Help me please

[Shelly77]

My son is five, he has been potty trained since he was 2. We have never had any problems with bed wetting.  He has had a problem with constipation for atleast 3 yrs, we have been to the doctors several times about this, they always put him on a laxative and when he is on it regualary he is fine. When he is regular again I take him off it, now unless he is on the laxative he doesnt go, we recently went back to the doctor and they sent him for  an ultra sound on his bowels, but it came back fine. We have another apointment next week out of sheer frustration. Three months ago my son started to urianate on the living room floor and a few times on the couch....now in the past 4 weeks he has taken a bowel movement on the floor twice, I should mention that I am six months pregnant as well, my doctor has mentioned that perhaps this is behavioral, im confused as to wether it is a behavior problem or a physical problem and I dont seem to be getting any answers from our family doctor as to how I deal with it ....I am getting seriously sick of cleaning the rugs not to mention the smell....I have diciplined him for doing it but I feel guilty because im not sure if it is a physical problem. Please help me Im concerned that it could a physical problem that is going undiagnosed....

Thank you

[Shelly77]

thank you for your response

[Kevin Kennedy, Ph.D.]

There are two issues to address. The first is his chronic constipation. That indicates probable problems with his diet (assuming that all is otherwise well from a medical perspective). Be sure he is getting adequate fiber and liquids in his diet. It is important that he drink adequate amounts of water each day. A referral to a pediatric gastroenterologist would be in order if you want to be sure you are covering the bases medically. The second issue is his urinating and defecating on the floor. That part of the problem is not a medical matter, but more of an emotional/behavioral one. It would be prudent to arrange an evaluation with a mental health clinician to address this problem. For a child of your son's age, that sort of behavior is generally an expression of anger, though it's important not to make assumptions about this. It is regressive behavior, and it's important to figure out why he is regressing. An obvious point of concern is the impending arrival of a sibling, but again don't jump to conclusions about this.