Encopresis (Soiling Underwear)
is when the child (almost all boys) have bowel movements(BMs) in their
pants. This starts during grade school but the problem actually begins way
back at 2-4 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. Plus they are busy and if they need to have a BM
they just release a small amount and leave. They don’t stay long enough to
empty the colon. 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.
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 because 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.
Clean out the bowels with a laxative. A tablespoon on Milk-of-Magnesia,
or mineral oil, or use dulcolax or high dose of Miralax. Use this for 3
days and clean him out.
Then start a stool softener every day. Many people recommend fiber but
I have not found that effective. You can use mineral oil --- it is not
habit forming, it just softens, and lubricates. 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 having soft to mushy BMs. Or you can
use Miralax or its generic form. Start with ½ capful of powder into any
liquid or food if they are preschool and a whole capful in school age.
Increase till stools are soft or even mash potatoes consistency.
Continue giving this for several years if not forever. They are not
Simultaneously start potty times. You cannot 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. (Men
are full of it…. Right ladies?) Notice men go in there with the
newspaper or I-pad forever!!! That is because men have a harder time
moving their bowels genetically. Girls train at 2 and boys not till 3-4
yr. old. That is why it is usually boys that have this problem. So keep
him on there for 5-10 min. and as he does better, you can decrease the
minutes or go to 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 their diaper
every time you nurse them and children want to go to the bathroom during
the meal. That is the normal reflex and if they have a stomach ache
during or after the meal, then let them go and use the reflex to keep
them regular. Use that as one of their potty times. If you do not let
them go, you are teaching them to hold it back and not follow the urge.
Keep this up for a long time and I promise this will work.