Witholding Bowel Movements

Updated on January 27, 2010
M.B. asks from Carlisle, MA
10 answers

Hi all--

My 4 yr old son, who has been potty trained for well over a year, just recently started withholding his bowel movements. He is not constipated, but he just doesn't like to go. Everytime he starts to feel the urge, he holds it in because he's afraid it's going to hurt coming out. He eats a very well rounded diet, and I've been adding extra water and fiber rich foods to his diet to try and make things a little easier, which it does, but it doesn't seem to help much in the way of him wanting to go when he feels the urge to do so. Also, at the advice of his pedi, we started him on Miralax on occasion to further help things along. He still continues to withhold. I'm at a loss on what to do. I'm taking his younger brother to the pedi for his WBV tomorrow, and will ask then, but does anyone out there have any similar experiences or tips? I've tried working back to a rewards system with him, and it's still unsuccessful...he just doesn't seem to care.

We're also potty training his 2-yr old sister and I'm afraid that his actions about going poop are going to adversely affect her as well.

Any help/advice/suggestions will be appreciated!!

Thanks,
M.
(Mom of three kids)

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So What Happened?

Wow, I guess this isn't all that uncommon after all! Thank you all so much for the tips and responses!! My son did end up going to the bathroom at daycare yesterday, which was great! And I did ask our pedi what to do about it when I took my youngest in for his WBV today. So for right now I am to give the boy 1/2 cap full of Miralax every day for the next few months, until he comfortably starts to go. In addition to that, I am also supposed to give him 1tsp of Mineral Oil 2x/day to help keep things lubricated in his rectum, which will also make it easier (and less painful) for him to go. He also said that if I need to, I can also use PediaLax chewable laxatives, if I feel he needs them. He said this will take quite a while to work through, but we'll get through it. But I am not to stop doing the Miralax/Oil combo any time soon. He also told me that I shouldn't make a HUGE deal out of it when he goes. I can give him a good praise (ie: Good Job!!) but keep it simple because he does need to be reminded that this is a normal bodily function. He did also say that I could revert back to using a rewards system with him, but again, to keep it very simple.

I have tried both making a big deal with lots of praise, and keeping it simple and to the point. And then from DS I get the whole "Why aren't you happy?" type comment. I told my pedi that I just have a very headstrong little boy. I have also had NUMEROUS conversations with him about how his body works, how and why he needs to poop, and that everyone else poops, even animals....and still he hates it. As I said, he is VERY headstrong. So we'll start again on the Miralax/Oil treatments and see how it goes from there. At least I have hope that there is an end in sight. Again, I thank you all so much for your help, advice, and encouraging words!

M.

More Answers

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D.W.

answers from Indianapolis on

There have been a few posts in the past few weeks about a condition called Encopresis.

I'm so glad I stumbled upon the discussions because our 21 month old has been having that problem since a bout with constipation a few weeks ago.

The pediatrician has her on Miralax daily for the next 8 weeks to retrain her to not be afraid to poop. I'd really advise talking to your pediatrician to get an opinion on it. We'd also been trying high fiber (adding Benefiber to her milk/food), lots of fruits/juices, without any luck.

That would be my advice. Ask your ped!
Good luck!

1 mom found this helpful
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M.J.

answers from Sacramento on

This is a condition called encopresis. There was a thread on this topic sometime in the past week, so you might do a search. Our son had encopresis and unfortunately, it's a condition that takes a long, long time to overcome. I mentioned in my post there that the way to get your child over it isn't through the fiber, mineral oil or laxatives, but to help them overcome the fear of going. For our son, a huge bribe to get that first big poop out was what worked -- was a huge bribe to get his attention and give enough motivation to even try going. We continued with rewards for a while to provide encouragement and gradually as it became less painful, the rewards weren't needed anymore.

Good luck!

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A.D.

answers from Portland on

My 6 year old has been struggling with encopresis for over a year. We finally saw a specialist, a Pediatric Gastroenterology who gave us a lot better advice then his regular Ped Doc. She said his bowls were very blocked and the softer stool was seeping out around the hard large stool. He had bad tears in his anus. Previously I didn't know any of this. We finally found his currency to get him to go even if it hurt: Video game time with dad each day. We tried sticker charts, rewards of every kind, time outs for pooping his pants (punishment is a big mistake by the way. I still feel very guilty about that and think it made things worse for him.) He is finally going almost daily, which is HUGE!! He still doesn't want to, but it seems to be getting better every day.
The doc suggestions were as follows: Miralax (she says it works the best by far for kids) Ask him to sit on the toilet for 5 to 10 min (no longer then that) everyday at about the same time, and at first twice aday. (For us we do right after school at 11:30 and again around dinner time. And even though I felt she might not think our reward of video game time was a good one, she did! Pretty much use whatever you have too to get him on a health reg schedule. It takes a LONG time to fix this problem so consistency is key. I the past he would start to do well and then we would forget to reinforce the behavior and the withholding would start again. You may have to do this for months. It doesn't sound like your son's problem as progressed as far as ours, so it's better to fix it now. It caused us all a great deal of stress which I am sure made things worse for our son. This is a way more common problem then I ever knew. Kids much older then ours have it, so try not to let it guilt you (I felt very guilty in the beginning, Like It was my fault, and that just isn't true) Good luck and keep your head up. It will get better with consistency.

A.

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K.S.

answers from New London on

After reading your "so what happened" response, I just wanted to also encourage your long-term patience in the whole process. It sounds like you have a good strategy in place with your pedi. We started my daughter on Miralax 2 1/2 years ago. In the beginning, I was anxious to have her issues resolved and get her off of it as soon as possible. But it has taken a lot longer than I thought. Even fnow she still has little accidents occasionally. I did try eliminating the Miralax about a year ago, but she ended up regressing back to very painful bowel movements. So, I have relaxed about it and know (partly from speaking with other moms I know who have dealt with this), that eventually it will all work out. Yes, I agree with the simple praise appraoch, helping him learn to feel good about it himself, not going for your sake, and have lots of patience! Good luck!

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A.H.

answers from New York on

when he finally goes... say to him... wow.. isn't that good to get rid of that... tell him how good he did... praise him... give him something.. like 2 m&m's for going.. i used to do that with my kids.. like a reward.. tell him how good that was... make it really sound great that he went.. good luck

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M.M.

answers from Milwaukee on

Hey, I struggled with my little girl to go poop for a long time (something like 6 months at least) it was a similar situation when she felt the urge to go she would jump up off the toilet and say she did not want to go. and finally that would make her constipated because she would not poop it out and when she finally had to poop it would be so hard and big it would hurt her even more and that just added that to the evil circle. What we finally did to get to the point where she just HAD to go (no choice about it) is we got the tea Smooth Moves and put something like a 1/4c or 1/2 cup (can't remember exactly how much it says how much to use for children on the box)in their drink every day (usually at night) and by morning she had to go.. we did this for like a week at a time and then took a break for a couple of days.. finally the poop just softened up and made her have to go poop at the same time everyday that it became just natural. She soon forgot that she disliked going poop. It really worked for us and now to this day she still goes poop in the morning (we of course don't use the tea when not needed) and goes very willingly. We otherwise tried everything prune juice, warm baths (which got her to poop but then she stopped liking baths), reward systems, Lactulos (medicine), praising and dancing when she finally did poop, it felt like we did everything.. She did get a reward along with the tea when she pooped.. I hope you can figure this out.. I completely realize how awful it is to deal with and it was like that no one took it seriously how this affects everyone in the family..

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D.P.

answers from Pittsburgh on

It may or may not be encopresis. Is there stool leaking out? Is he having accidents in his pants? If you feel it IS encopresis, after researching it, please talk to your doctor right away.

I would keep up the Miralax, water and give extra fiber. Have you discussed with him that food is a body's fuel and your body uses all the energy and then eliminates the waste? It might put a new spin on the idea for him.

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P.M.

answers from Portland on

As you can see from all the posts, this is a really common problem in little ones, M.. My 4yo grandboy had a bout of this a few months ago. His parents used liquid glycerin suppositories twice, which increased the urge and lubricated the movement.

He did NOT like the treatment, but agreed afterward that it helped. He was actually laughing with relief. With a renewed focus on drinking enough water and eating fiber-rich foods (prunes are good), he's been doing fine since.

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J.P.

answers from Boston on

I don't have anything to add that hasn't already been suggested. Your pediatrician's advice was similar to ours.
I just wanted you to know that WalMart now has a generic version of Miralax that can save you a little money.
Good luck,
J.

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S.M.

answers from Boston on

I don't have any suggestion to offer but to know that my almost 3 year old daughter does the same thing. I have been using the Mirilax every day for about 2 weeks with some improvment. I am planning on asking for a pedi GI consult at her next MD visit (2 weeks) if things don't improve. Please post your resolution, there are more of us out here with the same problem. Good luck.

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