Thank you to this parent for her recent question for our encopresis experts!
Question
My 9 year old is really struggling. He works so hard with his regimen of laxatives and participation in the daily routines we have established. He has regular toileting twice a day at home and once at school after lunch. He participates in daily exercises that are recommended by the program. Yet, he still has to wear pull ups at school and has frequent accidents throughout the day. I am sure the other children are aware of this at times; sometimes I can smell it when he comes home. How can I help him? He is going to be in middle school next year.
Response
Living with encopresis can be frustrating and difficult for children and their parents, especially knowing how hard it already is to fit into social circles with other children. When they have suffered for years with encopresis and are still struggling to manage the accidents, it is often a good idea to talk with a pediatrician, pediatric gastroenterologist, and/or a behavioral therapist. There may be options or aspects of treatment that have not yet been explored.
Keeping the colon cleaned out and keeping poop moving through the colon as quickly as possible are two very important pieces to managing encopresis. If your son is following a good routine but continues to have frequent accidents, it may mean he has the wrong laxative regimen. Sometimes it is necessary for children with frequent soiling to have clean out regimens with enemas or Miralax either weekly or perhaps more often for a certain period of time.
Making sure the school is working with your son and he is participating in the process, taking ownership of situations at school as well as at home are very important. Allowing him access to the nurse and a private bathroom are also important. This can help with communication as the nurse can assist in understanding your son’s progress and whether things like additional toileting times during the school day are necessary. Privacy and access will also make changing pull ups easier when necessary, which in turn will minimize or eliminate odor, help cleanliness and prevent skin breakdown.
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