UGH... 4.5yo WILL NOT POOP.. help?

[CariOfOz]

My youngest is 4.5yrs old now.. and he's great with going pee on the toilet and even mostly is dry at night.  No issues there.. but he WILL NOT POOP.  At first it started out that he would only go in a pull up... now he won't even do that.  He holds it and holds it.. we have tried what feels like everything under the sun to get him to go.  (the 'everybody poops' type books, reading to him on the toilet, LETTING him have the pull up, bribery)   This may be too much info, but the last time he DID go (on the toilet, after 45minutes there!) it was literally the size of his arm from shoulder to bloody wrist.  

I am really just OVER it, because he CAN poop.. there's no medical issue because it literally oozes out of him and he mucks up several pair of undies a day doing this. We thought we had it worked out when he did a 'little' poo (his words) two days running... now he refuses to do that even.   We've had him come to our bed in the night wailing of a tummy ache and put him on the toilet and he eventually did an enormous poop (only because he was half asleep and not coherent enough to fight about it) 

We've hit a new low... he puked all over my bed this morning (not much because he wouldn't eat last night.. likely because there was no where for it to GO)... and I can only assume that it's because he is THAT backed up.  After a bath and an HOUR on the toilet... still no go.  He screams at me that he will not go.   I'm just about ready to resort to laxatives so he has no choice.

If anyone has any brilliant suggestions, I'm listening *sigh*

[ElliesMomma]

i'm sorry you are dealing with this problem. have you taken him to a doctor for medical evaluation at all?

Edited by ElliesMomma - 5/29/11 at 12:02am

[mommytimes2]

We had this same issue with my DD from the time she was 1 year old to 3 1/2. Awful experience for everyone...scary for her and so frustrating for us as her parents. Really held up the "potty training" and she was in diapers until just recently. She was so afraid to go poop, and if she did go it had to be in a diaper. She could go weeks at holding it in. She wasn't constipated, and this wasn't a physical problem, she was just very very afraid of having a bowel movement.  We resorted to giving her a magnesium-based product that basically gave her diarrhea she couldn't hold in (suggested by a holistic doctor). Used this for about a year or so. She was already using the potty for urinating, so what finally did it was I told her we didn't have any more diapers (this was true at the time, we had run out)and she was going to have to use the potty. Then I promised her she could watch a movie (her favorite thing in the world) if she would try to go poop on the toilet. I figured if I could get her to go a couple of times, her confidence would grow and she would recognize there was nothing to fear. With tons of encouragement and praise she went for the first time. She was still scared for the first week, but she did it almost daily in order to watch a movie. Since then, there has been no looking back. Now, I wake up in the morning to her bringing her little potty into the bedroom and trying to go poop so she can watch a movie that day. I don't like the fact she is watching TV everyday, but for now it is the lesser of the evils. Her fear is gone and her self esteem is through the roof. She has been pooping regularly/daily for over a month. We are going to transition to the big potty soon. Whatever his absolute favorite thing happens to be (it needs to be reeaally good from his point of view), use this initially as an encouragement to face his fears...that's my advice. Overall, just try your best to be positive. It is HARD, but you will get through this! 

[CariOfOz]

Quote:

Originally Posted by ElliesMomma 

what will he eat? my 4.5 yo daughter loves kidney beans and blueberries and apples. esp. the beans and blueberries, those will work like natural laxatives. can you load him up on that kind of diet for a few days, and then require him to sit on the toilet before going anywhere? ie., preschool, playdate, store, time outside, whatever.

i'm sorry you are dealing with this problem. have you taken him to a doctor for medical evaluation at all?

He will eat... pb&j sammiches, yogurt (only ONE type), spaghetti (if he's feeling agreeable @@), crackers, cheese .  He does not tolerate whole wheat bread, his bum goes bright red and his poo is the equivalent of sandpaper, so I get high fibre white, which I guess is better than nothing. He will not touch fruit or vegetables  *insert eye roll* and actually wails, covers his mouth and runs away if you offer it to him.   Yesterday I DID get him to have a few tiny bites of apple, but he suddenly became very unwilling, and today he ate a small bowl of noodles (with MUCH coaxing.. just udon so no extra fibre there really)  That he even let it touch his lips is miraculous.

The problem hasn't been going on incredibly long... just a couple of months, before that he still wouldn't go in the toilet, but he would request a pull up and poop in that.  I'd even be willing to tolerate that arrangement again if he would just GO, ya know???

Haven't talked to the doc as of yet, as I really thought after he went once or twice he would go 'oh ok, this isn't SO bad' and be over it.  But yeah.. I'm going to give them a ring.

 

Originally Posted by mommytimes2 

We had this same issue with my DD from the time she was 1 year old to 3 1/2. Awful experience for everyone...scary for her and so frustrating for us as her parents. Really held up the "potty training" and she was in diapers until just recently. She was so afraid to go poop, and if she did go it had to be in a diaper. She could go weeks at holding it in. She wasn't constipated, and this wasn't a physical problem, she was just very very afraid of having a bowel movement.  We resorted to giving her a magnesium-based product that basically gave her diarrhea she couldn't hold in (suggested by a holistic doctor). Used this for about a year or so. She was already using the potty for urinating, so what finally did it was I told her we didn't have any more diapers (this was true at the time, we had run out)and she was going to have to use the potty. Then I promised her she could watch a movie (her favorite thing in the world) if she would try to go poop on the toilet. I figured if I could get her to go a couple of times, her confidence would grow and she would recognize there was nothing to fear. With tons of encouragement and praise she went for the first time. She was still scared for the first week, but she did it almost daily in order to watch a movie. Since then, there has been no looking back. Now, I wake up in the morning to her bringing her little potty into the bedroom and trying to go poop so she can watch a movie that day. I don't like the fact she is watching TV everyday, but for now it is the lesser of the evils. Her fear is gone and her self esteem is through the roof. She has been pooping regularly/daily for over a month. We are going to transition to the big potty soon. Whatever his absolute favorite thing happens to be (it needs to be reeaally good from his point of view), use this initially as an encouragement to face his fears...that's my advice. Overall, just try your best to be positive. It is HARD, but you will get through this! 

I'm going to have to resort to getting something to loosen his buisness up.. because honestly...as long as he holds it in, and as substantial as it is he's NEVER going to get over the fear of it if I don't.   I'm trying really hard to stay positive but today as soon as dh came in I left... I was that p*ssed off with him for just refusing to go and shrieking at me I couldn't stand to be around him anymore :(    I wish a movie would work .. but we aren't anywhere near tv free, so those happen regularly enough that he'd say ok.. and just wait it out :S

Thanks for the help mamas... my sanity appreciates it :)
 

[shahjehan]

I'm sorry you and your son are going through this.  It can be such a vicious cycle, poop gets held, starts to feel big and hard, child gets afraid to pass it and holds it even more, stops eating, repeat, repeat, repeat...  It is so frustrating.  I know all too well.

We went through this with my DD from age 2-4.5.  I tired everything too-bribery, ignoring it, throwing pull-ups away, bringing them back, etc.  Ugh.  When people withhold poop over a period of weeks/months/years, they can stretch their colon out so it essentially doesn't function the same.  This happened to DD.  She couldn't feel that strong, have to go right now urge that you or I have.  And when she did poop, she couldn't empty the colon effectively so there was always stool in there.  It was miserable for all of us.  But you can fix it.  We gave her Miralax in her water/juice with breakfast and dinner.  Half an adult dose each time.  It was pretty gentle on her system, with no side effects.  The goal was to get her poop so soft that it just came right out with little effort.  It took a week or two, but it started to get soft and she was going in a pull-up twice a day.  She was relieved, and we put no pressure on her to go in the toilet.  Finally one day she was going pee in the toilet, and some poop leaked out.  She was scared at first, but then thrilled.  We celebrated, and she hasn't looked back.  For DD, the mental/physical feedback loop was huge.  And her colon is healed; no more miralax and no more huge poops.

I hope you find something that works for you soon.

[deditus]

Food intolerances caused my dd's poop issues. She needs to be dairy, gluten, soy, and egg free, needs digestive enzymes, probiotics, and magnesium every day. I think what you are probably dealing with is encopresis. Here's some great info on it:

http://www.enzymestuff.com/rtencopresis.htm

[coop_mom]

I just wanted to chime in and offer my support to you, I'm going through similar issues with my 4.5 yr old son, and I totally sympathize!! hugs hugs hugs!

my DS *will not* poop on the potty...this has been going on for a looong time, and most of the time I can deal with it...until I can't!

making a trip to the pediatrician might not be a bad idea...it might be worth it just to make *you* feel better!

good luck mama, I know this is hard, hang in there and breathe! (and I will try and do the same :) )

[LynnS6]

It sounds to me like you've got an issue with encopresis. If a child holds the poop long enough, it will 'leak out' around the big stool and soil the underwear, but the child can't control it.

I would treat this as "My child CANNOT poop". The treatments for encopresis usually involve some medical involvement (stool softeners) and some 'psychological' work (usually just with the parents, sometimes with a professional) to get the child not to be afraid of going. Think about it: If his poop was as long as his arm, it had to have hurt!

[snoopy5386]

Have you tried Miralax? From what I hear it will make him not be able to hold it and have to go.

[CariOfOz]

Thanks mamas.. both for the commiseration and the suggestions.  I don't really think it is exactly constipation, as the stool is actually *fairly* soft.. and I know he is aware of the sensation as he hides and then comes out with squdgy pants :(    But with the size of the poos .. I definitely think the mag & scheduling suggestions on the site deditus linked are definitely the way to go.  We have already been taking him at least once a day but not much success.  I'm off to the chemist (pharmacist) this morning to see what 'natural' laxatives they can suggest.

[CariOfOz]

Originally Posted by LynnS6 

It sounds to me like you've got an issue with encopresis. If a child holds the poop long enough, it will 'leak out' around the big stool and soil the underwear, but the child can't control it.

I would treat this as "My child CANNOT poop". The treatments for encopresis usually involve some medical involvement (stool softeners) and some 'psychological' work (usually just with the parents, sometimes with a professional) to get the child not to be afraid of going. Think about it: If his poop was as long as his arm, it had to have hurt!

That's what *I* would have thought too btw (bolded bit)  but the grumbling and carrying on about being on the toilet stopped long before  he actually went.. and he didn't look uncomfortable as he did go (he demanded I stay put on the little step stool)  It wasn't humongously thick though so maybe that  helped.  
 

Originally Posted by CariOfOz 

Thanks mamas.. both for the commiseration and the suggestions.  I don't really think it is exactly constipation, as the stool is actually *fairly* soft.. and I know he is aware of the sensation as he hides and then comes out with squdgy pants :(    But with the size of the poos .. I definitely think the mag & scheduling suggestions on the site deditus linked are definitely the way to go.  We have already been taking him at least once a day but not much success.  I'm off to the chemist (pharmacist) this morning to see what 'natural' laxatives they can suggest.

[Freebies4US]

I am soooo glad I found this thread.  My DD who is just over 3 will not poop.  Took her to pediatrician who gave us some stuff to put in drinks and it does help - makes it softer and easier to go so she then decided that she will go if she feels the need and I put a diaper on her - she will go in diaper.  Have not made a bit issue about this as I would rather change diapers then her not go at all.  Have tried bribery with favourite toys and things but she would rather not go than get a new toy from the toyshop!  Now we seem to have gone backwards again and she is holding it - have gone back to giving her something to help.  I know that once she goes once or twice on the toilet we will have cracked it but finding it really hard to deal with.  Do not know anyone else with the same problem so felt really alone on this one and thought everyone else was doing something that I was not.  Thank you for sharing this one!!

[CariOfOz]

Clearly it's a lot more common than I thought..I'm glad it's not JUST my kid.  Just an update.. the pharmacist recommended movicol junior (aussie brand, not sure it would have the same name there)  I FINALLY, after much trauma, got him to drink it in chocolate milk.  You're supposed to put it in 1/4c of water, and it's allegedly tasteless... but he fought like crazy.  No movement yet, so I gave him another special choccie milk this morning and will be on the look out.

[CariOfOz]

UGH.. well after a day and a half, 3 doses of movicol, and ONE suppository.. still nothing but 'crumbs'  So we are off to the doc this morning. 

[Perdita_in_Ontario]

I'm really sorry you're all going through this. We had a terrible summer with our DD going through the same thing. It started after DS was born - we decided it was time for DD to use the toilet without one of us in there with her. But without one of us in there, she wouldn't sit for long enough to move her bowels, and everything backed up. I knew about encopresis, and I suspected she was developing it, but DH was very against giving a laxative at all, and instead of going to the doctor, which we should have, we tried everything else. And eventually, she developed full-fledge encopresis, with leaking fecal matter, loss of sensation, etc.

After some horrible days similar to what you described (crying, not able to sleep because she was so uncomfortable, us eventually losing it and shouting "just poop already!") we did resort to laxatives - at first we tried a jellied mineral oil (name escapes me) and then when that wasn't working, we did Milk of Magnesia. That DID work after a lot of tummy-rumbling hours, and after that we were able to maintain the poops with the mineral oil.

We have more or less weaned her off the laxatives now (which was a short time considering some kiddos are on it for up to a year). For her, milk seems to really stop her up, so we restrict milk and she drinks almond milk instead (sweetened, sigh, but pick your battles, right?). Apple juice is really what works for her though. We give her two full kids-sized cups of apple juice a day, and in combnation with a higher-fibre diet, that seems to help everything move through. I'm not thrilled with the sugar she's getting, but I'm battling one thing at a time, and a 5-year-old without poopy undies is a success for us at the moment.

Fingers crossed you can get this under control - it's horrible for everyone to deal with.

[CariOfOz]

Originally Posted by Perdita_in_Ontario 

I'm really sorry you're all going through this. We had a terrible summer with our DD going through the same thing. It started after DS was born - we decided it was time for DD to use the toilet without one of us in there with her. But without one of us in there, she wouldn't sit for long enough to move her bowels, and everything backed up. I knew about encopresis, and I suspected she was developing it, but DH was very against giving a laxative at all, and instead of going to the doctor, which we should have, we tried everything else. And eventually, she developed full-fledge encopresis, with leaking fecal matter, loss of sensation, etc.

After some horrible days similar to what you described (crying, not able to sleep because she was so uncomfortable, us eventually losing it and shouting "just poop already!") we did resort to laxatives - at first we tried a jellied mineral oil (name escapes me) and then when that wasn't working, we did Milk of Magnesia. That DID work after a lot of tummy-rumbling hours, and after that we were able to maintain the poops with the mineral oil.

We have more or less weaned her off the laxatives now (which was a short time considering some kiddos are on it for up to a year). For her, milk seems to really stop her up, so we restrict milk and she drinks almond milk instead (sweetened, sigh, but pick your battles, right?). Apple juice is really what works for her though. We give her two full kids-sized cups of apple juice a day, and in combnation with a higher-fibre diet, that seems to help everything move through. I'm not thrilled with the sugar she's getting, but I'm battling one thing at a time, and a 5-year-old without poopy undies is a success for us at the moment.

Fingers crossed you can get this under control - it's horrible for everyone to deal with.

Bolded mine.. oh hell yeah, you have to pick the battles wel.  I am definitely going to keep an eye on the situation now that I'm aware of encoparesis being a possibility.   Yesterday we went in to see the doc, this was after a few doses of movicol (which I found out is not a stimulant type laxative, but simply draws moisture into the bowel to losen things up.. so he had to drink tons of water or dehydration was a possibility as the movicol would not let go of *its'* water) and one glycerin suppository .. neither of which brought any success.  She suggested several ways to help with the behavioural end of things, as it is definitely conscious on his part.  After doing the tummy palp, she agreed that he was full of poop lol.  We had to do two separate doses of mirilax (which is like a mini enema type suppository.. only 5mm of gel though) before he FINALLY let go with a reasonable poo today.   

From the way he did it (he had a pull up on and hid) both times today.. we think that he's got some strange idea that he's going to get in trouble for pooping!  SO we had a big talk about how pooping is GOOD and everyone does it and that he doesn't need to be scared.  THen we decorated the tree and he danced around singing about not needing to be scared lol.  We're going to do some short term 'rewards' to encourage him to try, as well as have him sit on the potty 3 times a day for about 5 minutes with zero pressure to go.  Doc recommended keeping up the movicol to make sure nothing gets too firm, as well as trying a few types of fibre supplements (as he is extremely picky and will only agree to eat limited things... although he did have taco meat with refried beans in it tonight... just a few bites!) 

I'm just SO relieved because if he hadn't gone today, I'd be likely sitting in the ER with him now.  Thanks for the suggestions & support mamas :D  I really appreciate it!