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Child Behavior Forum
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Avatar universal

Disturbing hygeine (lack of) habit in 10 year-old boy

My 10-year-old son (diagnosed as ODD but extremely smart, clever and social) consistently fails to clean himself adequately after BMs (sorry, I know this is gross). Trying not to humiliate him, we've talked about the importance of keeping oneself "clean and fresh" and now have flushable wipes within arm's reach and even offered to "help" (you can imagine the response to that one!). Still, his underwear are always badly soiled (it's not a problem of bowel control -- it's definitely lack of wiping). Isn't it abnormal for a boy this age NOT to care about possibly stinking and being teased or shunned for it? I've even made him take his dirty underwear down to the laundry tub each morning and scrub them with detergent (so he can see what I have to do each day), but even that is evidently not a deterrent.  He is generally "lazy" but I would think that if nothing else, peer pressure not to be "gross" would be kicking in by now. In case it matters, he does have some lower GI sensitivities to dairy and wheat, which we are working on, but I still expect him to clean up! Is this some kind of weird twist on the old anal-retentive neurosis? I realize that intentionally annoying/distressing us is one of the facets of ODD, but again, I'm amazed he's willing to risk grossing out his friends in this way (especially since he is himself quick to feel queazy in other ways; for example, if he sees someone's leftover fried eggs on the plate, he'll run out of the room gagging.  Same goes for if he sees another kid with a runny nose. Go figure.)  Any suggestions would be appreciated. Thanks. Sorry to present such a distasteful question for you -- hope you're not reading this over lunch.
6 Responses
242606 tn?1243786248
MEDICAL PROFESSIONAL
While you imagine that your son might be mindful of the compromised situation he might find himself in with peers, this is not foremost on the mind of a child so young. This behavior is not indicative of any serious pathology. What I'd suggest is a reward system whereby his access to favored activities (e.g., television, video games) is gained by following good hygiene practices.
Avatar universal
An anal fissure might be a possibility. That can make it impossible or very difficult to clean properly after a bowel movement. What can also happen with a fissure is that someone has a bowel movement, wipes up properly, but then more stool continues to leak after he/she has left the bathroom. If this is happening, it is not under your son's control, and there's really no way for him to avoid the soiling. Other possibilities might include a fistula or impacted stool due to constipation.

If he has other GI problems (you mention some issues with wheat and dairy), you might want to get him a GI work up for celiac disease (inability to digest gluten) and inflammatory bowel disease (which can cause diarrhea, fissures, and other GI symptoms).

Good luck. I hope you solve this soon.
Avatar universal
Thanks for that information. But in case there is no physical cause (fissure or fistula, etc.), can you think of any psychological significance to this habit (power play?)?  Thanks.
Avatar universal
I have an 8 year old daughter who might (not yet officially diagnosed) also be ODD who has the same issue.  In her case I don't think it is lazyness.  She just thinks it is to gross to wipe herself (but for some reason does not find it gross to have it in her underware) (go figure).  She does not have a problem wiping after she urinates.  My husband suggested having us wipe her when able but I refuse.  She will just have to get over it and start doing it herself or put up with the consequences.  I do make sure that she takes plenty of baths and showers (which I still supervise).  I am interested in what the doctor will have to say.

Good luck, your not alone!
Avatar universal
Sorry, I don't have any expertise in that domain. But I'm sure the doctor responding to questions in this forum will have some good ideas.
Avatar universal
Hi,
   I had a childhood friend who was always leaving "skid marks" in his undies until his mom said she would hang all his underwear on a line in the yard for all his friends to see:)
    She never did of course but he was a little better at wiping himself after that.
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