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Encopresis in 7-1/2 year old boy

post #1 of 8
Thread Starter 

My son, who will be 8 in October, has recently started soiling his underwear.  It's quite extensive--not just a little bit.  He claims he has no knowledge of it happening--and is always surprised when I tell him to go check his underwear because I smell something.  He thinks that it just pops out when he passes gas--but honestly, it's a large amount.  He also wets the bed--but that's something that he's always done.  The fecal soiling is new.


He loves fruit and veggies and gets plenty of fiber.  We only eat whole grain breads, pasta, etc.  We eat legumes probably every other day.  I've asked him about constipation, but he says that he has a BM every morning at least.


My husband is a physician--although not a pediatrician.   He views the bed wetting as deliberate in spite of the medical articles I've given him.  Our pediatrician has even spoken to him about it--but he still feels that my son is doing this somewhat consciously.  It's taken a lot of effort on my part, but in the past year--he's just let it go.  My son has Goodnites which he puts on himself, and takes care of.  If he leaks, he tells me, and we take care of the problem together.  He knows that there's no shame in it, and I simply told him his bladder needs to catch up with the rest of him.  He does seem to have a small functional bladder--based on what I can tell.


What are some possible explanations for the fecal soiling? Could it be tied with the bed wetting?  Do I need to take my son in to see his pediatrician or a gastroenterologist? I really don't want to do that and deal with the co-pays if she's going to simply tell me to make sure he gets more fiber or some such thing.  I have had IBS throughout my life--and part of the issue was fecal urgency--but that is always very conscious.  My son says that he has no knowledge of this even happening.  It's not like he tries to hide the soiled underwear or anything.

post #2 of 8

The usual cause of encopresis is simple constipation.  Not always, but often.  I'd focus on addressing that with various natural constipation treatments (fiber, magnesium, probiotics).  Bedwetting can be linked to constipation, but don't know if it's linked to encopresis alone. If treating constipation doesn't address it, then sometimes there are behavioral approaches you can try, but that takes a psychologist. Our portable pediatrician book also has some good tips on encopresis written by my dad.

post #3 of 8
Thread Starter 

Thank you very much.  

post #4 of 8

Hi, I have a similar story with my 8-year-old, but his encopresis was not resolved until I began treating both his constipation and his tendency to hold - something he was unaware he was doing. It is hard to teach a developing child to pay attention to the signals his intestines are sending him when that is usually subconscious, and even harder if his colon is stretched out from constipation! Stool softeners just caused him to hold the soft stool even more, slowing down his digestive track.


What finally resolved my son's problem was a protocol developed by Dr. Roger Collins (he validated bed-wetting alarms). His website is encopresis.com. I wish I had found him sooner, I tried everything else first. As soon as we started the protocol my son's accidents stopped. Then we could work on what was causing them (which has been a process). There are many of us who have children with encopresis, and we who follow the protocol have a parents forum so we can talk to each other. I hope you check it out.


Good luck!

post #5 of 8
Thread Starter 

Thanks Incan.  I'm definitely going to check it out.  


We've been treating with fiber gummies, stool softeners, etc.  Still accidents.  My husband spoke to a friend who suggested we try a bowel cleanse using Miralax--so hopefully if there's anything still up there, we'll get it out.  I will say in terms of administering anything, Miralax has been the easiest.  The liquid stool softener had a very off taste--no matter what we mixed it in.  The Miralax is basically tasteless--and mixed well in juice.



post #6 of 8

My son is 6 and has had encopresis since he was 2.  What you are describing is enco.  Your son has probably been constipated and holding his poop for a very long time now.  That causes his colon to get really stretched out and slow down to the point he has little or no feeling left.  He really doesn't know that poop is squeezing out.  The bedwetting is probably caused by the backed up poop in his system pressing on his bladder.


Our son was on miralax for 4 years doing the standard encopresis treatment of keeping the poop mushy so it wouldn't hurt when it came out and using positive reinforcement for going poop.  This helped initially to get our son past the fear of it hurting when he'd finally go, but it didn't address the subconscious holding and still allowed him to become impacted.  We found that we had to wean him off the miralax and reteach him how to poop.  We would do things while he sat that encouraged him to use his pushing muscles like blowing bubbles, blowing party noise makers, blowing up balloons, etc.  This helped him figure out just what he was supposed to do and was like a light bulb going off for him.


Do the cleanout, but don't just let it go once you feel he's cleaned out because he will continue the holding and get backed up again very quickly.  It takes a very long time for the colon to go back to normal size and to function normally again and with that you also have to address the behavioral issues that caused him to hold in the first place.  Any shaming you or your husband do will only make it harder for him to work on the behavioral stuff too.  I encourage you to do your research.  Learn all you can about encopresis and how the colon works and what happens when it doesn't work properly.  Then educate your husband. 


Some of us from a very AP mindset may have a hard time with the advice and protocol at encopresis.com, but I would recommend you read it with an open mind and give it some consideration.  We found encopresis.com a few months ago and it has really been helpful to our understanding of what's going on and how we feel is best to deal with it.  I had a difficult time initially with some of the protocol, but we came to realize that it could really help our son have a normal life again so we gave it a try.  It really has helped him immensely and we've seen his self confidence soar since he's stopped soiling.  He even had his first overnight!  He does still need to be told to sit on the toilet and poop.  He still holds alot and needs reminders even to go pee, and occasionally gets backed up again, but I always know it when he does because he starts wetting the bed again.  Since the soiling has stopped and our son is cooperative with going to bathroom to poop, we have altered the program to try less invasive methods of clearing backed up poop (like adding prune babyfood to his smoothie or an oral laxative if the prunes don't work), but we will use an enema if those things aren't working.  We also continue to encourage "letting go" rather than holding so I stay very in tune with his body language to try and get him to go pee or poop if I see him holding. 


I know it seems daunting and frustrating, but there is hope. 



post #7 of 8



One year ago this month, I started the protocol as described in the materials from encopresis.com.  My son was 11 at the time and began having problems with encopresis at age 8.  He also had bed wetting.  The two are ABSOLUTELY connected.  For three years we took him to his regular pediatrician, a pediatric gatrointerologist, and a psychiatrist.  After thousands of dollars in co-pays (and underwear), I paid the $90 for the materials from Dr. Collins.  I followed the instructions exactly as described and worked with my son as a partner in the process. He has been soil free for 11 months. He had one staining incident after 1 month (the protocol materials predicted that would happen) and one bed wetting incident shortly after that because he took some benadryl before bedtime and drank too much beforehand.  


You will hear physicians "poo-poo" this idea (pun intended) all over the internet.  But for me, a plain-everyday dad, the information you get from this website was heaven sent.  My son has begun puberty and has so much more confidence in life.  Everyone around him noticed a difference in his attitude toward life immediately.  It was like getting my son back.  I listened to the traditionally trained physicians for three years without results.  The only thing that worked was the protocol described in these materials.  I wish you the best.



post #8 of 8
Thread Starter 

Thanks everybody.  We're going to try the CKM manual and see what happens.  I also found a link to a story called "Sneaky Poo" that somebody recommended.  http://www.narrativetherapylibrary.com/img/ps/beating-sneaky-poo-2.pdf

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