My son (almost 6) suffers from encopresis. Â My best advice, I suppose, is to find a doctor who is familiar with it and go from there. Â The university hospital near us has a clinic devoted to this problem and, after a 6 month wait, we got in with them. Â There, he sees a GI doctor and a child psychologist concurrently--one manages the physical aspect of his encopresis (she palpates his abdomen, manages his stool softener dosages, et cetera) and the other addresses the behavioral aspect (prescribing a certain number of "potty sits" per day, practicing with him how to relax his pelvic floor, talking with him and us about school, pooping, and a lot of other things).
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We began seeing them about 7 months ago, and we see them every 2-3 months (more frequently in the beginning). Â At this point, he takes a stool softener (Miralax) daily and has 3 prescribed "potty sits" per day. Â We keep a chart of every time he sits, every time he poops (and how much, what it looks like, et cetera), and every soiling accident. Â
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At this point, he is pooping on a pretty regular basis (every day almost without exception), but almost never without being prompted by us. Â He has "smears" occasionally, but not daily.
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Good luck--I know how frustrating this can be.