Potty accidents

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im sure we all dealt with those students who didn't make it on time to the restroom because they were playing, or simply just didn't make it on time.

One student in particular, an ongoing issue since last year is constantly defecating on himself, and we are calling parents for change of clothing etc.

Today mom was just in tears, felt helpless, and just didn't know what else she could do to avoid this from happening.

offered her the option of sending student with depends and change of clothing so he can change and clean self, student states he waits til last min because hes playing or that the noise scares him from the flushing.

have anyone encountered a similar situation?

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Does the defecation follow a pattern, such as during recess after lunch? If so, can student try to use the bathroom after lunch and before going outside? How old is the student? Can student have an adult such as Mom flush toilet with him separately from using it to desensitise him to the sound(school toilets are likely louder than the toilet at home)?

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Specializes in ICU/community health/school nursing.

What's the age of the student? Was the student ever completely toilet trained (and this is a regression)?

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Specializes in School nursing.
What's the age of the student? Was the student ever completely toilet trained (and this is a regression)?

My questions as well. Because depending on age, I'd be referring to the pediatrician.

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The accidents are occurring usually after lunch/lunch recess that because he gets caught up playing he "forgets" student is a second grader so around 8 years old. i advised mom i would get him after his lunch and take him to the restroom and wait for him outside, hoping that will somewhat minimize these types of accidents. apparently student was already taken to pediatrician for some test, things came out normal,

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Specializes in School nursing.
The accidents are occurring usually after lunch/lunch recess that because he gets caught up playing he "forgets" student is a second grader so around 8 years old. i advised mom i would get him after his lunch and take him to the restroom and wait for him outside, hoping that will somewhat minimize these types of accidents. apparently student was already taken to pediatrician for some test, things came out normal,

Interesting. 8 years old is certainly past the age this should be happening. Does the student have any emotional concerns?

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I've known several young kids that run and scream and hold their ears when you flush a loud public toilet. It does sometimes sound kind of like its going to suck you down. I myself try to run from the shower of yucky droplets flying after you flush!:bag:

Maybe he could cover it up with TP and have someone else flush. My kids would hold it until they got home because they didn't want to go at school. :sneaky::sniff::no:

I'd tell them just to let it out, but in this case I guess, it's just the opposite. It's just not natural for a nurse to have to say, "Just keep it in!", now is it?

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Research encopresis - in older children it's almost always a result of chronic constipation. Yes, there are medical things that can cause issues, but if it's an older kid who suddenly has issues - a medical cause like Hirschsprung's or something similar is very unlikely I have two students that suffer from it and have done research and learned a lot. The bottom line is that they essentially have rectums that are so stretched out from months or years of constipation that they no longer receive proper signals and stool literally just falls out. Even when they do make it to the toilet, they don't have the proper muscle tone to fully evacuate.

The "treatment" is full bowel clean out, ongoing stool softeners to keep things moving, a toileting regimen (my kiddos come sit for at least 10 minutes after breakfast and lunch) and patience as it can take many months for rectal tone to return if they stop the ongoing chain of constipation. It is also a common reason for bedwetting in older children.

https://www.gikids.org/files/documents/digestive%20topics/english/Constipation%20and%20fecal%20soiling.pdf

Another fascinating site I came upon is: HOME | Dr. Hodges | Bedwetting and Accidents | Resources for Parents

He is a doctor that recommends an aggressive regimen of daily enemas and has some pretty fascinating stuff and resources.

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Specializes in Pediatrics Retired.

Do you have a restroom in your clinic?

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Specializes in ICU/community health/school nursing.

The "treatment" is full bowel clean out, ongoing stool softeners to keep things moving, a toileting regimen (my kiddos come sit for at least 10 minutes after breakfast and lunch) and patience as it can take many months for rectal tone to return if they stop the ongoing chain of constipation. It is also a common reason for bedwetting in older children.

^River, You're brilliant.^ That's where I was headed; we had a kid who had to have an appendicostomy for a year - temporary to allow the anal sphincter to normalize. Ceelopez, I hope they get it figured out this summer.

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Unfortunately no bathroo, or sink in my office

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Research encopresis - in older children it's almost always a result of chronic constipation. Yes, there are medical things that can cause issues, but if it's an older kid who suddenly has issues - a medical cause like Hirschsprung's or something similar is very unlikely I have two students that suffer from it and have done research and learned a lot. The bottom line is that they essentially have rectums that are so stretched out from months or years of constipation that they no longer receive proper signals and stool literally just falls out. Even when they do make it to the toilet, they don't have the proper muscle tone to fully evacuate.

The "treatment" is full bowel clean out, ongoing stool softeners to keep things moving, a toileting regimen (my kiddos come sit for at least 10 minutes after breakfast and lunch) and patience as it can take many months for rectal tone to return if they stop the ongoing chain of constipation. It is also a common reason for bedwetting in older children.

https://www.gikids.org/files/documents/digestive%20topics/english/Constipation%20and%20fecal%20soiling.pdf

Another fascinating site I came upon is: HOME | Dr. Hodges | Bedwetting and Accidents | Resources for Parents

He is a doctor that recommends an aggressive regimen of daily enemas and has some pretty fascinating stuff and resources.

Thank you for this information, i will be looking into this. Parents of this student are a tad bit older, i want to say only child as well, only thing that comes to my mind when the subject about emotional issues is student seems a bit more on the feminine side, (which i have nothing against) but i think parents are strict on religion and dont seem to accept that. Again this is just all from my observation in the last 2 years but if has something to do with medical i will reach out to parents as best as i can.

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