Encopresis (Soiling Underwear)

This is when the child (almost 100% boys) have bowel movements(BMs) in their pants. This starts during grade school but the problem actually begins way back at 4 years old. The child is busy and doesn't want to come in to have BM (or urinate either) and holds it back till the last minute. It then hurts to go and this causes more retention and more constipation and more pain and a vicious cycle is started. Then they go to school and do not want to use the nasty bathrooms there and hold it all day. The rectum stretches and loses its feeling so that the child does not feel the sensation to move his bowels. Then any laughing, climbing, or movements that increase the abdominal pressure, will cause the feces to come out in the pants. He really does not feel it or know it is going to come out.

The way to treat it and this is 95% effective if you can stay with it. You have to do these things for 6 months to a year. Yes I said that long cause this came on over years and will take a long time to get control back. However they stop soiling quickly. But keep this regimen going for almost a year.

1. Clean out the bowels with a laxative. A tablespoon on Milk-of-Magnesia, or mineral oil, or use dulcolax. Use a lax for 3 days but no longer or they can be habit forming. Clean him out.
2. Simultaneously you need to start a stool softener, and many people recommend fiber but I have not found that effective. Use mineral oil --- it is not habit forming, it just softens, and lubricates but does not "cramp their style." It does not cause diarrhea or cramps. Start with 2-3 tsp. a day and go up till they have some leaking on the underwear, or going well. Or you can call your doctor for a prescription softener called lactulose that is a natural sugar that is not absorbed. It goes through and softens. The softener of some kind must be given for 6+ months.
3. Simultaneously start potty times. You can not make them move their bowels but you can make them sit there twice a day for 5 to 10 minutes. They can read, eat a snack, cry, or kick but they are on there for the whole time or you set the clock back to the whole 10 minutes and they start over. They are to also sit an extra time if the soil their pants. Do not check if they go or not, nor should you make a big deal if they go or not. the problem is they usually just get on the toilet for a second and get rid of a few lumps and jump back down. We need to teach them to stay on the toilet long enough to empty their rectum and colon like Dad. Notice men go in there with the newspaper for ever!!! That is because men have a harder time moving their bowels genetically. Girls train at 2 and boys not till 3 yr. old. That is why it is usually boys that have this problem. So keep him on there for 10 min. and as he does better, you can decrease it to 5 min once a day. There is a reflex that when you eat you have the urge to have a BM. That is why little babies mess every time you nurse them and children want to go to the bathroom during the meal.. That is the normal reflex and if they want to go in the middle of the meal, let them go and use the reflex to keep them regular. If you do not let them go, you are teaching them to hold it back and will make it worse. Use that time during or immediately after the meal as one of the potty times.

Keep this up for a long time and I promise this will work.