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New to constipation/Encopresis...Advice???

4315 Views 36 Replies 12 Participants Last post by  allilyn11
Hello mamas,

Has anyone had problems with toddlers holding poop before they are potty trained?

She's had problems since her father and I separated a few months ago, I know she's under a lot of emotional stress. She will tighten up her legs and hold it in, and inevitably a little poop sneaks by her, and this happens up to 8 times a day! Her bottom gets really red and sore from the poop and wiping. I have kept it under control with occasional enemas and suppositories, but boy does it rule our lives. Sounds like the beginning of encopresis, and I'm scared!

My holistic dr. recommends mineral oil and glycerin suppositories, and lots of emotional support and one on one time with her when she acts like she needs to poop. I feel so guilty and like it's all my fault for not being a better, more attentive parent- but I do feel better having read some threads here and learning that this problem is more common than I thought.

I am amazed at the constipation epidemic! What is to blame? Fast-paced society? Psychological trauma?

Let me know what works, or just help me keep my sanity during this!


Thanks,

Jill
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This is not fun. It's good that she's pooping some, anyway--as long as she can't hold it completely, it's better....

Ds started this after he was out of diapers. I think it has to do with control, and also fear after a poop hurt once. I have found that the worst thing I could do was to let it become a power struggle--it was important that he not see pooping as something *I needed* for him to do. I wasn't perfect in this, which is how I learned that power struggles made it worse.

The best thing to do....was to play with him at bathroom time. We hava a character called "hand" (like a sock puppet with no sock) who is afraid of everything adn doesn't know anything. He also faints at the smell of poop. Anything that could make ds giggle when he was struggling with this really helped relieve the tension and fear. Also watching his diet like a hawk so that he wouldn't get hard dry poops--keeping it soft so it wouldn't hurt, and explaining to him that prunes, etc etc would keep it soft (not "make you poop," which he didn't want) so he could feel some control.

I don't know the solution, except he has gotten less this way as he's gotten older. Physical and mental changes both, I think. And don't ever think that you have this dumb little problem that shouldn't be such a big deal. It can wreck your whole train--do whatever you can to take care of yourself and your family through it.
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Thanks for your kind words of wisdom, Denise K...

I will do my best to lighten up the situation and make her giggle. The sock puppet is a great idea. And the power struggle thing- thanks for that advice, because I can see that starting already.

It's funny (not really) that so many of the things we deal with as moms don't have one quick, easy solution- instead the answers are found in our creativity and patience with the process.

The mineral oil and suppository combo didn't seem to work today- she just had constant urges to go and would say "mommy...poop" but didn't go. Sound familiar?
To help my daughter poop I give her alot of water thoughout the day. When it is hard giving her water I give her popcicles made of a fruit juice and half water. The water seems to make her have to poop. I also give out treats for pooping and say "wow pooping is so good for your body, doesn't that feel better" My daughter still tries to hold it in for days her longest hold was around 7 days and when she finaly moved her bowels she tore herself. Hand out dried fruit and lots of water, that and praise will hopefully help. Warm bathes and a lotion or oil massage on the tummy often helps my daughter too. Some children don't like not being in control, so they hold it in and won't let go. Don't make it a big deal for her, relax nothing happens when the muscles are tight. Good luck to you.
been there!!!!!! & it was awful....I really feel for what you're dealing with.

DS was about 15-18 months old (and still in diapers) when this started happening. I had to be the "poop doula" as I came to be known around the house.

We didn't get driven to medical help & therapy until it had developed into encopresis at about age 2.5 (not sure we would have had control over that development anyway). I now believe that he is so distracted he tends not to notice what his body's feeling...that plus a few hard poops early on developed into not heeding nature's call and then to encopresis.

It was literally driving us insane, totally affecting the whole family situation. Only people who've been through this know what I'm talking about!!

what worked (at various times) was: more fiber, little tummies (an herbal laxative) every night (built up a resistance, tho), a prescription laxative (yes, I know, it was a last resort and necessary in our case), *constant* monitoring of behavior for signs that he needed to go, a good big breakfast first thing in the morning, family counseling to help us work on a systematic approach to the problem, regular potty times (with timer; and I know you're still in diapers over there), a potty kit that we'd take with us when we went out (OUR toilet paper, fave book, timer), glycerin suppositories if he didn't go every day.

We had to be rediculously vigilant about it and it sucked, but not as much as the problem itself, and he eventually recovered. When we moved states last year and he started a new school we had to cycle back through this a biit and it totally freaked me out...."not this again! NOOOOOOO!" but his teacher would give me the poop report each day.

I really feel for what you're going through....
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Jenny, thank you for your suggestions and sympathy!

We are basically overhauling our lifestyle to try to keep this from progressing any furthur. We're developing a routine daily schedule instead of the way relaxed one from before, and I'm trying to be super attentive to her and very present since this seems to stem from insecurity/overwhelmed feelings.

Did any of you ever use enemas? We had major results with one yesterday, it was amazing how much poop she'd been holding in!

Wow, this is an experience!
We used glycerin suppositories, and once we even used a liquid laxative made from herbs but I have never used an enema on my children. I know this is hard, do you have the help of a Dr or naturalpath?
I do have a great holistic dr. that is advising us right now. And the pros are you mamas who have dealt with it before. One thing our dr. recommended was getting her on more of a predictable daily routine in general, and introducing a more solid schedule that she can rely on- apparently a lack of structure can contribute to their feelings of insecurity and fear. I just thought I was being a nice, relaxed, easy going mom!
oh momma i feel for you. this has been a huge part of our lives the last 7 months and seems to be clearing up.

we had a stressful family event and my ds held his poop for days. ever since, it has been difficult.

turns out once it got to the point that he hurt from pooping, probably a tear/fissure at some level, it became very scary for him to poop. and he would do what he could to avoid it, a vicious cycle. i tried glycerin suppositories ~ they worked but were so traumatic for my 3 year old.

mineral oil worked the first time he drank it in some juice. he never would take it again ~ also, i reevaluated giving him an oral petroleum product. hadn't thought much about it before as he was so uncomfortable and i would try anything to help him hurt less.

We eventually used Glycolax - a prescription that softened the poop so it wouldn't hurt. I didn't follow the advice and once he was pooping i stopped using it. mistake. the theory i was told was to use for a month at least so poop becomes regular and soft and doesn't hurt and then the lil guy will be able to poop without fear. eventually, i think this was one of the keys to our success.

i also introduced a high quality probiotic.

we tried psyllium husks, flax oil, diet changes (no apple juice, squash, more fiber foods) nothing really seemed to change things.

coincidentally, i've learned that when he gets lots of running around and outside time things are much better. the exercise seems to help so much. now, having spent the winter in new england with a newborn we weren't always out so much and have really noticed a difference in pooping with playing vigorously

a warm bath high up their shoulders (cover the whole abdomen) seemed to be a great way to provide some physical comfort and often stimulated him to poop.

broken thoughts, but wanted to share some of what worked and didn't for us. it is such a sensitive subject and very difficult as mommas to see our kids hurting. best of luck to you with finding relief

edited to add that chiropractic care seemed to really be helpful!!
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Thank you, farmlife mama! I'm glad you're at what seems to be the end of this ordeal. Did you have regular attempts at poop time throughout the day?

I'm wondering...I don't know if something like Glycolex would even help, because we're doing enough intervention that her poops are already soft. I watch her get the urge to poop, and then she still tightens up her legs and holds it in, while a little tiny bit of soft poop is able to get by her. Wouldn't she get that it's soft and doesn't hurt? *Holding* seems to be such an ingrained habit by now. Any ideas as how to get her to relax so the poop comes out when she gets the urge? I don't know how much to intervene- like should I be trying to help her relax her legs, help her get in a different position- or just let her do her thing...

I'm hanging in there but it sure is frustrating to watch this vicious cycle and know that another suppository/enema is probably right around the corner. Also trying to be PATIENT.
When DS was littler and doing this more like your dd seems to be--holding soft poop until he cdn't walk and finally it wd just start coming out, or explode out on the toilet w a lot of cramping--I wd just get right down with him on the floor and hold him and talk to him about it: I can see you're really uncomfortable. Your tummy looks like it hurts. Your poop really wants to come out, your body wants it out, but you're holding it in. You must be scared it will hurt. I will stay with you. Pretty soon it will come out, and you will feel SOOOO much better. You'll be all right. I'll help you.
--Just your basic labor doula thing


And, to undermine his attempts to hold it (w/o letting him know that's what I was doing) I have always used "dance parties"--livlely music, and dancing with him. Or jumping like frogs. Anything to let him really move his middle/lower body; the great hting about little kids is you can draw them in through their imaginations and they'll forget that they are sitting down all the time for a reason....

And ditto on the exercise thing in general.
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skylerliz--do a search on encropresis as well. there have been some good threads in the past. one was very recent. JaneS linked to an interesting article.
I forgot about frogs! ds and I jump on the floor like we are frogs and as mom above mentioned, i often stay with him and talk to him about how it looks like it hurts and how i've felt like that before. he really responds to the idea that it happens to other people.
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I went through this with my DD as well. Unfortunately it lasted about a year! And it was awful. She would hold it in, and then when she HAD to go it hurt her so bad that she would hold it in - and the vicious cycle began.

She once held it for nine days and the poop was SO compacted I had to dig out out. Ugh. Sorry - TMI. I had to use suppositories, which I did every 3-4 days if she wouldn't go on her own. It broke my heart and it was just plain horrible.

When she got a little older, I talked to her about trash. I told her poop is like the trash in the kitchen. When it builds up it is time to throw it out - it's her body trash. And if I let the trash pile up in the kitchen without taking it out it would be hard to clean up - just like holding your poop makes it hard to come out. And I made up a silly body trash song. LOL.

Well for some reason this analogy worked with her and she started pooping - daily.

I feel for you. My PED said there are 2 things you cannot MAKE your child do - sleep and go to the bathroom. So true.
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Wow, mamas, thanks so much for your support and encouragement during this! What would I do without you?
SkylerLiz---how's it going over there? just curious; this condition is a long process to get past it....

jenny
Thanks for asking, Jenny!

We've got it under control for the most part using mineral oil every couple of days, but I know I need to switch to something she can take daily on a regular basis. I'm wondering if something like flax oil will be sufficient enough. She is still holding occasionally, but seems to be mixing that with actually letting some out and being really proud of herself when she does poop. That may be only because of the mineral oil, but I'm hoping it's getting her used to letting it out. One day at a time. The good news is we haven't had to use enemas or suppositories in awhile.
The habit aspect was really important (and continues to be, every now and again) in turning thing around....it's amazing how it takes over everything....good luck.
What a relief to find this thread and see that there are others who are dealing with this. Not that I'd wish it on anyone. Ugh!

My 2.5 year old has always hated pooping. At first he would just cry and be really anxious while pooping. I'd hold him, try to calm him and he'd poop. As he got older he'd spend a day or two doing an anxious poop dance everytime the urge to poop hit him but he'd refuse to let anything out. Eventually he'd go but those couple of days were miserable for him. Then he started only letting a little poop out at a time for about three-four days. He'd get a horrible rash around his anus and we'd change diapers constantly. Eventually, though, the "big poop" would come out and we'd enjoy a few days of poop free diapers and him being happy and carefree because he wasn't struggling to hold his poop in. He was never, ever constipated during this time, thank goodness.
Then, it started to get worse around November. He'd go a full week just letting out small amounts of poop at once but he'd always eventually do a big poop.
In late January his little brother was born and he did not have a normal bowel movement for three weeks. Just the same small amounts of poop and a very, very sore bottom. I called his pediatrician and he had a big poop the day before his appt. Everything checked out fine at that appt. Dr told me to bring him back in if he stopped having big poops altogether. Well, the last time he had a normal bowel movement was the day before that appt and it was February 19th. It's been two months since he's done anything other than constant small amounts of poops. We go through about 10-12 diapers per day. I think he has fecal incontinence and is probably constipated or impacted. I haven't noticed him acting any differently, though, but maybe he's just used to feeling that way? Either way, I think it's time for more agressive measures such as laxatives or suppositories because diet changes have never worked to stop this problem. He has a healthy, fiberous diet anyway.
I just didn't want it to ever get to this point because I know that getting him cleaned out is going to be so hard for him. It breaks my heart.
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hi allilyn11,

Wow, sounds exactly like our experience! It is absolutely awful and all consuming. I can totally relate to the 10-12 diapers a day and the horrible diaper rash. I would definetly recommend anything to get him pooping- he is probably pretty impacted by now. The things that have helped us are enemas, suppositories and mineral oil. I would start with enemas, but be sure to have two people there (or more!) It is not fun and my quite traumatic the first time, but now my dd knows that they don't last long. For us, laxatives and suppositories weren't effective in taking care of the impaction, but enemas got so much out it was scary. After that, we've been giving her mineral oil. She has been better at not holding, but needs a lot of encouragement while she's going- her father reports that he gets right there with her and gets super enthusiastic with her, laughs, they sing songs about all the people we know that poop...I'm not nearly as good at enthusiasm so it seems that her major big poops are when she's with him.

If you need advice about the enema thing, let me know. So sorry you're going through this.
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