Posted by: Dee | 2007/06/09

Retaining stools & soiling clothes

My 8 yr old boy has stages of retaining his stools, sometimes for up to a week, or, soiling in his pants. I've tried constipation medicines to loosen the stools but then find he soils his pants rather than going to the toilet.. Is this a physical problem or more likely a phobia?
He does find school work difficult and we do have him on homeopathic medicine for improved attention, which has helped, yet, he is always happy to attend school and is a generally happy child.
It's got to a point where he will go to any toilet but hide and hold it in rather than use the toilet..sometimes even at home ?
Why could he be doing this ? We are confused?

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Our expert says:
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There is a recognized condition called Encopresis, in which a child is capable of producing normal stools, but does so at inappropriate places and times ; and also something likewhat you describe, in which a child holds back from going to the loo. It can be a combination of physical and psychological problems.
Sometimes, for instance, a child becomes costipated, for any of a dozen temporary reasons. Passing a large and hard stool there may be a small tear in the lining of the lowest bowel ( such as an anal fissure ) , making it painful to pass a stool, so he holds back for fear of discomfort --- but then becomes constipated, which makes it painful to pass those stools, and so on, with a sort of vicious cycle. Not a phobia, where the fear is irrational, but a rational fear of real discomfort, though this is aoidable. They may be helped by a stool softener rather than a stimulant aperient.
You imply in your question that this is an intermittent problem, which would show that his bwels are fully capable of functioning normally, and you also describe this as though it were a fairly recent problem, and again a history of entirely normal bowel movements recently is encouraging and strongly suggests the bowels themselves are normal. Unlike the situation with actual bowel structural problems like Hirschpsring's Disease, which presents itself much earlier in life.
Assessment by a good local pediatrician would be wise, as he can check for a fissure ; and managing that could clear up the problem. If that does not work, then a child shrink could most probably help.

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Our users say:
Posted by: anon | 2007/06/09

Well if its not diet related, eg, fruit, fibre, vegetables and enough water during the day, then its certainly might have some emotional component which manifests physically.

Is he ADHD or ADD. He may appear to be happy to go to school but perhaps his anxiety is manifesting via his digestive system.

Take him to a paediatrition for a check up and evaluation, perhaps you might also get good advice from a dietician.

The topic suggests he is holding back on more than just his stools.....anxiety can manifest as either irritable bowel or constipation.

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Posted by: Hope | 2007/06/09

I know someone whos child did the same thing, also about the same age. It turned out that the child was sometimes afraid of going to the loo on his own. The problem was solved by mom waiting outside the door for him when he wanted the loo.

Reply to Hope
Posted by: RMC again! | 2007/06/09

Does he also get enough fibre? You shouldn't need to be giving him opening medicine.

Something small like even the medicine could be causing constipation if it is physical.

Reply to RMC again!
Posted by: RMC | 2007/06/09

Have you spoken to the paediatrician about this?

I don't think it is a physical problem or there would be no stools at all.

How long has this been happening?

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