8 year old pooping pants

[eetu]

Hey there, I’m really looking for some advice for my almost 8 year old who still poops his pants. This has been an issue for about 4 years. He was fully potty trained and I think around 4 we started dealing with encopresis (chronic constipation). We treated that with keeping him clean with miralax and he started having whole BMs like normal. Except the accidents never stopped. He absolutely hates using the bathroom, even for pee. When he does soil himself, he doesn’t care too much to clean it up. He would much rather keep playing or doing whatever he’s doing than clean himself up. Even when we offer to help. Sometimes he will go hide somewhere to have an accident so he absolutely knows when. During the encopresis we suspected he wasn’t even feeling BMs due to the condition of his bowels, but it has seemed to switch over to being all behavioral at this point.

We have tried everything from rewards to helping clean up to letting him do it alone. Allowing him to listen to his body, setting timers for potty times. Taking toys away, rewarding with toys/screen time. He just doesn’t seem to care, or is sick of talking about it. Believe me, we are sick of it too but we support him so much with this issue.

Unfortunately, it seems like there’s a lot of shame that comes with his accidents. He’s very embarrassed and shameful when he’s had an accident. He’s hidden soiled undies from us and refuses to go to the nurse at school or ask for any help. Kids have even mentioned that he stinks at school after he’s had an accident, and none of it drives him to make different choices. He has been able to string a few days together of no accidents, but it doesn’t last long. We can’t seem to keep him on board for very long with external sources, and he cannot keep himself on board internally.

Should we look into counseling for him? He doesn’t even talk to us about it much, so could someone he doesn’t know even help us? Thank you!

 

[harko]

@eetu The first thing to do is get an appointment with the pediatrician. There could be a lot going on here and the pediatrician can rule some things out and better advise you.

 

[bishopoflyons]

@eetu The lack of awareness (or denial) about soiling is a known symptom with encoparesis. The focus should be on managing the bowels and not on the child’s behaviors associated with soiling. It is imperative that the child is placed on a schedule for sitting on the toilet, even when they don’t feel the need to go, to establish a healthy bowel routine. Definitely need close supervision from a doctor skilled in treating this condition. It won’t get better with time nor with punishment.