12-year old boy poops pants daily. Parent enabled?

[jodykip]

jodykip posted:
I read bit and pieces of my question/problem, but never the whole thing.

My fiance's 12-yr-old son poops his pants every day, and still wets the bed. It isn't encopresis (I don't think). His parents split when he was 2.5, he was frantic and his mom "didn't have the heart" to discipline him for toileting. So today, his idea of bowel control seems to be "hold it until school is out" and "weekends are free."

He's coming to live with us this month, and maybe will stay for school in the fall. I love him to death. He is bright, wry, a crackerjack student and athlete, and a perfect small replica of his gorgeous dad (I'm marrying a great guy!). But I feel like I can't quite accept him because of the pooping. (He wears something like a diaper or pull-up to bed, and I don't mind that.)

I want to get a handle on this so I can understand it and help stop it. Can parents enable this? His mom is hostile to me, but once we were talking about Jack (the son) and she said "I was changing his pan . . . " -- and she stopped. I said, "You change his pants?" But she wouldn't answer, and seemed embarrassed. I know that his dad used to change him, and still will clean him up in some circumstances, like if he's dirty at bedtime. So, if parents do this, does it enable to kid? I'm sure there are no consequences for pooped pants at his mom's, and few here (he has to stop what he's doing and go change).

Jack himself never mentions that he has pooped, but he will admit it if you ask, and will go change without resistance (thank God!). But he doesn't do a very good job, because I don't think he knows how. I've bought a hand-held shower for the bathtub, and a hand mirror. I want him to put the mirror on the floor and to stand over it so that he can see if he's clean. Will this help?

The reason I don't know if this is encopresis or something else (like habit) is that the "accidents" never happen in school, but otherwise aren't real predictable. He poops 1, 2, or 3 times every day, but at different times. The poop that I've seen looks completely normal. I mean, not runny/pasty or pellets, like enco. (See, I've done some research.) He will go pee, and while he stands there, he might dirty his pants too. We've talked a little about his accidents, and he's told me that he feels it too late, and that it starts by itself, but he has to "finish it off." I think he has control, but that it comes and goes. Or something.

The "accidents" make me push him away even though he is such a great kid, and I want to embrace him as if he were my own son. I feel guilty. For instance, Saturday before Memorial day, we all went to a concert on a big lawn. It got chilly, so I invited him to lean against me, and I put my coat and my arms around him to keep him warm. Fine. I felt like a great mom. Nuzzled him, kissed the back of his head, and so on. But in about 5 minutes, the odor began, and I realized that he had just dirtied his pants as he sat there. I had to push him away. I said, "Jack, you poopied your pants and I just don't like it when you smell." He seemed a little surprised (I don't know why, since I've mentioned it before), and slid over to his dad, who took him in. And I felt like I'd rejected him.

So, it looks like pooped pants are going to be "business as usual" in our house until I can figure a way to interrupt it. Sorry to run on about this. Any ideas?

[Sandman2]

   Couple of thoughts.  Kids of his age don't like to go in school.  The bathrooms can be a nightmare - particularly if you are one of the younger kids.   Thus, he could be holding it all day, and then just can't control it once he gets home or on the way home.
   Also wonder how he does at school.   Sounds like he is a very sharp kid, but if his grades has lately begin to fall that could be an indication of ADD.  There is a good link between AD/HD and wetting accidents.  See http://www.medscape.com/viewarticle/752076?src=nl_topic.   Basically, "Children with ADHD also struggle to manage multiple activities, and might neglect to address the urge to urinate while they're occupied with other tasks."  And I would think that this would also apply to pooping.
    Mirror is a bad idea.  Get those "moist wipes".  They work better and are easier to use anyway.  Tell him to use them till he sees nothing (or very little on it).
   Make sure he gets enough fiber in his diet ( a good cereal will help), and that should also make him more regular.   And of course, plan ahead.  Going to a concert - hit the toilet first.
   But essentially, he sounds like a great kid.  He is now at an age or almost at an age where he will want to deal with this.  Work with him and his dad.  Don't use embarrassment as a tool.  Hope this gives you some ideas.  I'm sure other will post too.

[skepticalpeach]

Is it possible he has any allergies that are causing this? For example he could be lactose intolerant, have IBS, or any other food allergy. Has anyone spoken to his doctor about this? I wrote a journal about this http://www.medhelp.org/user_journals/show/320368/PSA-About-Little-Kids

I would also look into what Sandman said about ADD. Bathroom problems often accompany many developmental problems so I would ask his pediatrician if he needs to see a developmental pediatrician.

[jodykip]

Thanks for your thoughtful responses.

Writing this out yesterday actually clarified some thoughts I've had, and I probably should have waited to post a different version.

Unless there's such a thing as "intentional encopresis," I don't think we're dealing with enco. I think his soiling is a deeply ingrained habit, greatly reinforced by his mom. If she is still involved with changing his dirty underpants--as I believe she is, and believe his dad can also be--then I think he's being "rewarded" for soiling, or at best, not facing negative consequences for it. She has certainly made efforts to accommodate the soiling: Costco quantities of wipes, and dark-colored briefs only--because they hide stains and confine the accidents. (The bedwetting is a separate issue.)

I need, NEED to have a candid talk with his mom. But she is hostile to me, maybe jealous, and maybe embarrassed about the soiling. Jack and I talked only once, briefly. He just shrugs, doesn't see it as much of a problem--and of course he wouldn't since consequences are rarely negative. He knows that other boys don't dirty their pants. I asked if he wanted to stop and he said that "part of me does, part of me doesn't." I asked if he would miss it, and the question seemed not to compute--as if he'd never thought of it or couldn't imagine it. And there we stopped, as he probably began to think that I'm up to something.

So, I'm needing to break into a well-worn habit, I think, and I'm unsure how to proceed without instant resistance. We'll have him all summer and likely for the year (he wants to ski). Helpful ideas are always welcome.

[JC137]

The only thing you "need" to do, is love the child.

[Sandman2]

   You mentioned that his accidents never happen at school.  That probably is an important observation - if it is true.  Are you sure about that.  Got a feeling that he wouldn't admit to it and you don't talk with his mom much - if at all.  Anyway, its really important to know that!  And it may just be that his bowel habits don't come into play till later in the day - so he is fine at school.  But I think you can see why knowing for certain what is happening at school  is important.
    I just have a bit of a hard time believing it is a "well-worn habit".  Its certainly possible I guess.  Its just that dealing with a habit is one thing and dealing with a condition that maybe he has no control over is another thing.  For example, take a look at the post by Barbara in this link http://www.medhelp.org/posts/Child-Behavior/12-year-old-boy-smearing-poop-/show/585404#post_7653465      and you can get a feeling for how complicated this can be.   Which really leads to the question - has a doctor ever been consulted about this?  I would certainly go that route first.
   Of course, breaking a well-worn habit is also very hard to do.  I would say almost impossible with out the willing participation of the person.  
    I would think that it might be best (outside of seeing a doctor) to take it easy and work on some behavioral modifications.  Such as sit down when you pee, so you don't have mistakes.  Hit the bathroom before leaving the house.  You will have control over his diet since he will be with you this summer - that could be helpful.  It may be that as he spends more time with you and starts feeling more at home - the situation may resolve itself naturally.  This is a tricky situation and I would proceed with care ... and love.

[RockRose]

I agree with the others,  and think you're asking the right questions with the right helpful attitude.

I do think,  though,  that although you don't feel he gets negative consequence,  surely a 12 year old boy soiling his pants has GREAT fear that this will happen in a social situation - if in fact,  he can't completely control it.

Very interesting and insightful of him to truthfully say part of him wants to stop and part of him doesn't.  I wonder what apart doesn't -

Best wishes - I wish you success this summer with this problem.

[jodykip]

Thanks again.

You know, I have the strong suspicion that Jack PARTICIPATES in his soiling. As opposed to trying to avoid it. I can guess why that might be true (a bond with Mom?), but I'm unsure how it manifests. At worst, a completely deliberate and conscious defecation, held until he is in a setting where he won't get into trouble for it, and won't need to clean himself up. Better (I guess), careless slippage that he then has to "finish off" (as he has said), but miraculously, usually in a place where he can get away with it--or just get away.

I know that he comes home from school with poopy pants. His dad says that the school has never called about an accident in session since the first grade, and his mom (I need to TALK to this woman!) says it happens on the walk home, or in the car when she picks him up. And then again at about 7PM-ish. Just not in school or while among his friends. (I think.) Saturday morning is a sure bet. Sunday too. All this makes me think he is aware of his needs, and able to manipulate them for his own purposes.

I'm hoping that this is all just a habit, like biting nails--which I used to do, so I know how automatic it is, and how annoying it is to stop. But as RockRose says, it's significant that part of him doesn't want to stop soiling--or put differently, wants to keep on soiling, want to keep things as they are.

Something in him is being served by this.

He'll be here next weekend for the summer. I intend to have a long, good talk with him on the topic. I'm making a list of questions. Anyone have any suggestions for the list?

Thanks again.

[JC137]

Bet you and the husband are divorced, you just take the advice, you had to stomp all over his mom and dad. Just curious, are you still married to this kids father?

[RockRose]

Jody,  some thoughts come to mind.  This seems like a ritual,  to me.  Rituals are sought for SO MANY reasons.  Among them,  a reduction of anxiety that comes with routine,  and another common reason is a strong desire to control some aspect of their life.

There are many other reasons for rituals - and I think you need to find out what is causing him to engage in this one.  

I suspect,  reading what you are saying,  that this child is seeking the ability to control himself and his mother in this ritual.  This seems like he's in need of being able to control a facet of his life,  and also exert control over his mother,  and what more perfect way than to make her clean up his poop in a scheduled way.

Is it possible that he feels he has no control at all in his life (can't control what and when he eats,  what he wears,  when he goes to bed,  etc.) and he's aching to take some measure of control over himself?

[JC137]

Thank you, finally, someone that has read up on the subject instead of assuming they know it all.

[specialmom]

A couple of things really stand out to me from these posts.  First, where does the boys father stand on this issue?  What is HIS plan of action to help his son?  When issues like this arise in a household, especially when it is a step situation, that is the place to start.  Is his dad fine with it all?  Does his dad want to work on this?  What are his father's ideas?  You really need to and have to start there.

I would try to think of this as simply a boy that has an issue.  In terms of urinating, you'd be surprised how many kids into their teens are still night time bed wetting as they don't get proper signals to rise and go.  If you feel that there is a psychological componant with this behavior, then I would talk to his father and start this summer with a psychologist specializing in children.  Talk to the psychologist beforehand about this issue.

Because here is the thing.  For the parents and this child, it is a touchy subject.  When you mention his mother changed his pants . . .  well, that is a usage of words probably from his childhood and I wouldn't picture him actually changing his pants, but rather that she is helping him when this happens in a way a mother does when they feel badly for their child.  Families do get into habits of feeling empathy for their child and trying to minimize a problem which is perhaps what his mother is doing and perhaps his father as well.  

I would talk to his father.  Not in a judgemental way or any of this talk of parents enabling.  That is offputing.  Rather, talk about your great concern for this boy who will certainly at some point face social consequences due to this behavior.  What can the two of you do to help him work through this??  That type of conversation rather than any of the other talk.

And when you talk to this child, think in terms of his emotions.  You can tell him that we have certain rules and one is that everyone takes bathroom breaks on schedule.  ????  Or whatever.  Don't make him feel like he is a freak or something.  If you've 'heard' that he goes around 7 ish, then around 7 ish, remind him that it is his bathroom break time.  Heck, put some books or something in the bathroom that he can look at.  If he does soil himself, then you simply say, please go change and put your underwear in the trash.  Then he has to do a job to earn money for a new pair.  No embarressment or shaming.  But matter of fact.  Natural consequence for what has happened.  If you are out somewhere and he soils, he changes there and again, throws the underwear out and does a job to earn money to pay.  

These are just some suggestions but really first, you and his father have to get on the same page.  good luck

[JC137]

Very well put.

[JC137]

Don't think the person asking for help, got it, as they continue to push that they are the ones who "needs" to do this and that.

[jodykip]

Specialmom:

Thanks. In fact, you're exactly right about his dad. In anticipation of Jack's arrival, we're going to sit down tomorrow to have a long talk about our logistics and so on. The soiling is going to be a big part of the conversation, because as far as I can see, Mike (my finance, Jack's dad) is willing to let it slide. Since we're approaching this together for the first time, as a team, I think I can mold a different approach, lay out a strategy. (And no, I'm not a person who tries to "change" people.)

"Change" is an important word at this point, isn't it? Regarding Jack's dirty pants, I strongly suspect that his mom in fact changes him, i.e., does the wiping and handles the dirty underpants. And, I'm afraid, so does his dad: the night of the Memorial day concert during which Jack pooped, we got home very late; Jack went to his bedroom (not the bathroom), Mike followed, and about 20 minutes later joined me in our bed. I swear there was a faint odor of poop on his hand.

So, I need to find out about these things. Stay tuned.

Suggestions are always welcome.

[JC137]

Ugh. Yeah, that not kids fault if dad hand smelt. Really? Good luck.

[specialmom]

Well, a big suggestion is for your fiance to was his hands.  No reason anyone whether they've recently dealt with helping to clean their child up should have a lingering odor of feces afterwards.  That is unsanitary and odd on his father's part.  

Again, I would take out any judgement as to how things are handled then and now but rather just come up with some ideas to help the boy along.  You'll get a lot farther.

good luck with the conversation.  I would say if your fiance is unwilling to help you help his child, I'd see that as a reason to end the relationship.  You aren't on the same page regarding something you view as important and the troubles will grow from there.  good luck and hope this will work out for you all.

[jodykip]

Hi, I just needed to say that he did wash his hands; as you know, the smell can linger. He's very good about his personal cleanliness, sanitation and housekeeping. What he hadn't done was use latex gloves (I guess that's what he'd use) because Jack's mom hadn't packed any with his underwear and wipes.

Thanks for your response.

[specialmom]

Okay, but ya know, I don't think the smell of changing a poopy something is going to linger.  I've changed a lot of poopy somethings in my day and did not have a lingering odor nor did I use latex gloves.  Have you changed a diaper or a person before?  You don't put your hands right into the feces, right?  

Something is not making sense to me in your story, I'm sorry to say.  but good luck

[specialmom]

Regarding night time wetting which I see you also mention, again, that is a lot less common than you may realize.  Up to 12% of all kids wet until age 9 and then the percentage trickles down each year with plenty still doing it at 12 years old.  Sound sleepers are most susceptible and most late bed wetters had one or both parents also wet the bed until the later years.  

I find your constant reference to smelling poop and parents 'changing' the boy as odd.  I would potentially help a child who soiled himself by taking the clothes and handing him things to clean up.  What are you suggesting his father and mother are doing?  Laying him down and cleaning him like a baby or toddler?  

[specialmom]

I meant MORE common that you realize (said less for some reason).  sorry

[jodykip]

Laying him down and cleaning him like a baby?

Yes, that's exactly what I suspect: doing the cleaning for him. And that's what I'm going to find out about.

As for lingering smell: I've changed infants without benefit of gloves, and careful as I was, I recall occasional feces on my knuckles and, in any case, a lingering smell of feces/baby wipe on my hands. It didn't last long, but it was there immediately afterward, even after washing.

The bedwetting is a separate issue (I think, I hope) for which I'm going to propose purchase of an alarm. What does it matter how prevalent it is at his age? I intend to provide him with tools to end it.

I'm trying to get my ducks in a row so that I know what I'm talking about and know what I'm doing when I raise these issues seriously. I need to make a plan of action. I've been reading about encopresis (which this might not actually be) and about enuresis. I've posted my question here (and elsewhere) for additional perspective and ideas. I appreciate what's come to me.

As for Jack himself, he is very forthright about admitting an accident, if asked about it, and will go change his pants without resistance. But the result isn't very thorough because, I suspect, he has little experience doing it for himself. He wants to please me. We haven't yet talked seriously about his soiling, but I'm sure that he understands--intellectually--that boys his age don't poop their pants, even in the privacy of home with just mom or dad there. But how he connects to that fact emotionally, I'm still guessing.

Thanks for your response.

[specialmom]

Well, it is odd for both a mother and father to lay down a child of twelve like a baby and change him.  Something psychological in all three of them?  

The reason why the prevalence is of importance is that it may give you more empathy to the problem and not have it be something you blame the parents for.  Processsing in order to wake up from a deep slumber is difficult for some children.  I've heard of some alarms working and you can also wake him at night at specific times and walk him to the bathroom.  I wake at routine times myself out of habit, you can help build a habit.  But is important to realize that a parent doesn't cause a child to wet at night or enable it.  Or that a child is bad for doing that.  You sound like you are on target to help him overcome it as I'm sure he wants to.  Kids that wet at night suffer socially.  Sleep overs become an impossibility.  So, I think it is good to help him work through it with out thinking he is so strange for doing it.  

As to the pooping.  What you describe is such that i think you need to seek some professional help of a psychotherapist/psychologist to understand more about this boy and his parents.  

And clearly, talk to his father.  Good luck  BTW, why is this boy leaving the custody of his mother (in terms of where he lives and goes to school)?

[Sandman2]

   Going back to two things that you have said.
One:  "I know that he comes home from school with poopy pants. His dad says that the school has never called about an accident in session since the first grade, and his mom (I need to TALK to this woman!) says it happens on the walk home, or in the car when she picks him up. And then again at about 7PM-ish. Just not in school or while among his friends. (I think.) Saturday morning is a sure bet. Sunday too."
   That really does make it sound like he does it at school.  His mom has no clue when it happens.  If he can't control it at school, then he can't control it at home.  Kids of his age (due to peer pressure, etc.) just don't poop at school without a very good reason.  And the point is if he can't control it at school, then most of your reasons for why he is doing this are false.  Thats why I keep coming back to this point.
   You also said, "but I'm sure that he understands--intellectually--that boys his age don't poop their pants, even in the privacy of home with just mom or dad there."   And I agree with you completely!  Thats why I think that there is more going on here then just "him being rewarded for soiling."
    If he is a normal, great kid in every other respect - then why would he be doing what he is doing unless it was something he couldn't control.
    And I still am curious about his grades.  Have they fallen at all lately in any subjects like math?

[nola0805]

I think that you will have a hard time changing anything in this dynamic without both parents or at least the father fully on board.  This is ultimately up to the parent's.  You may disagree (we may all disagree) with how they are handling it, but that does not matter.  What matters is what will work and as long as they condone the behavior, it will continue, and you are perhaps setting yourself up for a battle with his parents and with Jack yourself, unless you get at least the father on board. It is clear that you care for this boy and want to help - that is wonderful, but I would suggest changing tactics if you want to help.

As others have suggested, I would start by getting more information, including talking to the boy's pediatrician. There is a chance that this is not intentional on his part, and I would not suggest treating it otherwise until these stones have been thoroughly unturned.  Right now it sound like you are drawing conclusion without the full information. I would start with a non-judgmental conversation with the father - key here is non-judgmental.  Remember, you want to help, not point out how terribly they have handled this. Most people are simply trying to be the best parents they know how to be.

Lastly, please keep in mind that shaming Jack will only serve to make the problem worse, no matter what the cause.

When you have more info and if the father is on board, then I can offer more suggestions then.

Good luck.

[Trialanderror]

Jody, your post and all its comments are a truly useful resource of thoughts on the subject and I hope you will all be able to look back at this poo dilemma as a "brief moment in history" without much drama.

My 10-year-old has gone through episodes such as your boy, less the bed-wetting, not on a daily basis - but about once a year for about 3 to 4 weeks from the time he was initially toilet trained. There were all kinds of physical and psychological reasons, not just one per se.

Based on a few tearful recent conversations with my son and based on observations over seven years, I could summarize as follows:
1. The Physical Trigger:
- the episodes have always been triggered by food intolerance and/or antibiotics (intolerance to artificial sweeteners or natural sugar substitutes)
- the "product" is neither constipation nor diarrhea but similar to what you would get after eating three bowls of oatmeal
2. The Physical Worsening:
- spending more than 9 hours at school (or daycare) without a moment of privacy, holding it in
- holding it in causing a loss of sensation at an earlier stage, thinks he has to go only when it is almost too late
3. The Emotional Worsening (Child):
- feels embarrassed even if not expressed
- anxious about timing, anxious about reaction by others
- can lead to denial, sadness, withdrawal, anger
4. The Emotional Worsening (Parent):
I made the mistake to search for behavioral and emotional answers only, questioning my son early on, only to realize that due to triggers above, he actually had physical issues. I used to get angry. In my son`s eyes, from infancy, I must have evolved from someone who "makes diaper changes fun" to a poo-furious mother. Needless to say - he recently asked me to mind my own business and to realize that everyone has some sort of problem to deal with.
We have an agreement that I do not interfere much but he cleans himself as quickly as possible should he ever enter another episode. Also, he avoids the triggers as much as possible. In addition, I am searching for more opportunities for my son to be his own boss so the focus can shift away from the poo topic.

I know this does not fully reflect your situation but from my perspective it is important to instate a few rules/procedures you can all accept. This is luckily what you seem to be doing anyway. After the conditions are set, just drop the subject and let the child take the lead. It is easier said than done when certain odors are present but respectful. Wishing you all the best.

[allmymarbles]

Maybe it is time for people to get angry. Let's face it. His behavior is disgusting. And it is willful. He controls himself at school and saves these treats for when he is at home. It is an ingrained and nasty habit that gains him lots of attention. Why he developed the habit doesn't really matter. Don't put up with it.

[Sandman2]

     Unfortunately, getting angry will not solve the problem.  And while his behavior might be disgusting, there is no way of knowing if it is willful or habitual.  As Nola, trialanderror, and specialmom have pointed out - this will take some time to gather information, caution and wisdom.  And I think perhaps a doctor's advice as a starting point.   Best wishes.  Keep us informed.

[Tnnurse2010]

WOW!!!! This is very interesting! I myself have a 12 year old boy that does the same thing. It has been an ongoing problem for him for most of his life. He has ADHD and has been on medications for that for 6 years. Most of his life I was a single mom who worked and went to college. My parents were his "second home".  I  very active in trying to help him with his problem. I have tried everything from rewards, punishment. Embarrasment, having him clean his pants, restriction. He says that he feels the urge but doesn't want to stop what he is doing so ignores the urge and then has the "accident" but that he doesn't feel it...... Or smell it, which amazes me because it is the first thing I notice when he comes up to hug me. Sometimes he will just continue on with his activities with the poopy pants. When he does change, he hides the underwear in his room or the bathroom or throw them away. It happens anywhere..... Home, school, church it doesn't matter. I recently married and have moved and it is definitely causing problems in the new home. I have been with my husband for 7 years before we married although we didn't live together. They(my husband and son ) seem to have a good relationship. But my husband thinks that my son is doing this on purpose and can just stop at anytime. I know the social implications this can cause for him and we have tried to stress to him that if other kids find out he will be ostracized and made fun of. Not a good thing when coming into a new school. I believe there is some conscious thought but also some things that he cannot control. I do believe that the ADHD is a factor to some degree. The impulsivity, the not wanting to take time to go to the bathroom when he is engrossed in activities, holding it, which compounds the physical issues. I believe encoporesis is also a part. I can help with increasing fiber, water and stool softners, but how do I retrain his thought processes? I am also fighting a battle with my new husband who does not really believe that ADHD is real and is just a excuse and thinks that my son can just "stop" when he wants to. This is a real problem that affects everyone in the household. There are some very good points and ideas here that I will incorporate into trying to help my son. But any support or advice would be welcomed with open arms:)

[Sandman2]

   I post over on the ADHD forum a lot.  If you need any additional resources to help convince your husband, let me know.  I have tons of good web sites, etc.  One book I recommend a lot is "The ADD/ ADHD Answer book," by Susan Ashley.   Its about 10 bucks on Amazon.   It covers everything from school to home in a very easy to read format.   I'll do some research and see if I can find anything on his bowel problem.  I do know that Its very common for ADHD kids to have that problem for the reasons you mentioned.  
   Got a feeling, like most ADHD behavioral modifications  , that working on a schedule is going to be the most successful for you.

[allmymarbles]

My point was that being too understanding might well be enabling. So I would try another tack. My guess is that his behavior is both willful and habitual.

Another thought occurred to me. If he controls himself at school, but not at home, that suggests that he never uses a toilet. It is possible his problem is toilet related?