Anonymous wrote:

Anonymous wrote:I think likely encoperisis. My child had this, was going every day and we had no idea he was constipated. He also kept having poop accidents.

I know this is old post but how did doc discover it and how often was he having accidents. My daughter goes regularly so DH doesn't think ot is constipation

Surprisingly, I hadn't responded before to this thread. There is so much ignorance regarding 'constipation', even within the medical community. In short, constipation isn't about being unable to poop. It's about clearing the 'fecal load'. You can have great poops every single day yet still be constipated because there is some unmoving fecal load in the intestines.

You and your DH need to read It's No Accident by Steve Hodges, MD. He's a urologist who started studying constipation when his DS was about to have bowel surgery because of constipation. I gave a copy to our pediatrican (who's really great and acknowledges it was super helpful and poorly treated).

https://www.bedwettingandaccidents.com/

My DS suffered from encopresis from about 2.5-8. Although we had excellent structure/routine/diet at home, had been working with all sort of specialists, had super soft poop and had done multiple Miralax clean outs (more Miralax until he poops liquid), DS always had encopresis. Upon physical exam by a GI specialist, DS was unremarkable and the doctor had no additional recommendations. Then, blessed DCUM Special Needs Moms told me about It's No Accident. It was lifechanging. I asked for an X-ray of his intestines and everyone (but me) was surprised at the uncleared fecal load.

We started the Modified O'Regan Protocol (MOP). Yes, I gave my then-7 yo enemas everyday for a month, every other day for another month and then 2 per week for another month. Did either of us like it? No. Was it effective, YES! It took a while before he fully recognized when he needed to poop but he's never had a relapse and it's been years.

Anonymous wrote:I think likely encoperisis. My child had this, was going every day and we had no idea he was constipated. He also kept having poop accidents.

I know this is old post but how did doc discover it and how often was he having accidents. My daughter goes regularly so DH doesn't think ot is constipation

Anonymous wrote:OP, there is a book on potty training children with ASD - it says very specifically that for some children it may feel good to soil their pants (sorry for details, but warm and soft smth next to their skin). I am not saying that your child is on the spectrum, but ADHD and ASD have some areas of overlap, so there is a real chance that he might be telling you the truth.

I've read your update, and hope the issue doesn't exist anymore, but if it crops up again, keep the above in mind. He may not have been lying to you.

Thank you. I sincerely appreciate your thoughtful reply.

He has been seeing a therapist. She has not mentioned any ASD symptoms that she has seen, nor has the school, but the other thing he has is the beginning of some oppositional defiant behavior.

Before we started therapy, he would often say the opposite of what his actual preferences are just to make the adult feel like any natural consequences to his actions didn’t mean anything to him. We don’t believe that he actually enjoyed the feeling of having poop in his pants, he was just being defiant. We would say that having poop in your pants is a consequence of not going to the bathroom, and he shot back that he liked it. Pretty typical for him at the time.

The pooping stopped pretty much immediately when we put a consequence in place, but things took a bad turn with other behavior over the holidays when there was no school structure. In January we were finally able to get in to a therapist. The oppositional behavior has decreased significantly since we started. I’m paying out of pocket and have no idea what my insurance will reimburse, but I can do this for a little while if it’s helping this much.

OP my son did this. Was perfectly potty trained and then started pooping his pants. I went through ALOT of bad advice from highly tauted experts in this area.

Step 1 is always tonrule out encopresis, and for this don't bother with your pediatrician. Go to a pediatric gastroenterologist. I recommend Children's Hospital. We went to a private practitioner first who had an x ray done. She looked at the xray and said "oh yes, you can see the stool blockage right here." Then put him on miralax for months. For this, she made a ton of money in office visits from us over many months.
When nothing changed I took him to children's where the doctor gave him a suppository and waited a few minutes. He didn't poop the table so the doctor said if there was a blockage, or he was holding, the suppository would have made him go immediately.

So then we went on to therapists who gave him more useless talk therapy and potty charts. (Like we never tried this???) AND took months more of our money for no effect.

Every message board I came across said it was 1. In boys 2. Often very high functioning autistic boys 3. Nothing they tried worked and it suddenly resolved itself as the boy reached puberty.

Here's my perspectives.
1. Your husband isn't helpful, has a very poor understanding of his child.
2. Mom you're on the right track but don't absorb this as a burden you can necessarily fix. This will cause you to become angry with DS.
3. Don't make him clean it up. Boy a ton of cheap and second hand underwear and throw it away. Have him shower after it happens to get clean.
I strongly suspect it's a combination of lack of Social perspective (not understanding or being embarrassed by it and not understanding that people can smell it. No matter how many times you demonstrate that it can be smelled a mile away, he isn't going to get it. Introspection problems. Not listening to his body telling him how it feels. My ds still can go the entire day without drinking any water. And sometimes food. Adhd- being focused on other things and not wanting to stop. But I also think part of it has to do with their testes development. The reason I think this is because they suddenly stop doing it near puberty when their testes begin to enlarge. I understand people will think this is crazy and baseless but there is some connection between the age and the time it stops.

Please try to understand he really isn't doing it on purpose and be patient. It's going to be hell and embarras you to death.
Try your best to get him on a wake up pooping schedule. Eating triggers the urge to evacuate so give him breakfast early enough that he will sit on the potty and poop before school. A tiny dose of laxative over spring break on schedule might help move him onto the AM pooping.

Please make sure that he's not just holding his bowel movements now. We had to put our child on a regular schedule and since he could not poop in a toilet, we put a diaper on him every night after dinner and that's when he would go. It prevented accidents from happening at preschool.

OP, there is a book on potty training children with ASD - it says very specifically that for some children it may feel good to soil their pants (sorry for details, but warm and soft smth next to their skin). I am not saying that your child is on the spectrum, but ADHD and ASD have some areas of overlap, so there is a real chance that he might be telling you the truth.

I've read your update, and hope the issue doesn't exist anymore, but if it crops up again, keep the above in mind. He may not have been lying to you.

Anonymous wrote:OP here with an update.

We were able to get an appointment with our doctor in September. Doctor advised us to try Miralax and heard my concerns about ADHD.

It turns out that it was 100% behavioral. After the accidents continued, we told him that he would not be able to take part in a weekly activity that he looks forward to all week long if he has any accidents during the week. Pooping in the pants stopped immediately. He just didn’t prioritize using the bathroom over whatever he was hyper focused on at the moment.

We checked in with the doctor during his December well visit. We found a therapist in January who immediately diagnosed ADHD based on assessments from school and home, as well as interactions with my son.

Therapy is helping, we are starting the medication journey now.

That's good, but he might just start hiding it form you, especially if he is washing his own undies. Washing my own and making my parents think I had stopped is exactly what I did.

Anonymous wrote:OP here with an update.

We were able to get an appointment with our doctor in September. Doctor advised us to try Miralax and heard my concerns about ADHD.

It turns out that it was 100% behavioral. After the accidents continued, we told him that he would not be able to take part in a weekly activity that he looks forward to all week long if he has any accidents during the week. Pooping in the pants stopped immediately. He just didn’t prioritize using the bathroom over whatever he was hyper focused on at the moment.

We checked in with the doctor during his December well visit. We found a therapist in January who immediately diagnosed ADHD based on assessments from school and home, as well as interactions with my son.

Therapy is helping, we are starting the medication journey now.

Please spend some time educating yourself for the sake of your child. Do you understand that saying it’s 100% behavioral and then saying that your child has ADHD is contradictory? When you approach this with a punitive mindset, kids with ADHD work really hard to cope but it doesn’t mean it was all behavioral. I foresee you posting in a few months that the problem with accidents have restarted— because you aren’t really taking the time to understand the thoughtful responses many people have posted. You just seem relieved at what is likely a temporary respite. Please do better for your child.

Anonymous wrote:Omg OP, way to humiliate your child by making him wash the poop out. Trash the $3 underwear and work with a pediatrician. You suck.

+1

OP here with an update.

We were able to get an appointment with our doctor in September. Doctor advised us to try Miralax and heard my concerns about ADHD.

It turns out that it was 100% behavioral. After the accidents continued, we told him that he would not be able to take part in a weekly activity that he looks forward to all week long if he has any accidents during the week. Pooping in the pants stopped immediately. He just didn’t prioritize using the bathroom over whatever he was hyper focused on at the moment.

We checked in with the doctor during his December well visit. We found a therapist in January who immediately diagnosed ADHD based on assessments from school and home, as well as interactions with my son.

Therapy is helping, we are starting the medication journey now.

Train kids to poop in the AM once they become toddlers. It is very healthy habit for them to empty out bowels in the morning with regularity. Of course, this means that they also have to have good diet with high fiber, good probiotics and good sleep habits.

In Ayurveda, apart from genetics, it is believed that ADHD is triggered by poor gut health and poor sleep. Proper pooping is also connected. So teach good healthy habits and it will go a long way to also mitigate ADHD and stress.

If he is doing it intentionally because he likes how it feels it might me quite difficult to get him to stop. I would consult your doctor and possibly a psychiatrist if there is no medical cause. As strange as it sounds there are some kids that like how it feels, and I speak from personal experience. Rather than seek medical, or therapist advice my parents took the out of site out of mind approach, which didn’t help me at all, and I kept doing it all the way through school.

If he is doing it intentionally take him to therapist and don’t give up. If it becomes a habit, like it did with me it could be very difficult for him to stop, even if there is a part of him that might want to.

Anonymous wrote:I would consider using Miralax at least short term, because like others here I have a kid with encopresis and impaction and longer term bowel issues that started with simple constipation (which can present as normal poop or even runny poop, but there's still a ball of impacted poop stuck up there). To make that less likely, especially this early into the problem, Miralax may be the way to go. Also make sure he's getting enough water.

Can you have him sit on the toilet before school? If he refuses you could try a short term sticker chart.

+1.

Fiber in diet also helps. Of course we try the best choices of whole grains, fruits, and vegetables, but frankly my kid is really picky and won't eat enough of them, so we only saw a difference in regularity and fewer accidents when we introduced fiber bars at breakfast.

I echo what others said, but you need to get on the list for a new pediatric practice ASAP. ADHD and these GI issues can be a long road (I know personally), and you need a supportive pediatrician and one that you can get in to see more regularly. Meanwhile, I would also make an appointment with a GI doctor.

You can schedule this as a "sick visit" at the pediatrician. If you can't get in in the next week, you have a lousy practice and need to find another. You also need a doctor who is familiar with these issues, even if you are going to other specialists.