Hi moms,
My husband, nearly 4 year-old son, and I have been working with a therapist on a number of behavioral issues as well as some issues with potty training. She thinks that he might have encopresis. I've done some research, and although he matches with a lot of the symptoms, I'm hesitant to call them symptoms because they seem to mirror a lot of the potty training challenges I've discussed with other moms. Before we jump into diagnosing him with something, I wanted to check with moms who may have experience with encopresis with their little ones. He's finally doing really well with potty training and I'd had to mix things up by introducing the treatments I've read about.
I'd appreciate any first-hand advice or experiences related to symptoms, diagnosis or treatment. What really sticks out as the top three symptoms that raised the red flag initially? How was it diagnosed? What was treatment like? Is there anything you wish you had done differently?
Thanks in advance for your help and insights.
Follow up;
Just to answer a few questions...
We haven't taken him to a GI doctor yet. His therapist just brought it up last week and we wanted to wait a week to monitor him more closely so we can see if his activities and behaviors match the symptoms. The therapist has been quick to diagnose issues before, only to find out a few weeks later that she wasn't correct. She wants us to see a behavioral pediatrician, but maybe we should go right to the GI specialist.
My hesitation is that he HATED getting x-rays in the past. She said that the doc would want to do an x-ray as part of his initial exam. Then they'd want to "clean him out." He's been doing so well with potty training that I'd hate for him to have diariaha for a week and backslide on potty training.
This just started in the last few weeks, so I'm wondering if he's just constipated and needs a stool softener. On the same not, I don't want to wait too long and cause damage to his GI system.
Based on your feedback, sounds like we should met with the doc or a GI specialist sooner rather than later.
Thanks everyone!
O. of my good friends sons had it.
Skid marks and lingering smell were the big signs for her.
Routine pottying schedule & O. or two MIralax intense weekends were involved to get it under control.
To diagnose for Encopresis... a Pediatrician needs to do that or Pediatric Gastroenterologist.
NOT the Therapist.
And not yourself.
It is a medial issue.
1. They deny they've had an accident.
2. They can't smell it.
3. They've lost the ability to feel when they have to go.
4. Watery leakage precedes a huge ball of fecal matter.
5. Accidents are more common in the late afternoon.
6. They hide it.
What works is a daily dose or two of Mirilax and behavior modification. You sit them on the toilet for 5 minutes, 15 minutes after they have finished eating ANYTHING. You don't punish EVER. Lots of fiber and fluids in their diet.
We had to wait until my son was almost 8yo before anyone took us seriously. If I could change anything, I would have started treatment earlier, but then, I didn't know what that was until I got a firm diagnosis and started doing research online. You can follow the behavior mod protocol even without a diagnosis or the Mirilax. It's helpful in potty training regardless of whether or not your child has encopresis.
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Our son has had it off and on for years (unfortunately, if it is encopresis, it doesn't solve itself overnight).
Big symptom was, for lack of better way to describe it, poop tracks in our son's underwear. Like he was leaking, which is what was going on. We initially thought he was having accidents, but soon it became apparent he was holding it in. When he'd finally go, huge poop, so we knew he'd been holding it in.
Diagnosis involved going in to the doctor, describing the symptoms and going from there with treatment.
Doctor started with having us give him mineral oil mixed into his drinks (which doesn't work that great, btw, because it floats on top). Also had to use suppositories when he hadn't gone for days. Fiber supplements, too.
Honestly, none of this was particularly effective. What really worked was helping him overcome his fear of pooping. We initially gave a huge bribe, like a Lego set, and then tapered off to smaller bribes. Had to be huge to have the "wow" factor to stand out more than his fear of going. Then, we made him go at the same time each night. It became routine to go before bathtime at night.
Four years into this (started when he was four years old), we still have to remind him to go poop, but sometimes he'll go on his own.
Started with very small poop accidents in his pants...this was after he started Kinder. He would be so ashamed and tell me he didn't even feel it come out or it popped out when he sneezed. He tried to hide it as first, but when I told him it was okay to let me know and we could clean him up, he started telling me about it.
I took him to his pediatrician and she felt his tummy and could feel at least 12 to 14 inches of backed up stool (no x-ray needed). We did Miralax for a couple of days to clean him out (no diarrhea, just softened it up so he could get it all out of him). Then we started Benefiber three times a day and use double fiber bread.
We discovered his real issue that started it all was he would not go poop at school and was holding it. So, we got him on a schedule where he would poop everyday right when he got home from school. So, he wouldn't get backed up again.
I caught it very very early as it was not like him to have accidents and I knew it had to be medical. Plus I didn't want it to happen at school...he was having these accidents at home, but I knew it was only a matter of time before he might have one at school.
Go to your pediatrician...the earlier it is caught the easier it is to treat.
I think Encopresis starts with constipation. My son had a problem with Encopresis and went to a pediatric GI. they have to make sure that no damage has been done to his body. What are your reasons for not taking him to a medical doctor to get a diagnosis?
Our doctor did not do an x ray, just a physical exam
My daughter has been dealing with this since she was two years old (she's now 11). Because she was so constipated, then she also had issues with her bladder (overactive bladder is what they called it). She was taking meds for encopresis/constipation and for overactive bladder.
Once we got her healed up and got her system retrained, she did better. She still suffers a bit from overactive bladder--usually has to go a number of times (pee) before she'll go to bed (I still think it's nerves/trying to get herself to go to sleep). We constantly have to make sure she's drinking water every day, that she's eating enough fiber, that she's eating her veges. I constantly have to ask her when's the last time she's gone #2; if she goes two or three days without a BM, then she has to take magnesium so she'll go. I have weaned her off all pharma drugs and I only use natural/herbal remedies.
It's an issue that can take a long, long time to resolve, especially if you have a child who is a picky eater/has sensory issues (like my daughter).
And this is a medical issue that needs to be handled by a medical specialist. My daughter saw two different nurse practictioners, one for her overactive bladder and one for the encopesis/constipation. They both worked for a different medical department (one with colon, the other with urology). They take special classes in how to deal with this type of issue. We couldn't have helped our daughter without their help. I don't really see how a therapist can help your son when it's a bodily issue he's having problems with.
