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Our Journey With Faecal Incontinence (Encopresis)

This guest post comes from a kiwi mum on an ongoing journey with her son's Encopresis. Her account is real, raw and emotional to her family as they continue toward success. We hope her honesty will help other families to know they're not alone and that there is help available.

My 5 year old poos his pants. He has a condition known as Encopresis and, since the age of one, he has had ongoing issues with irregular bowel movements and withholding his motions. As a Mum this has caused endless frustrations, stresses and countless visits to numerous doctors who have recommended trying all the laxative and stool softener products on the market with little success.

The challenging thing for me as a parent has been to understand my son is not being lazy. His body is conditioned to building up and withholding the poo, which creates a dry, hard motion that becomes painful to pass. Because the build up sits there he gets tummy pains and starts to leak in his undies which we've call "skiddys" - these skiddys are enough to be dirty and smelly and unpleasant for him and those around him.

He is good at hiding accidents and, at times, is actually unaware that he has dirty pants. He has no issue knowing when he needs to wee and going to the toilet to do this yet he has a fear of pooing in the toilet; a fear that I struggle to understand. For me, knowing he is capable of pooing in his pants, I get frustrated wondering how it's any different to sitting on the toilet. Sometimes it's hard not to be angry with him; especially if he's sat on the toilet for 5 minutes swearing he doesn't need to go and then a few minutes after he's got off I have found he's gone in his pants...and then lies about it.

My husband and I have tried it all. We've used bribes. We've had well-intentioned family offer their suggestions. We've got so frustrated we've tried punishing the "bad behaviour". Nothing encouraged him or persuaded him to use the toilet to poo.

Knowing he was soon to start school I went back to our GP who finally referred us to a Paediatric Gastroenterologist. He was very helpful in educating me about this condition and gave us some exercises for my son to practice while sitting on the toilet. He also assured me that one day it would just click but unfortunately there was no magic cure. He explained that it was a common condition and my son wouldn't be the first child to go to school with soiling issues. We amended his diet for a while and cut down on dairy products, which saw a little success, but nothing significant.

In January he started school. He got really upset at after-school care one day when an older child said he smelt because he'd pooed in his pants and not told any of the teachers about it. We spoke to the teachers and told him he didn't need to be afraid to tell them if he needed to change his pants and they would help him in a way that other kids didn't need to know so he was not teased. When he does poo at school he isolates himself away from his friends and is quite embarrassed. He has become really good at withholding during the week while at school, which then makes our weekends a total nightmare as we deal with countless soiled undies and arguments about not going in the toilet.

In a recent appointment with our paediatrician he thought we might benefit from talking with an occupational therapist. My son has started going to weekly therapy sessions. The therapist believes we should see results in the next 4-6 weeks with the objective of overcoming his fear of pooing in the toilet and gaining some consistency in the frequency of the motions and stopping the withholding patterns he has developed.

He is learning that he is the boss of of his body - he can't control when he needs to poo but he can control where he does the poo.

I feel like we are finally getting some help! That he is talking to someone who actually understands his issues. He isn't going to change his patterns overnight and it will take a lot of encouraging and consistency from us but I am feeling a little more positive about the future. We have a plan which hopefully will allow him to gain some normality with his toileting. I am also concerned and a bit scared as part of the treatment requires giving him the laxative daily that potentially will create a problem with diarrhea during the day at school. We are fortunate to have supportive teachers who will help through his process while he is at school. While the OT has assured me that, once we get into a routine, he should be able to clean his body out once in the mornings and shouldn't continue to need to go during the day.

So far he seems really responsive to his therapist so hopefully this reflects in positive behaviour when it comes to using the toilet, and this nightmare for him and our family will soon be at an end.

For help and support with Encopresis (faecal incontinence) see:

UPDATE

Since this article was published we have fantastic news on the family's progress. Here's an update from the mum...

I was a bit sceptical about the therapy - for years people have been telling us "one day it will click" - this is really the last thing you want or need to hear! However one day it literally just clicked for him!!!

At his last appointment he was still struggling and having limited success in actually going in the toilet. My husband was extremely sceptical and believed I was wasting our money taking him to these sessions, which also required me taking 3 or 4 hours off work to pull him out of school and to drive over the other side of the city - the whole thing was really stressful - and likely to end in needing to go to marriage therapy haha!

However since our last appointment he has had NO issues - not one accident! His toileting has been transformed and something did just click! We have stopped using the drops and he is regularly pooing in the toilet once or twice a day like a big boy! We are even having dry nights! He is so excited to go to the toilet and we are so proud of him - who would have thought poo could be so exciting! As a result he is so much more confident and happy. A brilliant result, and well worth the money for him to get a real understanding of his body and gain control of it - one very happy family!

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