Encopresis - anyone familar with this

kids · Jul 12, 2004

How can a fissure heal if he doesn't start going everyday? Also, can't it get worse?

They heal as long as they are not being over stretched by large hard stool, the patients I have seen who developed them were place on stool softeners & diets that kept the stool soft.

studentdeb · Jul 13, 2004

Andrea,

Thanks, I will check with the doctor in a few weeks. Today we had no luck with having a bowel movement. I am hoping we don't go another 5 days like the last several weeks.

My son is very stubborn and does get upset if I talk about it too much so I know it does bother him alot.

Debi

Deb,
My son has encopresis. He is 8. I have never been uptight about him using the potty--he was between 3 and a half and 4 when he completely potty trained, I just never pushed it, figuring he's ready when he's ready. Just trying to point out, it isn't necessarily anything you've done, unconsciously or directly-- although I agree with you that relaxing a bit does help.
It was a long process for me to figure out that what was going on with him was not a hygiene problem--i.e. not wiping properly--but in fact, intentionally witholding stool. When I finally got him to talk about it, he recalls that it hurt him to poop ONCE a few years ago, and ever since then he tried as best he could to hold it in, because he didn't ever want to feel that again.
Before I took him to the doctor, I had already cut pretty much all dairy out of his diet (he gets calcium from lots of leafy greens, which thankfully he likes), adding bran to pancakes and such, and I was already a whole-wheat-only kind of gal. Lots of water and fruit juice, and fresh fruits and veggies. We tried this and a stool softener for a couple of weeks, with somewhat mixed results. His doctor put him on Miralax (after an abd xray and a negative thyroid panel), and suggested that, with dosage modifications, I can expect him to be on it for about two years--because we need to completely break that mental association he has that pooping hurts.
This makes complete sense to me! Especially since, even though I have always talked to my kids about everything in as straightforward a manner as possible, still he couldn't tell me what was going on. He was embarassed. Even without pressure from me to stop soiling his underwear, HE still felt bad about it. I will mention that he is also very very hard on HIMSELF, and I think this played into his issues as well.
Anyway, my advice would be, if things don't improve with what you've tried so far, to talk more with the doc at your f/u visit about what to try next. If your doc is "hands off" about it, ask to be referred to a pediatric GI specialist. Yes, he's young and not all kids are potty trained at your son's age....but ignoring a potential problem means he may end up like my son, dealing with it at age 8, when it's a much more ingrained habit. I wish I had put two and two together sooner.
Hang in there. Believe me, I know how you are feeling!
Andrea

studentdeb · Jul 13, 2004

They heal as long as they are not being over stretched by large hard stool, the patients I have seen who developed them were place on stool softeners & diets that kept the stool soft.

I looked at stool softeners today but don't know what to buy. They all seem to come in capsule form. How do you give this to a 3 year old? I am definitely working on the diet, but my son does not eat well and makes it very difficult.

I can most certainly tell the difference though in his mood and attitude when he is cleaned out. Today he was fun loving, running around the house, not crabby. When he is uncomfortable, he is crabby, cries alot, does not want to play, wants to watch more TV. The TV was only on for a short time in the evening today. I really want to make this better for him and the rest of us.

Thanks for all your advice.

kids · Jul 13, 2004

Docusate (generic) is probably the most common stool softener and comes in a liquid, you might ask your pharmasist as it may be a presctiption item.

studentdeb · Aug 5, 2004

Took my son to the regular doctor yesterday for a follow-up. I asked to be referred to a pediatric gastroenterologist. You can tell they hate doing referrals. I told him I know my son and I know what he is doing. I told him I don't want this going on until he's older and that I know he's not afraid of the toilet etc. He wants to be trying using mineral oil for a few weeks and if that doesn't help improve his condition to call his office and tell him it isn't any better and he will give the referal. He said this is mostly a behavior thing but I want someone who is much more experienced with this and you can tell that this doctor is not.

So I will wait the few weeks, give him the mineral oil (that will be fun) and see what happens.

nurseiam · Sep 21, 2004

My daughter has encoprisis. She is now 12 and usually only has problems when she has stress. But she started very similar to your son, just kept having accidents. Finally when she was 8/9 she went to a gasto. She had severe GERD, lactose intolerance and was inpacted. It was heck. She had to do milk/molassess enemas, go litely. It was horrible. Toilet retraining worked well, she was also on Murilax and a high fiber diet that helped. Sometimes I still have to remaind her that she has to actually spend a little time on the toilet. But I have to agree with the first person that commented....when things start immpacting telling her she might have to get another enrma usually cures the problem. Its not a threat it is a reality.

studentdeb · Oct 4, 2004

Thanks everyone for all your advice and comments. I wanted to give an update on my son. He seems to be on the right track. We never made it to the Gastro doctor because he started having semi-regular bowel movements, although in his pants, I didnt' care, just was happy he was going.

It has been a few weeks since he has gone in his pants now and tells me that he has to go and goes right to the toilet and goes. He goes almost daily now. He has also learned to pee standing so maybe that helped him.

The wierd part is my daughter started to have "skidmarks" in her underwear just around the time he stopped. But I think we might be past that now. I think it was an attention thing with her.

So for now, we are doing well and hopefully we will not have any reaccurrances.

Thanks again

Debi