like the feel of it.  He's never constipated and his stools always seem soft, though formed.
Then, last week, he said that when he goes, it hurts his stomach.  At first I thought maybe this was his stomach cramping up when he has a bowel movement.  But I asked him to show me where it hurt and he pointed to his lower abdomen and then also pointed up higher in the center of his torso.  
Is this most likely a psychological issue?  Or can it be medical.  It's not that he doesn't HAVE to go.  By his behavior, I would guess that he would have a bowel movement every other day at the very least.  The urge to go is there, he just holds it and holds it and holds it.  If I wasn't watching, he'd hold it for up to 5 or 6 days.  Could this be a medical issue?   Should I take him to a specialists?  I'm at a loss as to what to do.  Any suggestions or comments are appreciated.  
74 Responses
Avatar universal
I have known other children who would hold it in because they found the act of defecation very unpleasant for some reason or another, even though it was not painful.

If his stools are normal, and he has the urge to go, and this issue has been going on for that long with no other symptoms, then the chances of him having a medical issue are pretty low. However, you mentioned that he is very small in stature. You may want to consult a specialist about small stature/ abdominal complaint/ defecation issues -- just for your own knowlegde and to rule out that there is a medical issue.

In my opinion, it is most likely that he just really has an aversion to defecation. It could well be sensory. It could be that he does not want to take the time to do his business, so to speak, because it will take him away from playtime, or something more enjoyable. I knew one kid who hated the smell-- and held it it until he actually DID develop a serious medical condition.

If it were me, I would rule out with a phone call or two any possible medical causes, and then I would consult with my pediatrician again, to get advice on what to communicate to him so that he will be encouraged to feel more comfortable about this body process. Because as you mention, it ain't gonna stop:)
376008 tn?1312484756
I'm certain that the "unpleasantness" plays a part in his feeling.  I wasn't really too worried before because he had the urge to go.  This is why I didn't want to keep giving him the bulk laxative. Because he wasn't having a problem going.  His problem is that he won't go when he has to.

It was when he mentioned the pain in his upper abdomen that raised concerns for me.  Though I am well aware that he could also be using this a way to keep me from pressuring him to go.  I've tried to explain to him that he could hurt himself inside if he continues to do this.  

I'm uncertain who to call with questions on the phone.  Possibly I should take him back to his regular pediatrician first who can recommend a specialist.  Possibly if I run this question thru the pediatrician expert forum here I could get some feedback?
Avatar universal
I think running the question by the expert forum here is a good idea. It might give you some more direction about where to take him for additional evaluation.
376008 tn?1312484756
Possibly it takes awhile to post question in the forum.  I've tried yesterday and it stated that the max amount of questions had been asked for the day, and to try the next day.  I am able to post only while at work during breaks ect, so I tried frist thing this morning and guess what-said the same thing.  Busy place :-)
Will keep trying.  Tried talking to my son again last night about holding it in and how it's possible that it could hurt him if he keeps doing it all of the time.  I asked him if it hurts "inside" or "outside" when he goes and he said a little bit of both.  When asked, he also said that it doesn't hurt quite as bad if he holds it for "awhile".  The problem is, "awhile" can be 5-6 days if I didn't hold the box of suppositories in my hand for him to see.  I'm wondering if the longer he holds it, the less he has to "exert" himself, for lack of a better term, when he does finally go.  Though he never appears to be straining in any way.  

I'm amazed at how many past posts I've found on children holding in thier BM's.  I had no idea it was this common.  though many of the other posts state that their child won't go in the potty, just goes in their pants.  My son doesn't do this. He just won't go
Avatar universal
As for getting on the expert forum, yeah-- I definitely find you gotta be up like super early to get in there!!! Sunday AM seems to be best time.
And overall, I am sure that in about 10 years, when he is driving, and dating girls, and talking about college and sports and all that-- you won't even really remember today:)
Avatar universal
This sounds exactly like what we've been dealing with with my 6 yo son and 3 yo daughter. . .

We've given them daily milk of magnesia / miralax for years. . .  I don't like to, but the alternative is that they'll hold it for, yes, 5-6 days and end up passing very painful BMs. . .

We have them sit on the potty each day after lunch and supper to try to poop.

The fiber/ stool softener combined with 2-3 daily sit-on-the-potty times is what their doctor proscribed when I first asked about it when my son was 18 months old. . .

I wish this condition had a name.  It seems like a fairly common problem with a definite set of symptoms. . .  I guess I'm thinking that if it had a name, we could talk about it more easily and learn more about it. . .

I had constipation issues as a child and I outgrew them completely as an adult. . .    I wonder if we'll just be dealing with daily meds, manditory potty times, poopy accidents, pain and tears, and the frustration of watching them fight their urges to go - until they are all grown up. . .  I remember my mom having to clean up poopy messes, rewarding me for pooping in the potty when I was in elementary school, and giving me fiber supplements even in high school.

It is pretty disgusting and frustrating, but I guess it could be worse. . .

My main concern right now is reminding myself that it is counter-productive to argue with him about whether or not he "has the feeling" to go. . .  This damages our relationship. . .  My job is to give him his meds, maintain the regular potty times, and increase his meds if he doesn't poop in a given day, clean up messes, and wash my hands very very well. . .


Avatar universal
I found this topic because just now my daughter was in so much pain that I thought I was going to have to take her to the doctor. She is 4 yrs. old. She has a tendency to hold her poop for days. But, she has never complained about any pain since she has been potty trained. Back when we were still in the potty training process, she would not go poop for many days. Then, she would go behind the couch and start crying in pain and have a really bad BM. When we caught her doing this, we would set her on the potty. It took her a long time to get trained. She finally just decided a couple weeks before Christmas last year when she was 3, that she would finally just go. But, since then she still holds it. But, she does go eventually and never complained of pain. Back to today. She ate and then all of a sudden said her behind and tummy hurt. She mentioned that she needed to go poop. But, she wouldn't go. Them, when I was explaining that she was hurting because she had to go, she then refused to admit she had to go. Then, she was arching her back so much and said her tummy hurt under her belly button and above it. So, I started worrying that there was more wrong with her. But, then as I was looking up info about abdominal pain and when to seek emergency care, etc., she bent over and started crying and pooped on herself! She has not pooped on herself since she was 3 and going behind the couch. Anyway, I took her to the bathroom and helped her clean up and she had a lot more to go. I mean, it looked like 3 weeks worth of BM, if not more. Anyway, now she is back to normal and that was all it was! No doctor needed. But, it still worries me why she is refusing to go. Maybe there is a medical condition that cause these kids to not want to go. Or maybe it is just part of the potty training. Even though they do eventually go and don't mess on themselves. They still are not fully trained if they are having issues with it like this. Unless of course it is medical.
376008 tn?1312484756
So Sorry,  I've not had a chance to be on this site for a very long time.
Kind of an update:  My son is now 8-1/2 yrs old.  He is MUCH bette than he was about holding BM's.  But he DOES still do it.  Many times when he has to go, he'll just go.  But there are still plenty of times where he holds it.   I've gotten very good at seeing the signs of when he's holding it.  I don't make a big deal about it.  When I notice it, I may say to him, "why don't you go in and go to the bathroom.  I can tell that you have to go".   Usually he denies it, and I just say "OK, but if you hold it it will just make you stomach worse, we already know this don't we Nate?".  I do not force him to go, and eventually he will go in by himself.  There are rare times when I know he's held it a long time time and I'm certain he has to go but is ACTIVELY holding it in and I'll tell him that he will not be going to the party he's been invited to the next day (or whatever exciting activity he may have) if he has not gone  to the bathroom. I remind him that he will spend his day finding a place to sit down until the urge passes and won't have near as much fun.  That usually gets him to go.  While it obviously is a concern healthwise when our child holds it, and I do believe we must really be vigilant in keeping track of it, I've learned the best way to handle it "hands down" is to NOT argue and NOT force.  It does no good and only seems to make them hold it more.  I've tried be sure he understands that HE is in control of his body and that HE is the one who can make the decision to go when he has to.  I think he still doesn't LIKE to go, he just does NOT like the feeling.  But he's learned that he will really will eventually HAVE to go-it won't go away. so he's gotten better.  All I can say is have patience.  Difficult as it can be.  It's taken alot of time for my son to get to the point he's at.  Good luck.  
Avatar universal
Thanks for the follow-up.  We have an 8 year old with very similar behavior.  I have been finding a lot more stained underwear.  As others have said, going at school is out of the question.  At times, I am sure we go 4-6 days, but then there are periods of every other day.

While reading the posts, I had was racking my brain for any "regular" activities in recent memory that were followed by a bowel movement.  BATHs.  Jackson hasn't taken regular paths in a few years, but as I thought about it, I would guess that 50% or more of his baths are interupted by the need to sit on the toilet. Not a pretty picture, as I write about it.  We are going to try nightly baths to see if his frequency improves.  I'll report back any results.  -- RS
Avatar universal
Sounds like he'll need hospital treatment for encopresis - sorry (for both of you)!
Then again...if threatening him with the suppositories doesn't motivate him to do the doo, maybe the fear of an enema will do the trick?!
1235878 tn?1267884994
My 5 year old son has had this problem for the last two years since he was potty trained. It seems to have gotten worse recently. I'm at my wits end because he just point blank refuses to go. He says he doesn't like how it feels. He will go for up to week without going to the toilet when I can see he is desperate to poo and then has to have his underwear changed about five times a day because they are dirty. I am constantly washing his butt because he smells bad even though has a bath daily. I have to sit him on the toilet and encourage him to stay there several times a day but he refuses to push it out. I try to explain to him that he has to poo but he just ignores me or changes the subject, or he gets angry and covers his ears while shouting at me to go away. Apart from this he is a great kid and doing really well at school and has very good manners etc, but I am so worried that this problem will have medical implications for him. I have given him a stool softener which doesn't seem to work because the poo just comes out in small bits in his underwear. He has also gone in his pants in his sleep and obviously this is only because he is unconscious he is doing it and his body just loses control. I've tried reward charts which have worked temporarily but before long he goes back to holding it in. He will lie on the couch wriggling his legs and arching his back and he's obviously desperate. I can't keep forcing him to sit on the toilet and I want him to go by himself but its been going on for two tears and I really thought the problem would be solved by now. I am taking him to the doctor on Monday and I hope there is something which can be done.
1235878 tn?1267884994
My 5 year old son has had this problem for the last two years since he was potty trained. It seems to have gotten worse recently. I'm at my wits end because he just point blank refuses to go. He says he doesn't like how it feels. He will go for up to week without going to the toilet when I can see he is desperate to poo and then has to have his underwear changed about five times a day because they are dirty. I am constantly washing his butt because he smells bad even though has a bath daily. I have to sit him on the toilet and encourage him to stay there several times a day but he refuses to push it out. I try to explain to him that he has to poo but he just ignores me or changes the subject, or he gets angry and covers his ears while shouting at me to go away. Apart from this he is a great kid and doing really well at school and has very good manners etc, but I am so worried that this problem will have medical implications for him. I have given him a stool softener which doesn't seem to work because the poo just comes out in small bits in his underwear. He has also gone in his pants in his sleep and obviously this is only because he is unconscious he is doing it and his body just loses control. I've tried reward charts which have worked temporarily but before long he goes back to holding it in. He will lie on the couch wriggling his legs and arching his back and he's obviously desperate. I can't keep forcing him to sit on the toilet and I want him to go by himself but its been going on for two tears and I really thought the problem would be solved by now. I am taking him to the doctor on Monday and I hope there is something which can be done.
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