12 year old with encopresis, I'm at my wits end?

[Denise101]

My 12 year old daughter has been dealing with retentive encopresis since age 6. She avoids going to the toilet at all. This results in soiling and the production of an amazing huge toilet-clogging log-like object every week. We have been trying for years to get her to talk about this, but when we do talk about this, the response is ALWAYS "I don't know" despite what her pedi, GI doc and psychologist tried to do or suggested we do to get her to talk about it. We switched psychologists last year after a year of not talking about this, no luck.

We have tried so many treatment plans for years, specifically tailored to her, such as enemas, scheduled toilet sittings, rewards, consequences, psychologist, etc. she just keeps holding it in. Right before summer, her pedi and the GI doc laid out a clear treatment plan of laxatives, regular bathroom visits, and a rewards program. She did take the Miralax (2 table spoons) but she just kept holding it in and soiling her pants. She avoided going to the toilet. I made her stay at the toilet and told her "if you poop, I will buy you XYZ" (something she REALLY wants)" you can do XYZ only after you poop" and not letting her do things "you can't do XYZ until you poop" and XYZ would be something she LOVES to do. I wouldn't let her leave the toilet until she pooped, so she sat there for hours, no luck. When school started, she refuses to take the Miralax.

Now we laid out a new treatment plan. We TRIED to involve her, the response is again "I don't know." She is supposed to take an enema every morning and sit on the toilet, but she fights daily about taking it. When she does take it, she holds it in and won't sit on the toilet. There is also a diet plan she refuses to follow. She is not supposed to drink dairy, but drinks milk at school. Now the past 2 weeks she refused all treatment which we fight daily about. She refuses to sit on the toilet, no matter what we try. 2 years ago we tried ucanpooptoo, didn't help.

We asked her why she holds it in. Does pooping hurt? Does it scare you to poop? Does it feel good to hold it in? The answer is always "I don't know" and you can question her for hours and hear "I don't know". We explained to her digestion and she knows why she needs to poop. We ruled out any physiological reasons for retention, and all the professionals working with her believe this is entirely behavioral. Luckily her friends don't notice, but one day her friends might smell her soiling, and I talked to her about this, how it would affect, boys, high school, etc. Her response was "I don't know" and she would not talk about this.

Has anyone gone through this? Does anybody have suggestions for me? Any advice appreciated.

[Anonymous]

omg. Our DD does those giant toilet cloggers. Has since she was 3. We absolutely NEVER made an issue of it as I would think it would make the kid neurotic as hell about a very private, primal function. Get some plastic knives that you keep by the toilet and chop it up to get it to flush down. And really, sorry, but you might want to see a therapist yourself to determine why you feel the need to control your child's bodily functions this way. Giving a twelve year old an enema for this is loony.

[Denise101]

Anonymous wrote:omg. Our DD does those giant toilet cloggers. Has since she was 3. We absolutely NEVER made an issue of it as I would think it would make the kid neurotic as hell about a very private, primal function. Get some plastic knives that you keep by the toilet and chop it up to get it to flush down. And really, sorry, but you might want to see a therapist yourself to determine why you feel the need to control your child's bodily functions this way. Giving a twelve year old an enema for this is loony.

I see a psychologist 1ce a week, but never talked about this.

[Anonymous]

First, I have no direct experience here. My sibling had encopresis, but it resolved by time he was a pre-teen. I can totally understand why you have done what you have, but at this point, she's 12 and she needs to take responsibilty for her body. You are in a battle of wills with her and you have no way to win. She has to want to do it and nothing you say is going to make her want to. It is her body and she has to learn to live with it and be in control of it for the rest of her life. Maybe just let her know that you love her and that if she wants your help, you will be there, but this is now her responsibility. As she gets older, peer pressure and fear of soiling may change her behavior. Good luck. This can't be easy.

[Anonymous]

Is she special ed? This is fucking weird. Maybe she was anally abused...I'm not kidding.

[Anonymous]

You need to let it go and let her work it out for herself. You have become very controlling with her pooping. She is rebelling. You can't control her eating or her elimination.

You should probably back off in a big, big way. Give up. Tell her that it si up to her to resolve this problem. She knows what she has to do. Make her do her own laundry.

[Denise101]

Anonymous wrote:You need to let it go and let her work it out for herself. You have become very controlling with her pooping. She is rebelling. You can't control her eating or her elimination.

You should probably back off in a big, big way. Give up. Tell her that it si up to her to resolve this problem. She knows what she has to do. Make her do her own laundry.

She already does her own laundry (as does my 10 year old).

[Denise101]

Anonymous wrote:Is she special ed? This is fucking weird. Maybe she was anally abused...I'm not kidding.

She is not in special ed.

[Anonymous]

OP,

I have a SN kid with constipation issues. You really need to use a positive reinforcement approach ONLY. Read the Kazdin Method. You reward with points and praise with every toilet sit. Points turn to prizes. Have her sit 5 minutes after every meal to help with the elimination reflex.

If she still needs a therapist, see one that's specifically trained in the Kazdin Method. Stop "talking" to her about it.

[Anonymous]

You may want to repost - you are much more likely to recieve constructive feedback in the Special Needs forum.

[Anonymous]

I'd try accupuncture and or hypnosis. A little out there, but the worst you'll do is waste money. I'm sorry. This must be horribly difficult.

[Anonymous]

Have you looked into Soiling Solutions or ucanpooptoo? I'm very sorry you are going through this, toileting issues are horribly frustrating.

[Anonymous]

Sorry, I just reread and I see you did try ucanpooptoo. It sounds you have done all the right things and it is time for her to take some responsibility. Again, I am really sorry you are going through this. Soiling Solutions has an active online community, you might try asking there for more advice.

[Anonymous]

OP,

The withholding poop is a control issue. Your DD is probably not purposefully trying to withhold poop but probably more of a reflection of the control you're trying to exert in her life. Use a behavioral therapist.

[Anonymous]

OP - If your daughter is otherwise healthy, I would agree that you just need to back-off at least for a while. She has won the battle of control. You may benefit from working with her psychologist on what approach would be best as you certainly do not want to give her any sense that she has 'won." But the idea that age 12 she is in control of her body is a good approach. Question has her menstrual cycle started as yet? Is she interested in boys as yet? Because some where there might be a better approach that rather than what you want her to do,you want her to be at ease with her body and with friends and frankly - not smelling etc. But again how you go about this you need some professional advice on.

If you ignore this area of her life, do praise her for other areas in which praise is due. And be sure that she has the expectations of participating in the household etc. as siblings. My only other thought is could this be a way of getting Mom's attention over other slibling9s)? Unusual, but it is an element of control and perhaps because she feels other areas of her life are not in her control.