Getting past encopresis

amother

Mon, Jan 29 2024, 12:29 pm

My eight year old is an extremely carefree happy and stubborn child. She has encopresis. We are under the care of a GI for a while and are bh at a very manageable place but her progress has stalled. We can’t go a week with completely clean underwear.

I can reward, remind, punish etc but I can’t get through to her. She just does not care. I believe that at this she has to want to be “cured” for any more progress to be made. She has to want to develop proper habits and be willing to work with me. When the toliet becomes a power struggle it is not good for anyone…..

She is taking laxatives daily and there is no backup in her. She jsut runs to the bathroom when she literally feels it coming out and many times the first drops are in her underwear.

How old was your child when they finally got over it and how did you do it? Was it a power struggle or was your child willing to work with you?

amother

Ballota

Mon, Jan 29 2024, 7:53 pm

I've had this with 3 kids and managed it all successfully! First- get a good GI doctor. Do not use Miralax long term. You need to do a clean out. We were prescribed a cleanout that consisted of gatorade, miralex, and ex-lax. We stayed home all day drinking this crazy ccocktail until we knew everything was out (pooping only clear liquid). Then 1 square of ex lax daily. Sit on the toilet twice a day after meals to poop. After several months of consistent pooping with the ex lax, we very slowly tapered down (VERY SLOW taper or your will backslide). The whole process could last anywhere from 6 months to 2 years. But after following this procedure, my kids have all been regular for years!

amother

Ballota

Mon, Jan 29 2024, 7:56 pm

amother Ballota wrote:

Re-reading your original post-- 1st off, kids with encropresis lose feeling because the nerve endings in the backside region get dulled so its possible she doesn't feel the need to go. It takes a while for the nerves to re-generate and the feeling to come back fully. So, it may not be entirely her fault. Next- her laxative dosage right now may be a little too strong and it may make sense to taper down a bit based on what you are saying.

amother

Mon, Jan 29 2024, 8:54 pm

amother Ballota wrote:

I try to have her sit on the toliet right after supper but that becomes a battle. If she were to do that nicely that would be a huge step to regulating. Did your kids sit nicely or was it a battle?

amother

Mon, Jan 29 2024, 9:35 pm

amother Nasturtium wrote:

Hate to say this but my DS was finally cured when he hit puberty. As is common. Hang in there.

That’s honestly what I think will happen with her. She has to want to fix this problem in order for us to be able get results. Was your son on any regular laxative the years before puberty to make sure he does not back himself up, and how exactly did he manage to resolve the problem at puberty? Was it natural or was that jsut the point that he cared enough to work on it (sit on toliet to regulate)

amother

IndianRed

Mon, Jan 29 2024, 9:38 pm

amother IndianRed wrote:

Fellow enco mom here. Just wondering, how are you sure dc isn’t backed up still? We went through this many times and it always resulted that dc was backed up.

Just asking this again, I’ve been shocked at the times that DC was actually backed up. I didn’t think so, but it was always when DC was having accidents. Always. In other words if DC was having accidents DC was backed up when we eventually got an X-ray, or doctor felt. DC was never having accidents when not backed up.

That’s been my experience. We’ve been dealing with this for 3+ years

amother

Mon, Jan 29 2024, 9:48 pm

amother IndianRed wrote:

I don’t think she ever had a week straight with all clean underwear since this started three years ago. She consistently has 2-3 smears in her underwear each week. It’s the same pattern. We don’t really have any major ups or downs. The GI does not do anything more
Then feel her and say she’s good, but we have been to a urologist a few times who did ultra sounds amd there was no backup.

The urologist ultrasounds were showing backup before we started with the GI.

amother

IndianRed

Mon, Jan 29 2024, 9:57 pm

amother OP wrote:

Can you get an X-ray as opposed to an ultrasound? From what you’re describing it really sounds like there is backup, based on my very own humble experience.

Did she ever have a full clean out?

amother

Ballota

Mon, Jan 29 2024, 9:58 pm

It wasn't a battle to sit on the toilet. My kids were pretty on board for the most part. We did do rewards for complying with the program. If you are using Ex-LAX, they feel a pretty strong urge to go-so they typically WANT to sit on the toilet. So, again, if you are using MiraLAX, I'd encourage you to switch to EX-Lax. Miralex does not produce the urge to go- but EX-LAX does. We were never successful with Miralax.

amother

IndianRed

Mon, Jan 29 2024, 9:59 pm

amother Ballota wrote:

Yes! This! Miralax doesn’t make the urge it just makes the poo soft. Exlax is going to give the urge

amother

Ballota

Mon, Jan 29 2024, 10:03 pm

amother IndianRed wrote:

Can you get an X-ray as opposed to an ultrasound? From what you’re describing it really sounds like there is backup, based on my very own humble experience.

Did she ever have a full clean out?

when we did our clean outs we made sure we got to the point where they were only having clear liquids were coming out of their bums- you have to make sure you get that. That's how you know you are in the clear.

amother

Tue, Jan 30 2024, 12:08 am

amother Ballota wrote:

I did clean outs before. At this point she
Refuses to drink anything with miralax in it so
I didn’t do one in a while. She takes
Two ez lax every morning. If I get her to sit on the toliet for ten minutes right after supper and she actually goes number two - those days her underwear are clean. If I can’t get her to sit and I rely on her to to go when she feels the urge, she will many times
Have a smear in her underwear those days. Even when I did weekly clean outs we had this same pattern
And I don’t think she is backed up. I think she’s just stubborn!

amother

IndianRed

Tue, Jan 30 2024, 12:10 am

amother OP wrote:

Ok! Good luck.
Dc doesn’t take miralax either. We have done quite a few hospital clean outs. Recently trying a new form of magnesium for clean outs which I hope will work

amother

Nasturtium

Tue, Jan 30 2024, 12:43 am

amother OP wrote:

He did one full clean out once with a gallon. I believe it was called go likely. It’s something people use before colonoscopies.
After that he used regular MiraLAX, plus an oral solution. It don’t remember what it was called. It was many years ago.
He also had to do suppositories periodically. This went on for many many years until he hit about the age of nine or so. Just starting to enter puberty I believe the puberty somehow kicks in and is able to solve this.
As many has said it’s really a physical problem. We had taken him to a therapist to try to deal with the psychological issue, but I believe they get so backed up and their nerve endings are so damaged. They literally cannot tell when they need to go to the bathroom plus. Plus there’s so much compacted dry stuff inside it tends to leak.
It’s a really horrible challenging situation but it will end. People used to tell me he’s not gonna walk down to the chuppah like this. And he didn’t!

TwinsMommy

Tue, Jan 30 2024, 8:49 pm

how are her manometry results? it's important to have regular KUB xrays. You may have to demand that from the doctor. You also might want to go bottom up (daily enemas) instead of top town (exlax/ miralax). We did years of daily enemas before cecostomy--- that's a good next step. If daily enemas help her regain RAIR and help her colon shrink, then they're a great tool. But she needs to be on board.