Encopresis in School-Aged Children

Parent Q&A

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  • We have a 6 year old with encopresis and we are in a good place with medical management right now and he is no longer soiling but any change in routine or week off school etc causes him to get a bit backed up again. It seems like anxiety to us and we are looking for a therapist who is good with this age group and familiar with encopresis. Hoping for east bay or virtual!

    I am so jealous!  We also have an almost 6 year old with encopresis but he continues to have to wear pull ups because of it (and because of likely related pee accidents) despite almost 6 months of medical treatment.  As it happens we had been wondering whether some of this is behavioral and have been seeking therapists in this area.  We have Kaiser so have reached out to their pediatric psych department.  Can't comment on their efficacy or provide specific names because we haven't had an actual appointment yet.  However, we have heard really good things about Dr. Becker at UCSF Osher Center and have been trying to get an outside referral to him.  Not sure if he does virtual but perhaps give his office a call.  https://osher.ucsf.edu/patient-care/patient-care-team/david-becker.  If you get any recommendations and/or find someone you like, I would be so appreciative if you could circle back here and post their name.  We are honestly a bit at the end of our rope.

    Mindy Szelap is an expert in encopresis and really helped our kid and us.  You can reach her at  mindy.szelap.lcsw [at] gmail.com.

    My daughter saw Dr. David Becker at UCSF, last summer, and he was great.  She saw him at the pediatric pain management clinic.  He also has a separate therapy practice at UCSF.  Very good at connecting with my daughter, and very knowledgeable, and very caring.

  • Encopresis for 7 year old

    Apr 26, 2021


    I am seeking suggestions and recommendations for a specialist who has worked with kids with encopresis. My daughter is 7 and we have already done the clean outs, mirilax, sitting, timer etc. We are looking for specialists (be it therapists, OT, etc) who have worked specifically with helping kids with encopresis move away from the associated fears and behaviors that keep them withholding. 


    Hi, I am not sure if your 7 year old daughter is in school/ around other kids, but this may have something to do with it. My 5 year old was having issues with this, although she was more "choosing to go in her underware as I think she felt in control. All of this started around the beginning of the pandemic. She was out of school for 10 months, and the week before she went back to school she stopped having accidents 100%. Still to this day, on spring break and with a  week off from school she had a few accidents with the change in routine. I think it has to do with a different routine and when they are around kids there is more social pressure  to do what your peers do. 

    I am not sure if this is helpul or not, but I too thought it was Encopresis for a while. Then I realizied it was her trying to have more control over her lift.  What dramatically helped her, was letting her wear dresses or leggings, with no undies, and this really encouraged her to go to the toilet. We did this for a week, and it was a game changer. I also didn't ever make a big deal about the accidents. Just was there camly to help her get changed. 

    I hope this helps or may give a new perspective on what could be going on. Let me know if you want to chat more :)

    Hi, my heart goes out to you!  We have an almost 7-yr old boy and we have been struggling for years.  Tried everything.  No advice aside from wanting to say that you are not alone!  Happy to connect separately to share all the different things we have been/are trying, and just to offer some emotional support.  Please contact us through our username here to connect.  

    Like other parents, I just wanted to say that you are not alone. We have a 6.5 year old boy and still struggle with accidents & regressions.

    As for specialists, we have had a couple of consultations with Elizabeth Gleghorn at Children's Hospital, which were helpful to get additional perspective, but honestly didn't change all that much. The biggest benefit from those consults were getting referrals for xrays so that we knew the cleanouts had actually worked, and to know that his issues didn't stem from dietary issues. 

    Like the other parent who posted, we notice a big difference with changes in routines (more time at home = more accidents; more regular school routine = fewer accidents). We found that, despite all advice to the contrary, reducing daily Miralax helped firm up stools and give him a better sense of physical control. We have also found that doing a lot of mental preparation before potty time followed by a simple reward ("when we get home the first thing you are going to do is sit on the potty, and then after you poop you can have a snack/ipad time/soccer/etc.") have been the biggest help. Going potty as soon as we get home seems to help reduce the chance of him getting distracted, going into another room to withhold, etc.

    We've tried super hard not to show our frustration, but have been honest about consequences: "If you keep having accidents we need to do another cleanout to help your body poop regularly again." That usually helps reset expectations about how hard he has to try. 

    Best of luck, and feel free to DM me for additional support.

  • Hi BPN, 

    So we have been struggling with our 6+yr old’s potty issues for years.  We have the pee issue mostly ok, but have never gotten a handle on the poop front.  We have seen a long list of providers over the years including various psychologists, a gastroenterologist, a potty consultant and a biofeedback specialist.  Though we have gotten a diagnosis of encopresis, no “treatment” regimen has had any helpful effect and we remain very lost on both the physiological and the psychological aspects.   Now that our child is in elementary school, this issue is really having a major effect on quality of life (both our child’s and ours).  Has anyone gone through this, what eventually helped, and what type of providers helped with the diagnosis or the solution?

    Feeling Stressed and Desperate

    Feel free to PM me if possible. It can be really hard. Keeping things moving and avoiding getting backed up is key, and can mean daily doses of Miralax (for years), maybe also with prune juice, flax oil, and avoiding constipating foods, and prioritizing high-fiber ones. Regular potty try times, 10-15 minutes after every meal, and clean outs as needed. For some people, I've been told that they need Miralax for their lifetime. :(

    Up until recently, we have had this very same issue with the same age kid.  One thing that really has helped, rather than us watch for signs of him holding in his poop until he got constipated or had an accident was to get a potty watch.  There are kinds where you can set them for intervals as short as every 15 minutes or as long as 90 minutes. Every time the watch buzzes, the kid has to go to the bathroom and check, even if they don't feel anything.  This has not solved ALL our problems, but it has really helped.  It also takes the onus off of us, the parents, to constantly monitor him and bother him by telling him to go check and leaves it up to a neutral party (the watch).

    Oh my.  I am mostly posting just to commiserate.  Would you believe I have an 8 year old who has had encopresis since she was 5.  She does see a gastroenterologist at Children's Oakland, as as you can imagine, we have tried so many things.  The best the gastroenterologist has had to offer is to switch up her meds here and there and provide the usual advice about setting potty time etc.  We have done some additional testing and will do more.  From all I have read the impression I have is that there are some kids who just have this and it goes on for years sometimes.  Then magically goes away once their bodies get a little older.  I wish I had more to offer.  I just want to let you know you aren't alone in this.  And of course I will follow this thread to see if anyone else has figured out something we haven't!  Thank you for posting.

    Hi, I’m so sorry you’re dealing with this. It sounds like you’ve seen various specialists, and so maybe you’ve already ruled out underlying medical diagnoses. I thought I’d just offer our experience since we struggled with this for years with my daughter, who is now 5. She ended up getting diagnosed with Celiac Disease, and the combination of a strict gluten free diet and daily Miralax for about 6 months helped her stool issues completely resolve. (She hasn’t had any further problems with stool withholding, leakage, constipation, etc). There was also some behavioral component, and having her sit alone on the potty at the same time each day after a meal also helped. We tried all the typical diet-related advice for years (increase fiber, vegetables/fruit, nondairy fat, prune juice, increase fluids, etc), and it wasn’t until we were aggressive with the Miralax that we started seeing a difference. It also took the pressure off and reduced my nagging related to food and fluid intake.

    Celiac was not on our radar, but I’ve since learned it’s way more common than I realized, has a wide variety of symptoms (especially in children), and the initial test is just a panel of bloodwork. I had no idea it runs in families and is an autoimmune disease (not a food allergy). If your child hasn’t been tested already I think it’s worth ruling it out. (Just FYI, you need to be eating gluten daily for the bloodwork to be accurate). Good luck!

    I feel your pain!  Encopresis is not easy.  My daughter was diagnosed when she was 4 and we have had our ups and downs.  As a starting point I bought the book "The Ins and Outs of Poop" by Thomas R. Duhamel, which came recommended and then I joined a few facebook encopresis support groups.  I felt the most helpful thing was to get educated about the condition and to talk to other parents about it.  I have had some really insightful information come from the group that helped the way I view the condition.  The gastroenterologist should be the most helpful in regards to the physical aspects.  Though, to be honest, mine has only been moderately helpful.  I feel that I have to be very proactive in scheduling phone visits and emailing to get more information.  If you need to talk, please feel free to reach out.  

    I was feeling pretty stressed and desperate about this with my 4 year old a few weeks ago but we've tried a few things, after speaking with our alternative pediatrician: Christine Ciavarella (we have a Kaiser pediatrician, but sometimes I call Christine instead because she is more personal and wonderful and often helps in ways Western Medicine doesn't). My daughter kept pooping her pants at preschool and then was too shy to tell the teacher, and would sometimes sit in it for lunch. I felt so helpless and I truly think each child is different and has different needs but here's what seems to be working for us (fingers crossed):

    My daughter is very imaginative and creative and smart...so I feel like her brain is often way ahead of her body. She seems to be "in her head" so often that she either doesn't sense the poop coming, or (with pee) just doesn't want to stop her playing to do something as boring as go potty.

    So we've been focusing on 3 things:

    1) Routine (trying at first to get up a little early, or keeping her home a little late from preschool to establish a routine of poop IN THE POTTY rather than in her pants. Be consistent to establish routine.) After a week or two, she was ready to go to school without pooping, and thought she could remember to do it at school. She did! And she even has added a BM some afternoons but has made it to the potty.
    2) Body awareness "exercises" - some little games, and tricks to help her be more grounded and "in her body." I've told her they're to help her sleep better, but they also seem to be helping her get to the potty on time. These are KEY. I really think they are helping with body awareness. We do them before bed. One is with a yoga ball (fun!) and one involves rolling her up like a burrito (also fun!!)
    3) We've been giving her a little fiber every morning (which scared me at first, because I thought this was for constipation, but supposedly can help regulate both loose or solid BMs). This, I told her, was to help slow down her poop, so she can feel it coming and get to the potty in time. This also, seems to be really working.

    I also ALWAYS notice more accidents when she's not getting enough sleep. Which can be often, because her brain is so active. That's why the exercises are so helpful at bedtime.

    These 3 things have really seemed to shift the pattern for her with poop. Feel free to contact me. Or Christine. She's great.

    As for pee...we finally broke down and are doing an incentive sticker chart. This is because the pee accidents are more willful (she just doesn't see the point of stopping her game to go). I was told this really works for some kids, even though I thought this wasn't the best parenting technique. So this is starting to work. Switching up the "prize" each week.

    Good Luck!

    I’m so sorry you’re struggling with this, it sounds really hard. I don’t have personal experience but I work in MH and asked a colleague about her thoughts. 

     TBS (therapeutic behavioral services) has helped a lot of kids with enuresis and encoprisis - though I don’t have a specific referral for anyone currently accepting clients.

    She also recommended you might explore working with an OT to assess for sensory issues, sensory issues get overlooked a lot and tactile input can have a major effect on encoprisis. 

    My kid is now grown, but we had this painful issue when he was 3-5. The only thing that worked was Soiling Solutions (https://www.encopresis.com/). It sounds like a weird program and I was very worried to try it, but I only wish we had tried it sooner. Like you, we tried sooo many things first, basically everything, including therapists, timers, bribes, doctors, laxatives, and even me leaving work once a day to take my kid to the bathroom in kindergarten (yes, it got to that point). When I read that some kids could have this issue until their teen years, and it could cause permanent damage to the colon, I was ready to try anything. Well, Soiling Solutions worked. It was brutal for about 10 days and then it was done; he was "cured". After the program is over, you need to ensure they have soluble fiber every day (not Miralax or Metamucil) and the best source is Acacia Fiber powder. My kid had a teaspoon or two every morning in juice or a smoothie until he left for college! You can also bake it into oatmeal cookies, add to yogurt, etc. My kid needed quite a lot of the acacia but you will find out the right quantity for your child; start small and add more if it's not working. Plus lots of strawberries, blackberries, and blueberries and limit the bread, rice, apples, bananas, etc. Good luck. It was a long time ago for us, but I still remember the helpless feeling and I hope you find some relief for your child and your entire family. 

    My son had the same issue. We worked with the Pediatric Urology Service at UCSF and solved this issue quickly. Their Nurse Practitioners are fantastic and specialize in treating this issue. We meet over Zoom and it has been great.  

    Our kid (now 15) also had encopresis at that age.  She still has issues with constipation, and has since she was an infant.  We were told that she had a big poopy plug and that newer, softer poop would ooze around it.  Thus the solution was first to clean out the plug using an enema, and then retrain her stretched-out bowels by giving her Miralax daily for at least a year so that her poop was very soft, near diarrhea.  This dealt with the encopresis, but the underlying constipation remains a big issue.  We still use a lot of Miralax and other fiber products.

    Our kid also had ADHD, and I remember the doctor who diagnosed the ADHD nodding when I mentioned encopresis.  The two conditions frequently co-occur.

Archived Q&A and Reviews



Have you successfully dealt with encopresis?

March 2009

We are in search of any advice from folks who have successfully dealt with their child's encopresis. anonymous

My son suffered from encopresis for several years and I know what you're going through. We tried EVERYTHING in different combinations: homeopathy, miralax, probiotics, magnesium supplements, fiber supplements, Juice Plus Fiber, diet vigilance, reward charts, little presents, shouting (I don't like to admit that one, but it is so frustrating at times), and even saw Meg Zwieback paying out of pocket. None of that really worked to cure the problem. Well, I will save you the time and money and tell you about Soiling Solutions (http://www.soilingsolutions.com/). It was the best thing that ever happened to us, it absolutely changed our entire family's life. It costs $75 online and I was super reluctant, thought the whole thing sounded weird/quackish etc., and even tried to back out of doing the program. But this program is a miracle. It's tough in the beginning and we didn't get results for the first 2 months, but it works. I would be happy to talk to you more about it via email (curanto [at] yahoo.com), and we even have the manual that I'd be happy to lend you. We don't need it anymore -- our son is fully cured for the last two years. He is a different kid. Sorry you're going through this, and the pediatricians really don't know anything about how to help: they just push Miralax and that is not the answer to this complex physical/emotional problem. Been there

We are still working on encopresis at our house. The new bit of help that we got was that the g.i. specialist ordered an x- ray for our son. The x-ray showed that he is constipated although his stool comes out soft and he goes all the time. Now he's supposed to get Miralax daily for 6 months. He and I are feeling more hopeful. Good luck! Dealing with the same problem

5-year-old witholding bowel movements

June 2003

Help! My son had a bout of diarrhea and it seems to have freaked him out. For the last 3 wks he has been back to normal physically, but he is terrified to have a bowel movment. He starts to cry when he knows he needs to go, telling us it will hurt, it will hurt. He works himself up to quite a state, and refuses to go alone to the bathroom. Often we sit with him for an hour while he tries to go, with him crying and worrying the whole time. While the diarrhea started this, I think, it is clearly just psychological now. His poop is normal, and we have tried everything dietwise to make it soft and easy to go. When he does finally go, he says it didn't hurt, but that doesn't seem to make the next time any easier. Now it seems he is starting to withold because of his fear...when he does go, he goes quite a lot. But he is still going every day or so. We are at our wits end, and trying very hard to be patient, but sitting in the bathroom for an hour is no fun! Also, this is a kid who has never had any problems with this kind of thing before...usually he's great about toiletting and its no big deal. Any suggestions much appreciated...we are running out of reassurances to give him and ideas. Ann

You have my sympathy! We went through this on and off (mostly on, unfortunately) from ages 3-5 starting with a bad case of constipation. Our doctor recommended powerful laxatives which we tried but eventually decided was a bad idea. What finally seemed to do the trick was offering a prize for every poop, with a ''big prize'' after 3 poops (then 4, then 5,...). Prizes were things like stickers, plastic frogs, whatever sort of one-dollar party favor type thing. The ultimate big prize was a computer game. We were amazed how this finally worked after years of the sort of struggle you described. Then again, she was a bit older by this time (almost 5), so maybe she was otherwise just ''ready''. Good luck! Karen

5-year-old terrified to have a bowel movement

June 2003

Help! My son had a bout of diarrhea and it seems to have freaked him out. For the last 3 wks he has been back to normal physically, but he is terrified to have a bowel movment. He starts to cry when he knows he needs to go, telling us it will hurt, it will hurt. He works himself up to quite a state, and refuses to go alone to the bathroom. Often we sit with him for an hour while he tries to go, with him crying and worrying the whole time. While the diarrhea started this, I think, it is clearly just psychological now. His poop is normal, and we have tried everything dietwise to make it soft and easy to go. When he does finally go, he says it didn't hurt, but that doesn't seem to make the next time any easier. Now it seems he is starting to withold because of his fear...when he does go, he goes quite a lot. But he is still going every day or so. We are at our wits end, and trying very hard to be patient, but sitting in the bathroom for an hour is no fun! Also, this is a kid who has never had any problems with this kind of thing before...usually he's great about toiletting and its no big deal. Any suggestions much appreciated...we are running out of reassurances to give him and ideas. Ann

You have my sympathy! We went through this on and off (mostly on, unfortunately) from ages 3-5 starting with a bad case of constipation. Our doctor recommended powerful laxatives which we tried but eventually decided was a bad idea. What finally seemed to do the trick was offering a prize for every poop, with a ''big prize'' after 3 poops (then 4, then 5,...). Prizes were things like stickers, plastic frogs, whatever sort of one-dollar party favor type thing. The ultimate big prize was a computer game. We were amazed how this finally worked after years of the sort of struggle you described. Then again, she was a bit older by this time (almost 5), so maybe she was otherwise just ''ready''. Good luck! Karen

5-year-old with encopresis


My son, who is 5 and 1/2 years old has been having problems going to the bathroom when he needs to have a bowel movement. His doctor told me that he has a mild case of encopresis, and that it should be treated right away or it could become very serious later. She ruled out the possibility of being physiological, she thinks he needs to see a psychologist for that. What happens to him is that, when he is out of home, or playing with a friend, he doesn't stop to go to the bathroom, if he needs to poop, he tries to hold and most times gets his underwear dirty. When he is at home by himself he usually goes to the bathroom normally. This used to happen from time to time before, but in the last six months it is happening almost every day. I would like to know if anyone have had a similar experience and what they did. Also, if anyone could recommend a good children's psychiatrist that preferably would take Health Net. Thanks a lot.

I have no personal experience with this problem, but a few years ago I read a very convincing study about an experiment that helped kids with the problem. The experiment showed that group cognitive behavioral therapy and biofeedback was highly effective at helping kids with the problem. The group aspect helped the child feel less embarassed, the cognitive therapy helped them understand and adjust their thoughts and feelings about it, as well as teaching them about eating high-fiber foods, and the biofeedback helped them to re-learn how to poop normally. The kids in the study had encopresis combined with constipation, and had basically lost touch with their own body's coordination of how to poop. These kids, who were described as typical of encopretic kids, ended up with a habit of pushing the poop to get it out, but at the same time squeezing their anus closed, so that the poop couldn't get out. So they would just hold it, and it would eventually come out on its own as soiling their pants when they couldn't hold it anymore. The biofeedback helped them re-learn what the feeling of opening the anus felt like, so they could push effectively at the right time, e.g. on the toilet. It is definitely something to address right away, so that the uncoordinated habit doesn't get entrenched, and to avoid the development of painful conditions like anal fissures and hemorhoids and otherwise painful poops. Best wishes.

Feb 2000

I originally posed the constipation problem to the digest over a year ago - and, as usual, you guys came up with great advice! Since the issue has come up again, I thought I'd share what worked for us. At the time, my son was 5 and had been having problems pooping for over 2 years. For the past year, we have made real progress - though it's still a big part of our daily routine. Here's what we did...

An x-ray showed a big bag of poop. His muscles were stretched all out of shape, even after months of mineral oil and Lactulose (prescription). Our doctor recommended clean out either with daily enemas for 4-5 days or surgical removal. Why she hadn't recommended that 18 months earlier, I don't know - but I digress. We opted for the lesser trauma of the enemas. Our little guy was a real trooper.

Now we're on a daily dose of mineral oil and Milk of Magnesia. Yes, both. Some hints...

1. Mineral oil hides really well in milk shakes.

2. The emulsified mineral oil, Kondremul, is best served cold. Mix in a little chocolate syrup or strawberry syrup for flavoring. You don't need much to get results.

3. Walgreen's sells a *concentrated* Milk of Magnesia that's strawberry creme flavored. You only need to give half as much as the regular - a real plus when you're having to coax the stuff in. We serve ours cold mixed with regular milk.

Since our little guy was a pre-schooler, we were able to reason with him and explain the consequences. If you don't drink your milk and oil, your poop will get clogged and you'll need a squirt (enema). Well, no arguments there. In fact, he reminds us if he doesn't get his milk and oil for the day!

Finally, the absolute best thing we did was a consultation with Meg Zweibec. Our pediatrician had been helpful, but, by this point, I felt we really needed a coach. Our little guy was in quite a bit of discomfort, and it was impacting other parts of his life (i.e., socially, potty-training, self-esteem, etc.). Meg was great - she gave us the confidence that we could solve this one and we walked away with an action plan on how to do it. Meg's hourly rate isn't cheap - but she's worth every penny. Her number is in the Oakland white pages.

Bottom line - don't let the problem go unsolved. Exercise, increased fluid intake (good luck with that one!) and improved diet (well... you can try..) might solve the occasional bout, but if this is a persistent problem, you need extra help. Avoid prune juice - it can cause cramps (per Meg, our pediatrician and the surgeon we consulted). So does Senekot (over-the-counter). Try everything and anything til you find what works. But, whatever you do, get it resolved as soon as the symptoms develop. Good luck!

5&1/2 yr old daughter will only poop while sleeping

My 5&1/2 yr old daughter will only poop while sleeping. It all started 3 yrs ago, when she accidently pooped in the tub 2 nights in a row. She was sharing the tub with her sister, and the hysteria that insued caused her so much trauma, she started holding her poop in. Needless to say, constipation problems began (14 days without pooping the all time record), which also made pooping traumatic. We now have the constipation problems somewhat under control via encouraging liquids, and adding a little aloe vera juice to a night time drink (works great - doesn't block absorbtion of nutrients the way mineral oil does and doesn't cause stomach cramping). My daughter really wants to stop wearing pull-ups, but the mess with a pooped bed in the am is unbearable, and she will not wake up. She tearfully told me that she doesn't know how to poop during the day, and cannot feel when it wants to come out. Could she have permanent damage from years of constipation? Any ideas?

Sometimes the pattern you describe occurs when a child is constipated. If a child tends to hold in a lot of bm she can have a feeling of fullness in her abdomen that makes it hard for him to feel the pressure in her bladder (If she's really constipated, she might even have lessened bladder capacity, so she'd have to go more often to stay dry). To check this out, you can monitor her bowel movements for about a week. Assuming she eats a pretty normal diet, she should have a bm every day, and it should come out soft, not hard (if it plops into the toilet it's on the hard side). If you think that she's constipated, make an appointment with her health care provider for an evaluation--a two year history of withholding and constipation probably won't just get better without help (don't just get telephone advice--that's fine for a temporary problem, but not for one that has gone on this long).

Two possible strategies that I've thought of follows. For both, a really important thing is to see this as a lesson in building confidence in one's body, and trusting nature to work things out (with a little help here). Even though you sound really worried about this (and who wouldn't be?) it is also important to ACT confident that things will work out. Your child will pick up on this. And remember, to poop is normal, nothing disgusting here. COngratulations are in order even when she poops still in her pull-ups. THings willwork out, it just takes some time. (of course, this is true as long as you know this is not a medical condition.)

Strategy one. Figure out when your daughter is having her bowel movement. BEfore or after midnight? And then narrow it down. Don't wake her up, just see if you can do some detective work (nose). She probably does it at about the same time each night. If you can, then try to catch her in the act and talk softly to her (good job, feel your body pushing it out...)..still don't really wake her up, you don't want her to do her automatic response of shutting things down. Eventually, wake her up a little, not much, so she can start to feel what her body is doing. (I'm assuming that you have explained the strategy to her already...see it as a training period to get reaquainted with her body). Eventually when she can poop in her bed while awake (half asleep is good), then it's time to move a potty chair into her room, and see if she can, half-asleep, sit there (even still with her pull-ups on) and poop. etc.. eventually, you'll have a sleepy girl going to bathroom, pooping in the toilet, in the middle of the night. From there, it can be translated to recognizing the feelings during the day. This approach takes a lot of night time work though, and who can afford to lose more sleep?

Strategy two. Again in the atmosphere of a training program (like athletes have), your daughter will start a training program to retrain her body and her mind to recognize her body's signals. It can be a special project. Nothing to worry about or get overly focused on trying to poop right away. Her body's signals are still there, but may not be very loud any more and your daughter has tuned them out. SO, if she tends to have her bowel movement early at night, try an after dinner session, otherwise, maybe go for the mornings...but that's complicated by school. What this involves is stimulants to encourage the bowels to move even when she is awake. So what do you do after dinner? Exercise is a natural stimulant...start jogging with her a few blocks. DOn't expect miracles right away. But plan on a regular schedule after dinner, and then see how it goes. CHocolate, coke (caffeine) can also be used to stimulate the bowels...though different people have different sensitivites to them. SOunds like you'd rather avoid the caffeine route--so do what you're comfortable with. I'd suggest having your daughter wear pull-ups while running etc. you want her to focus on the feelings (or not focus, just start to recognize them) and not have to worry about finding the nearest bathroom. She may hate wearing them, but hopefully you can convince her that they are simply a tool to help her get in touch with certain feelings again.

ANother idea, you may want to revisit the bathtub scene--and just talk about how her sister was going through a stage where she thought pooping was disgusting. ONe's body knows when it's time to poop, and it just so happened that it happened in the bathtub. It shouldn't be any big deal. Your body is amazing-- poop is really quite a good thing. Sure, it carries germs etc., so it needs to be cleaned up, but ....you get the idea.

Good luck. I spent some years constipated as a teenager (only vague memories of it now) so your message got me thinking. There are books too about special exercises one can do to motivate the bowels (I remember laying on my back with my legs stuck up high in the air). YOur daughter might enjoy reading the potty- training or poop oriented books for toddlers (the stage my daughter is now going through). Remind her she has no problem recognizing her urination urge, so it's just a matter of time before she and her body can communicate about the bowel movement urge. Sorry for the length of this message!

My son had a similar problem, only it was slipping out during the day during rest time at school! Our pediatrician had us giving him mineral oil at night so that in the morning he would poop it all out. The thought was to help him become more regular -- fixed time every day in the comfort of his home. I don't know how much that really helped -- he still had accidents. Another frustrating thing was that he would get it under control for several weeks, then start having the accidents all over again. I can only say that he did get it together and now is just fine. He was doing it at 5 as well, so I don't think your daughter is all that unusual in this. Maybe if you can get her to sit and relax every evening before bed and read to her while she's on the toilet? Good luck! I think she'll be fine, but I know it is frustrating and disheartening!

A while back, in a similar (but different) thread, someone suggested that drinking a glass of warm water seemed to loosen the bowels, and that they would 'go' within a 1/2 hour. Haven't tried it myself, but perhaps you could get your daughter to drink a glass of water when she wakes up in the morning. Good luck.

6-year-old daughter has encopresis

Nov 2007

We just asked our pediatrician about the fact that our 6 year old daughter has occasionally been pooping (a small amount, not a full bowel movement) in her underpants without realizing that she's doing so. (She also has a lot of stomach aches.) He asked some questions about her habits (one big, large-diameter poop each day), and determined that she has ''encopresis'' -- chronic constipation, with poop leaking around whatever's stuck in her intestines. He advised that we give her strong laxatives for three days to ''clean her out,'' and then a course of mild laxatives for 6 months. This all seems counterintuitive in light of what seems to be her easy regularity, but the internet completely backs him up, both on diagnosis and on treatment.

My question is: Has anyone else experienced this problem and been given similar advice, and yet achieved good results WITHOUT doing the three-day ''clean out''? It sounds so horrible, and one would think that a full six months of mild laxatives, resulting in more frequent bowel movements, would do the trick! Of course we will take our final orders from our doctor, after asking him more questions, but I'm just curious what other people's experience with this condition has been (including, for that matter, whether the three-day ''clean out'' really WAS that unpleasant, if you did it).

Thanks! Anonymous

My daughter has gone through the exact same thing and I think for your daughter's sake, you must go through the ''clean out.'' Just plan for it over the weekend. You don't mention whether or your not your doctor explained that part of the reason for the cleanout is to empty her bowels completely. Just because she's pooping every day doesn't mean she's not constipated. The reason why she's having ''leaks'' is because she needs her poops to be of ginormous size in order to feel the warning signs. When the tiny poops come, she has no idea. So her bowels are so stretched she can't have a normal size poop without an accident. You will have to clean her out and effectively, re-potty train her to poop. The good news for you is she does sound ''regular'' I assume this means at the same time too? That will work in your favor. The not so good news is you should cut back on the laxitive (Myralax, no?) but give it to her everyday for about six months.... Good luck. Been there, done that!

6-year-old son encopresis - clean out?

Nov 2007

Hi everyone- I have a 6 yr old son who was diagnosed with encopresis and still isn't potty trined with the bm's. He will only sit on the toilet, with a fight, in Pull-ups only. That took a year to do. We are seeing a Pediatric Gastro here in Sacramento and she took an xray and said he was backed up. We are going to do Magnesium Citrate over the weekend 3X, which he gags on and I haven't been successful. After that he does his Mirilax and ex-lax.

My question is- Has anoyone had their child end up going to the hospital and getting cleaned out with the NG tube? I'm so scared and she said if this weekend doesn't work we'll have to do it.

He has a deathly fear of the potty and I cried my way into his Ped's office and said he HAS to get over the fear before wwe can do this! I dont want to clean him out and then we're back at square one. She said our ins. won't cover a psychologist but I don't know what to do. Aren't they expensive?

I'm so scared for him becuae I think this is hurting him emotionally too. We have 4 other children and it's hard to devote 100% of this to him. Any advice or suggestions of doc's would be great. We have an HMO but I've fought to get referred somewhere with our other son. Thank you so much, Marisa

We did not go through any medical intervention for my child's constipation. But I saw that we were approaching severe issues and needed to do something. We have had great success since age 3 with using Metamucil cookies on a regular basis - 1 cookie every other day seemed to work well. My child quickly understood the correlation and would ask for Metamucil if I forgot. At about age 7, we switched to FiberChoice fiber pills at 1 per day - easier and quicker to chew up. If we skip and constipation is a problem, we use regular Metamucil in diluted orange juice. Our pediatrician did not suggest any of these initially, but once we tried it and no longer have constipation problems, she says this approach seems fine. a mom

Yes, my child went into the hospital to have an NG tube placed so that she could be cleaned out. She needed to have a colonoscopy. Luckily for us she was only 8 months old at the time and thus, did not have any hospital (or pooping) anxiety. It was not a pleasant experience to say the least. Getting the tube up her nose was horrible. Maybe you could tell your son what might be in store for him if he is not able to take the Miralax himself. I suppose that's not the gentlest approach, but one way or another he's going to get cleaned out, right? I hope others are able to offer you better information on the psychological aspects of your dilemma... anon

7-year-old holding bowels at school

Nov 2006

Today, while cleaning out my children's closet I came across 5 (!) lightly to moderately soiled old undies stuffed in the back of the closet. This is not the first time I have found undies hidden like this, just not so many at one time.

I knew they belonged to my 7 year old son. I talked to him about it, letting him know that it is okay to tell me he's soiled his underwear and that I would not get mad at him. Everyone has accidents. I let him know that when he hides his soiled undies (they could have been there for weeks) it might make his room smell, I might not be able to get all the poo out of them, I have to throw some of them away(the ones beyond hope), undies cost money etc. so please allow me to wash them right away. He said he understood and ran off to play.

Then it occurred to me what the real reason is behind the hidden underwear! I remembered that for 3 years of pre-school my son NEVER, EVER would have a bowel movement during school. He always waited to come home. I always thought that he would out grow this obsession(of not pooping at school). I think he's having accidents holding in his poo at school and soiling his undies in the process.

The thought of this is breaking my heart! He needs to, but won't poo at school, has icky undies and is self conscious about the smell, uncomfortable etc. then hides the undies when he gets home. My son is a VERY well liked, and popular child at school. He gets along well with everybody, and is an excellant student.

I gently told my son that it is perfectly fine to go poo at school, and that it is not good for his body to hold it for so long.

I wonder if this had anything to do with his perfectionist personality? Is it a control issue? We are pretty layed back parents (except when it comes to social graces and table manners), and our son is a really good, well mannered, intelligent boy.

Has anyone encountered this problem before? What did you do to solve it with your child? How can I encourage and help my child understand that it's natural to go poo (even at school)? Worried mom

This is a common issue. Many children don't like school bathrooms because they are dirty and not private. Talk with his school or with your pediatrician and get permission for him to use the teacher's bathroom. He might then feel comfortable to go at school Local Pediatrician

I think I would talk to your pediatrician about this issue. It may be encopresis and benefit from medical intervention. It seems to me that your child could be ''trained'' to have a BM at home most mornings, as many people do, but there may be more to what's going on than what seems obvious and may not be, at this point, entirely within his control. pediatrician mama

My son had this same problem, and his doctor suggested he might actually be constipated, though it didn't seem like it to us. When hard poops block the way, the only thing that gets by is a trickle that is impossible to stop, leading to that soiling. His doctor suggested he take mineral oil at night for a few days in a row to help him poop in the morning. When he did, the problem (that had lasted many years and that we had thought was psychological) miraculously went away, and has not returned in several years. Ask your child's doctor, to be safe, but simply taking the mineral oil for a few days sure worked for our son. Might want to try it on a Friday night relieved mom

I think that you are handling this very well. My son is like yours and I remember in kindergarden he refused to pee or poo at school and would almost explode on a tree on the way to the car. We had a portable potty ready, lined with plastic grocery bags 3 layered so I could toss it and clean up with a wipe instead of how you would dispose of it at home. Interestingly, he was not alone in this. Several of the boys at school were holding it all day. I am laid back like you. Maybe more so! I let him wear diapers until he stopped on his own. He was changing them himself at age 4 and talking about it...''I don't want to poo in the toilet. I want to poo in a diaper.'' So, by 2nd grade, he was peeing in the boys room. He doesn't poo at school though and he has a fast system; poos shortly after every meal....except lunch on school days! I don't know if this is a problem. I am approaching it as something that will pass. Some people, when I told them about him lining up things as a toddler (just one quirk) responded by saying ''They have drugs for that.'' Which alarmed and hurt my feelings. OK, he is a control freak. Is that a clinical problem? No. Not really the subject, but I feel compelled to note here that my second son stopped wearing diapers at age 2, wants to use every public restroom everywhere....very different! I really feel for you because your boy felt he had to hide it. My boy also was ashamed of bodily functions etc. Maybe I just haven't found the stash yet! I decided to weigh in on this for you so that you would know that lots and lots of kids are like yours Really, what is normal anyway?

Hi-Our six-year-old son went through the same exact thing. He refused to go poop at school. His underwear were often smeared and soiled. He had several accidents (that I know of) in which he'd have a small ''ball'' of poop come out. He said he couldn't feel it until it happened. As it turned out, he was right. We finally took him to his pediatrician and she said he has a very common condition, usually caused by constipation (or too much milk making his bowel movements very hard.) These hard balls would build up inside, stretching out his bowel muscle to the point that he really couldn't feel he had to go until it was too late. She prescribed him a gentle stool softener, which should sort things out in about six weeks. This had been causing him a lot of embarrassment (despite our reassurances), so he was very relieved to have his doctor reaffirm that it was not his fault anon

8-year-old with encopresis


My son just turned eight and is having problems with encopresis. He has had this problem in the past, we saw a counselor and things seemed to have gotten better. However, the problem has started back up again.

I am at a loss as to what to do. I have looked online and the resources I've found have stated that this problem is often a result of constipation, that I need to give him laxitives and get him back on a regular bowel-movement schedule, yet, I just don't know where to start.

Because he is so ashamed of the situation he often tries to hide the situation which makes things worse. He very often has accidents in his pants which I can smell it, and sometimes falls from his underwear onto our floors. It really is unsanitary, and quite awful. Though I don't let him know this, I am disgusted at the uncleanliness that he lets happen, and his resistance to clean himself up after these accidents. Again, I just don't know where to start, or what to do. Any help or advice would be so appreciated.

I've had the same problem with my son off and on since he was about 5, long after he had been successfully toilet trained. he's nine and still occasionally has problems. I'm afraid I've not been as non-judgmental as you sound. he knows that we find this unacceptable, but he's basically in denial about it.

When he starts having the problem again we point it out to him (he doesn't want to talk about it!) We try to get him to drink more water, eat applesauce and other natural methods of reducing his constipation, and when desperate we use mineral oil (he does tend toward constipation also). We also make an effort to get him to use the toilet before school, when he gets home, and before bed. The bathrooms at school are not nice and clean like at home, so he holds his bm's in at school... this leads to a bad habit of holding it. Also, he really hates stopping playing to use the toilet, that's why we've tried to get him to sit at regular times. Although it actually hasn't become a habit.

It's less frequent now... I don't know if it's because he's older and more in control of himself or not. he's definitely not a good wiper, and I often wash his soiled under separately in bleach after soaking it. I make sure that we have flushable moist wipes in the bathroom to help him clean himself better. The doctor we saw when he was 5 suggested getting him to blow up balloons while trying to make a bm: this uses the same muscles as pooping and was fun besides.

Best of luck. It's gross and you'd think he'd be too old for it, but that's the way it is. Lynn

My 6 year old daughter has had the same problem for a quite a while. I took her to a pediatric gastro-type doctor last spring and he prescribed absolutely soft stools with the help of Milk of Magnesia (non-habit forming, non-stimulant) - 1-2 tablespoons a day. The problem went away, but Ihave not yet weaned her off of the Milk of Magnesia. We saw the same doctor a week ago and he recommended a new product called Juice Plus Fiber. It is a relatively new product that comes in apple, grape and orange juice and has 10 grams of fiber in 1 8 oz carton. He claims that it does not have the type of fiber that gels into those disgusting little balls like Metamucil does. I just ordered a trial pack of 8 so can't say if this will work. They are not in the stores and are not cheap but I figured it was worth a try. You can order them at http://www.earth-friendly.com. Carol

I went to ivillage just to figure out what encopresis is, and thought the explanation and advice given there by a doctor was helpful. The link is http://www.parentsplace.com/expert/pediatrician/general/qa/0,3459,1249,00.html. You may be beyond his discussion, on the other hand, it seemed to address many of the points that are troubling you. Good luck. Kim

You need to revisit a doctor or counselor with experience with this problem. I had a child with this problem and it can become really complex psychologically for all of you. Make sure organic problems are ruled out and follow the recommendations of an expert third party. Laxative may be needed, OR some change in the way the problem in handled by the family, OR something else. We saw Dr. Durant at Kaiser Oakland. It took forever to get an appointment but he was terrific. He was able to differentiate between three possibilities:
1. an organic problem,
2. a problem that is out of the child's control,
3. a problem that is within the child's control.

Each requires a different strategy, and I don't think that the parents can figure it out for themselves, because of all the issues you mention. My daughter is still rather peeved at Dr. Durant but he is my hero. Good luck!

9-year-old's encopresis & bedwetting

May 2006

My 9-year-old daughter continues to struggle with encopresis and night-time bedwetting (actually, she is still in pull-ups at night and always has been). She has taken Miralax for years for encopresis, and has done the ''sitting'' thing and all the other recommended stuff, yet the problem persists. Has anyone had success with alternative medicine (e.g., homeopathy, accupuncture, whatnot?) Any suggestions would be welcome! Discouraged mom

My daughter struggled with encopresis, ages 3-5.5, with little help from pediatrician. I eventually followed advice from a med. school URL. I dosed daily on Ex-Lax chocolated laxative (senna) at the level that the urge to go exceeded her will to hold it. At first, she still had lots of poopy accidents, but at least no more 3-in.-diameter poops.

I also did heavy incentives for her to poop daily. She loved Barbie, so I gave a Barbie outfit for each poop, anywhere. Excessive maybe, but stickers did not motivate, and no time to gamble her health to find the min. that would incent her to poop. After 6 months, I lowered the dose. She had every Barbie outfit made, and we went to check-marks on the calendar. She was relieved that it got easy to poop in the right place, and to hold it until she was at the right place. Then I gradually backed the laxative down to zero. Now, at 8.5, she knows she must poop every day, part of her bed-time routine (so she can put it off as long as possible). I do not let her to skip more than 1 night without giving a dose of laxative. She now only has occasional skid marks in her undies. BTW, I got resistance from all - daughter, husband, pediatrician, friends - about my program, but felt it was my duty to do *something* beyond the nothing that they proposed. It worked, thankfully.

On Good-Nights (pull-ups): my daughter wears and needs one every night (actually she needs but eschews them daytime too). I say G-d bless Kimberly-Clark! Imagine this problem without their fantastic product!! With these, she can sleep-over and camp-out. No success story on this problem, nor advice, other than: you are not alone.

These have not helped much: acupressure, Jin Shin, homeopathy, chiro, UCSF pediatric incontinence clinic, NAET, chiropractic neurology and nutriceuticals (still working on this), DNA analysis, shame, blame, wet beds, will-power. My latest effort is a ''broth urine culture'' to discover/rule-out interstitial cystitis. Next, I'll check for Lyme disease (borellia infection), and/or hypnosis. All of these therapies have done wonders for a lot of other issues, like sluggish learning and over-sensitivity to *everything.* I'd love to talk more, if you like. Meg

I was wondering if you have had your child evaluated for sleep apenea? It is a hidden underlying cause for bedwetting in a large majority of children. Our child was a bedwetter until nearly 5 years old when some sleuthing discovered this link. He had his toncils and adenoids removed for obstructive sleep apenia at 5 years and never wet the bed again.(well maybe once after the surgery). Dr. Wesman at Children's Hospital is informed about topic and did the surgery for us. There is not a lot of literature about it. Maybe you can check Stanford Sleep centers or the ENT Dr. Wesman. Maybe worth checking out? mom of a past bedwetter