When to decide DS's potty accidents are not behavioral and take him to the doctor?

[quelindo]

My 5YO was VERY late to potty training...in fact, he was 4.5YO. I had to sort of force the issue because he had no interest whatsoever, even though he had so much control that he would stay dry all night since about the age of two on.

So at first he had some accidents, but nothing major, and then he went for about six weeks straight with NO accidents at all. But in the past few weeks he's had MAJOR accidents -- pee and poop. Some days he has 5-10 of them, almost all of them in the bathroom. Puddles of pee on the floor, poop in his underwear, poop on the floor, etc.

I did wonder if he was constipated so I started giving him juice, muesli, nuts, flaxseed meal and fruit smoothies. And that seemed to help for a bit -- the frequency of his accidents went down, but now they seem up again.

Two things -- he seems to be drinking less water than he used to (he drinks out of a bottle so I can see just how much he drinks) and we're having a baby next month, which he is NOT happy about.

So what do I do? If I took him to the doctor what would the doctor do about it, anyway?

ETA: DS has a sacral dimple. His ped checked him out and made sure he could see the bottom of it, but I wonder if this could be a problem. DS is five, as I said, and he seems to have no issues because of it.

[Oubliette8]

Do the accidents seem to happen more often in certain outfits? Since they happen in the bathroom, I'm wondering if maybe he gets there but has trouble taking his pants off in time? Some snaps/button/zippers on kids pants can be really difficult for them to undo.

It could also be regression because of the new baby. Its pretty common to have potty training regression when mkids are unhappy or under a lot of stress, and a new baby is a huge change. If he's already unhappy about it, it seems like a big deal to him and very distressing- maybe he's overwhelmed by the potential changes a baby would bring, or he has fears, like that the baby will replace him etc.

I would assume that the doctor would check to be sure there is no medical reason for the accidents. If none is readily apparent, he might suggest a different strategy, or possibly refer you to a child therapist who is experienced with soiling issues.