Does anyone have any experience with Childhood Encopresis?

[Snoopymom]

Please tell me what you did to help your child...please tell me that something worked.
Thanks so much!

 

[The Mystery Machine]

My dd doesn't have the "encopresis" but she is on Miralax daily for constipation. What therapy are you doing?

 

[cepmom]

DD5 took Miralax daily also for a while when she was a younger ~ about 18 mos or so to about 2 1/2 - 3 years old. Have you seen a pediatric gastroenterologist yet? I also tried to get DD to eat plenty of fiber and lots of water (which she really didn't care for). I also used to order special high fiber juice boxes for her from a place in CT. I can't think of the name of the place ~ the juice boxes were called "Juice and Fiber" and came in grape, apple and fruit punch flavors. I had to order a case at a time and it was a little pricey but really did help her.

Once she was potty trained, it was much easier for her to have a bowel movement without pain or holding it in. I did have to wean her off the Miralax very, very slowly. I got a kitchen scale that measuered in ounces and I gradually decreased her dose an ounce at a time. It seemed to take forever, but eventually she did get off of it and now she's fine. Good luck.

 

[kimbac3]

My DS10 has struggled with this forever. We have tried everything. What we do know that seems to work is 1.We cut out almost all dairy with the exception of an occasional glass of milk. 2. Making him try to go EVERYDAY!!! this has been key. Because, with my DS at least, the longer he waits the harder it is for him to go and the more it hurts. The more it hurts the more he tenses up.... you get the idea. We have citrucel that we use as needed. We also have used exlax and Fletchers for kids in the past. He stuggled so bad for so long!! We FINALLY think we have a handle on it. Don't get me wrong we still have rough patches but it has gotten better. I know the frustration and helplessness your feeling. I really wish you luck with this. I had to research alot on the internet because my family DR didn't seem to know how to help. I didn't want my DS to become to dependent on laxatives and such. That's when I tried experimenting with diet and keeping a record of when we went and when he tried.
Good luck and if you have any questions feel free to ask away!!
Kimba aw:
Forgot to add WATER!! Lots and lots of water. He drinks that all the time. He's allowed lemonade at dinner and sometimes milk at breakfast but it's mostly water he drinks!!

 

[Snoopymom]

No therapy or gastro doctor yet. It began when ds started Kindergarten this year. He's adopted, came home at two, and we've been dealing with some controlling behavior problems, and this seems to be another one, only more internal than the ones we dealt with when he was younger, so the pediatrician recommended a psych evaluation.

He was diagnosed with mild Reactive Attachment Disorder and mild ADHD. Our first therapy session is next week, but after reading up on it, I started increasing his fiber (he was already getting a lot, and I always had to push him to drink milk, so that hasn't been a problem) and I started giving him some fiber tablets this week and if nothing "big" happened, I was thinking about giving him a kid's over the counter laxative this weekend.

He's old enough to understand that he shouldn't hold it and he doesn't do it all the time, only when he's feeling stress, so I'm not sure if a "softener, physical type" of therapy will work.

Thanks so much for all the help, and Kimbac3, since your child was older too,
did anyone suggest it was psychological or do you think it was? I admire your patience, I think our house will implode if this lasts until he's 10, LOL.

 

[kimbac3]

Hi again! The only psychological factor that I can think of was the fear of pain. He now realizes if he goes regularly it won't hurt. He was in agony going quite a few times! He hasn't been diagnosed with any type of disorder (ADD or such) It seemed to have gotten worse around 6 or so. I have two DD's and neither had this problem. I really believe he has more of an internal problem than a psychological one. Something I read about an unusal small opening. Because of that it would hurt when he went, that led to him not wanting to go and that led to more pain.
He still can't go everyday. He tries but can't. Sometimes he goes 3 days - It's funny because I can always tell when he needs to go. His tummy gets distended and he's GROUCHY!! My youngest DD will come in and say "He's being mean..he needs to poop!"
I'm always reminding him that it will hurt if he waits.
When we tried the laxatives it took like 3 or 4 does before any results. Just keep that in mind, also when you do try the laxitives you may want to stay at home for a couple of days. When it comes it comes fast and often!
Kimba aw:

 

[The Mystery Machine]

For the both of you that do not have them on Miralax, I highly, highly recommend that you get this from your Doctor.
It has change our lives like you wouldn't believe.
All hail the Miralax!

My 9yodd's bowels are ruined from chronic constipation. Please go to a gastro.

 

[disneygals]

My niece had this and finally was put on the Miralax. I don't know all the details because we live 3000 miles away and only saw her once a year, or couple of years. I know it took a long time and did become a power struggle between my sister and her. When she was about 10, a dr told her it was in her control (she was finally old enough to understand what she needed to do to help herself) and my sister was able to step back from it. The good news is that it did become manageable, hopefully sooner for you!

 

[shortbun]

We have beaten encopresis!!! We had a pediatric gastro intestinal counselor. We went through Xrays, mineral oil, ducolax: the whole bit. How did we beat it? We were diligent as he-doublehockeysticks! Every meal(no exceptions) was/is followed by a sit down in 10 minutes. We added fiber to the diet until we were at age plus 7 grams of fiber daily. The largest percent of the fiber is fruit/water soluable fiber. Water is the main source of liquid and lots of it. Excersize was not a problem as our child is an athlete naturally but excersize is important. Lack of understanding the sensation to go was an issue-it had to be learned. Motility was also a problem. The water and fiber have taken care of that. Fiber is sooooo important and can not be added all at once or it causes similar problems. After we got things running smoothly, we quickly began adding fiber at a rate of 1 gram per day until we got to 12. Some days we went over, the day after that, we backed off a bit to balance but not that much. It was a real job for a few years. Now I am fierce about my child's right to go to the bathroom at school. For some reason, teachers really have a control issue about the bathroom. They want children to hurry or wait. Hurry and wait cause encopresis to return. Good luck.

 

[Wishing on a star]

Long term constipation can, and does, affect the bowel!!!

In young children, the bowel begins to act as a storage area, removing liquids and retaining the waste, instead of doing just the opposit, adding liquids and eliminating. The child can then can no longer 'go' in a completely normal manner!

One dose of the Miralax, and you will see the difference! You will see that your little ones system is simply not working properly! One dose will make you a believer.

If it is to the point where you are seeing incopresis, (leakage), then it is quite serious. You should really see a pediatric gastroenterologist and try the miralax!!!!

Letting this continue to be chronic problem without real treatment could cause real detriment to your child. Physically and psychologically. It just creates more 'control issues' if you have to force feed your child tons of fiber and laxatives. It is not normal for a child to need that much fiber and laxatives.

Miralax is much safer than laxatives... It works!!!

Like the other poster said...
All Hail the Miralax!!!

 

[Papa Deuce]

Please tell me what you did to help your child...please tell me that something worked.
Thanks so much!

My daughter still has bouts with it, but it seems that basically it is over. She still gets daily glycolax, as per the doctor. And it seems to have worked.

But here is one thing I learned from the folks here on the DIS. no matter how frustrating it is for you, it is probably much worse for your child if he or she is already "potty trained ".

My daughter used to stain her pants, and sometimes worse. At fisrt I was angry because I though she was just being lazy. And also, when she would do it, She would say, "I'm sorry Daddy, do you still love me"? Whan that happened I actually cried. What a jerk I was.

So, not saying you would be like me, but just wanted to relate my experience. A little bit of love, and a whole lot of Glycolax seems to have worked wonders!

 

[Snoopymom]

Wow, thanks for all the info, I can't tell you how nice it is to ask real people,
so I hope you don't mind if I ask some more...

He's had 3 accidents at school over the last three months, and 2 while we were on vacation last month, and he's had approximately 3-4 during the year before, which I ignored, because I thought he was just playing to intensly to notice or he wasn't feeling well, so with this frequency do you think a daily treatment with something like Miralax is necessary (yet)?

I'm guessing that leakage means watery, and I haven't seen that, it's more like clay, and sometimes a lot, does that mean anything? Maybe he's not completely blocked up? (sorry)

Also, there have been a few times where he's almost had accidents when he's in the bath. I figured he was holding it because he wants to keep playing and doesn't want to get out, or could it be because the bath relaxes the muscles and he can't hold it any longer?

I really hate to put him through all the tests and doctor's appointments yet...it seems that bringing all this attention to "a problem" will make it more stressful for him and bring it on even more, but when it's something that can cause physical damage to his colon, I can't ignore it, what do you think?

For the same reasons, I hate to do the whole chart thing and how do you monitor this when they're in school? When we ask him, he's pretty vague and shuts down...of course he doesn't want to talk about it, and it doesn't matter how lightly or nachalantly we ask, we've even resorted to silly potty humor at the dinner table, LOL.

I'm going to talk to his teacher today. He refuses to go number 1 or 2 during potty breaks and she always asks him, "are you sure, maybe you should try, you can't go once you get out on the playground" etc. Yeesh, I hate to tell her that maybe that's too much pressure, and she should wait for him to decide he has to go, but it might be worth a try?

Thanks so much, I really appreciate it and I commend you all! Why don't kids come with a personalized manual, LOL!

 

[Wishing on a star]

Okay, here goes.. TMI, I know!!!!

Yes, I would think that this number of accidents would warrant concern.
No harm done to see a doctor!

No, leakage does not mean 'watery'...

A dark (bad smelling) clay consistancy would describe it.

the normal bowel us up to 80% water... Waste that has been withheld for a long period becomes thicker, harder, and clay-like.

We did not have to go through a lot of tests or anything. As a matter of fact, based just on the info I told our family Dr., he prescribed the Miralax. But, out of concern, I had him refer us to a Pediatric Gastroenterologist, who did do an examination.

Wow, I really sympathise with you about the school problem!!! Been there, done that!!! At least his teacher is trying to be helpul and accomodating!
I would remember to ask the Dr. how you should approach this.
It sounds like your child has developed a kind of aversion to 'potty' issues.
This is NOT your fault! This is not that uncommon!

If the doctor prescribes the Miralax, then maybe you could try this approach... Start the Miralax on a Friday. I would want it to start working when I could be with my child. Then, if school is a big issue, that may continue to cause problems. I would consider keeping my child out of school for a few days...

The trick is, you want the child to become accustomed to the normal bowel movements. You want him to learn to become 'aware' of his body. Because, yes, encopresis does involve a lack of awareness. As they learn to withhold, they also learn to tune-out the uncomfortable sensations.

I knew that DS would simply not go #2 at school. So, we had a set routine. (Kind of still do!!) Part of his morning routine is to sit on the toilet after breakfast. (No strong pressure to perform... it will happen if it can...) He eats a breakfast that includes fiber and juice, etc.. and then he sits on the toilet. Same thing in our evening routine... He sits on the toilet before he gets his bath...

The trick is to make it a 'routine', not 'pressure'. The child simply does this... and nature, along with the Miralax, will take it's course!

Perhaps a simple reminder to the teacher that too much focus could be seen by your child as 'pressure'. And to keep it down to one simple reminder...

You will know you are making headway when, one day soon, your child actually comes to you, or goes skipping into the bathroom, all of their own accord!

 

[The Mystery Machine]

I'm guessing that leakage means watery, and I haven't seen that, it's more like clay, and sometimes a lot, does that mean anything? Maybe he's not completely blocked up? (sorry)


I really hate to put him through all the tests and doctor's appointments yet...it seems that bringing all this attention to "a problem" will make it more stressful for him and bring it on even more, but when it's something that can cause physical damage to his colon, I can't ignore it, what do you think?

You know, I am going to say this to you and I hope you take it to heart.

#1 leakage can mean compaction, which can be dangerous, even life threatening. If he is leaking you need to get medical help.

Please, please take him to the Gastro. I waited with my dd (they weren't doing Miralax then), and now her bowels are RUINED!!!
She will be on Miralax forever at this point. I urge you to go, you will kick yourself later (like me) if you don't.

 

[Toby'sFriend]

we dealt with this for a very long time. Let me attempt to do with without triggering word filters.

He had a prescription laxative - I think it was Enulose Syrup or something like that.

We had to enforce time in the bathroom. In the morning, you go in and sit for at least 15 minutes. After school you go in and sit for at least 15 minutes, before bed you go in and sit for at least 15 minutes -- and try to empty your bowels even if you don't feel like you need to. I kept lots of reading material stocked nearby - multi tasking that homework reading time and this job.

I also had to really push the fiber in addition to his laxative. I found the tablets did the job ok, but I also tried to get him to pay attention to what foods to eat.

Basically, it took a long time for his bowels to shrink to the normal size again.

 

[allie&mattsmom]

Another vote for Miralax here. DD/10 has had chronic constipation since birth. We see a pediatric gastro and she is on a daily dose of Miralax. She still has problems, especially if she misses a dose of her Miralax. She has notes from the pediatric gastro that she must be able to get up and go to the restroom whenever! And she is also allowed to have a water bottle at her desk at all times. The teacher thing and the bathroom really bothers me too. Allie no longer wants to be able to just get up and go to the restroom whenever b/c it brings attention to her and kids will know she has a problem, same with the water bottle. Other kids can't have one, why can she? So she won't take one to school with her anymore. The Miralax is key for us. She's getting pickier about what we mix it with now, which makes it a bit more challenging. At first it was only lemonade, now it's only fruit punch or cranberry juice. I have a really great chocolate bran muffin recipe with All Bran cereal if anyone wants it. They are full of fiber and taste just like a brownie! My DD begs for them. I'd be glad to post it if anyone wants it! Good luck!

 

[The Mystery Machine]

Hey, I will take that recipe if you want to share it!!!!

 

[allie&mattsmom]

Hey, I will take that recipe if you want to share it!!!!

I'd be happy to share it! This recipe came from my SIL when she was doing Weight Watchers.

3 cups All-Bran cereal
2 1/2 cups water
1 1/2 tsp. baking powder
1 box low fat brownie mix

Soak cereal in water for 5 minutes. Mix in baking powder and box of brownie mix. Pour into sprayed muffin pans. Bake at 350 for 25 minutes. Makes 24 muffins; 1 muffin = 1 WW point.

My kids love these. Just make sure they don't eat too many or they will have the opposite problem of constipation!

 

[Wishing on a star]

Just a note:

I am not sure what some posters are referring to as 'laxatives'.

But, laxatives, such as OTC remedies, are not the best for children. They are not recommended for long term use. They can be harmful.

Miralax is safe.
It is not a chemical 'laxative'.

 

[Snoopymom]

Thank you for all the sincere replies!!!

I made an appointment with the pediatrician to start off with. Wow, it's hard when it's something that is both psychological and physical...and both can cause more damage to each other, if that makes sense.

I'd also love the recipe or any other diet info!