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Fecal Retention, Encopresis in 5 Year Old

I am a working mother of 4. My five year old son when he was younger had trouble using the bathroom (#2). At the age of 3 I would have to set in the bathroom with him and literally spread his cheeks apart for him to be able to have a bowel movements. I believe this has traumatized him. We had to end up going to Johns Hopkins and he was prescribed Miralax to help him have regular bowel movements. He is now 5 and we are still having problems with him going to the bathroom. I give him the medicine to help him have a bowel movement but he will not do number 2. Usually he ends up holding it in for so long that he goes in his clothes. I have sat down and explained to him that it is okay to do the number 2 and we have medicine so it won't hurt when you go but nothing seems to work and I don't know what else to do. Can you please help or maybe suggest something that I haven't already tried.

I hear how frustrated and worried you are.  It does sound like your five year old was somehow traumatized in relation to having bowel movements. I don't think your holding his cheeks apart to help him go when he was three caused this, btw.  It is very common for kids to have painful BMs and then to develop a habit of "fecal retention" (which means holding in their stools; often the term encopresis is used because that describes the soiling of the underwear which usually results). Sometimes, other stresses cause the fecal retention.  Unfortunately, fecal retention soon becomes a habit, and it causes bigger stools, which makes them more painful, so this sets up a vicious cycle of avoiding having BMs.

The bad news is that your son needs Miralax to move his bowels, and that is a physical addiction that should not be necessary for a child. Worse, Miralax can lead to bowel accidents.  Even worse, he resists going enough that even with the Miralax, he ends up going in his clothes.  Miralax does work for some kids, but it doesn't work for many kids, and it can keep you stuck in a bad situation that only gets worse as your child gets older.

I know this seems like a psychological issue, and it may have begun that way, but I urge you to reframe this as physiological.  Kids desperately want to solve this issue but it is not in their control because their bodies are not working properly.   His stools may still hurt, or he may have lost the ability to recognize his own rectal urges, or his colon may be distended, which makes his BMs larger and more uncomfortable.  So this is not just about what goes on in his head. His colon is not working as yours or mine does.

I assume that since you took your son to John Hopkins, a doctor is following his case.  That would be important, since the colon can become impacted. I am a psychologist, not an MD, so I want to be sure you are consulting with an MD.

Your goal--as you obviously already know--is to help your son overcome his fear of having a BM. But it may well be that he has to also restore his colon to normal function.  I would suggest that you give yourself no more than one month to see some change, using the following suggestions:

1. Make sure that it does not ever hurt him to move his bowels. That means you do need to keep him on the Miralax--probably for a year--to make his stools soft. You want his BMs to be about the consistency of oatmeal. Of course, you also want to be sure that his diet is healthy, with plenty of water, fiber, good oils, etc. 

2. Make sure your son is in control of his own body.  In other words, avoid enemas, as long as he can move his bowels with Miralax.  It does not cause cramps and it leaves your son in charge of when he will move his bowels, so it is a good solution if it works.

3.  Have regular bathroom times when you sit with your son while he is on the toilet, at least twice a day.  Your goal is to keep him company to allay any fears he has about it hurting, and to help him relax so that he is more likely to move his bowels. A warm bath before his "sits" helps move the bowels.  Then have special books, games, etc that he can only play with you when he is in the bathroom. Make these times with you really fun. You are his partner, assistant, and cheerleader.  If he does have a BM, celebrate.  Stay in the bathroom with him for half an hour each time, and encourage him to move his bowels.  If he doesn't, after half an hour, say "Ok, let's take a break, but please tell me when you're ready to come back and try again, ok?"

4. Schedule your bathroom times at the same time every day to establish a habit, preferably right after meals.  After eating, the intestines move the food through by squeezing, so it is easier to have a BM.

5. Teach your son the Valsalva maneuver to help him move his bowels.
He needs to:

  • Hold his breath.

  • Squeeze in his abdominal muscles.

  • Push hard to push out the stool.

6. Offer your son the choice between a potty chair and the toilet.  I know potties will mostly be too small for him, but he might be more comfortable with one.  Many kids are frightened of falling in the toilet.  Many other kids just can't get the leverage they need to push, because their feet dangle.  Dangling legs tighten rectal muscles and make defecation difficult.  You might want to consider a stool like this:

http://www.thepottystool.com/index.html

I know it might seem excessive to buy a special stool, but it gives kids the support and security they need, as well as the leverage. What is important now is that your son become comfortable moving his bowels on a regular basis.  Once he accomplishes that, you can help him transition to the regular toilet.

7.  If your son soils his pants in spite of your efforts to get him to use the potty, don't punish him.  That will only make him hide his soiled pants and begin lying to you.  This is not a habit you want him to develop.  Instead, take a deep breath, stay as calm as you can, and say "I guess you couldn't make it to the bathroom this time.  Soon you will be able to use the bathroom every time. What can I do to help you use the potty instead of your pants?" He may not know, of course.  Most kids with encopresis don't feel their urge to go until they're in the middle of it.

It is important to resolve this issue now, because when kids reach school age this becomes much more difficult to solve, which can lead to all kinds of problems, not the least of which is an enlarged colon and reduced sensitivity to their own urges. School-age kids often begin to hide their problem, have accidents at school, and have their self-esteem eroded.  For this reason, I would only suggest the above protocol for one month.  If you see improvement, then great -- keep at it.  Within six months your son should have normalized and you can wean him very gradually off the Miralax.

However, if you do not see positive progress within a month, I would strongly recommend that you take more drastic action and consult with a gastroenterologist to see if your son is blocked.  He may need a complete clean-out before he can normalize with the program I have outlined.

I will add, though, that doctors often seem stymied by this issue, and it drags on without solution. The usual medical approach is basically like mine, although they do medical tests to insure there is nothing medically wrong. But they just continue to keep the stool soft and hope the child will get used to having stools.  Unfortunately, this seems to work in only about half of cases.

There is a different approach now, pioneered by  Dr. Robert Collins. Basically, he recommends the time in the bathroom that I recommend, only if the child does not go after the first two sits, you use a suppository to help them, and if the child does not go after that, you use an enema to make sure the child moves his bowels.

Most doctors have been nervous about the suppository/enema approach for fear of traumatizing the child.   I have to say that is my instinct, also.  I think giving kids enemas is very invasive.  However, encopresis is a severe problem that can traumatize a child for life, and the longer it goes on the more traumatic it is.  So even though I would not subject a child to enemas lightly,  if my child had this problem and the approach I have outlined above did not work within a month, I personally would try the Collins approach.  I have come to this conclusion after several months of following the Collins discussion group that uses his approach. 

Watching new parents begin this approach is interesting, because they feel just as nervous as I would.  But then a miracle seems to happen.  It may take a few weeks, but the kids begin being able to move their bowels on their own without resorting to the enemas and suppositories as often, and within a few months, most of them are off them.  So this approach does seem to retrain the bowel reflexes.

As I follow the discussion on Collin's list, I see relieved parents and kids who are thrilled as they regain control of their own bodies.  However, he doesn't just give them enemas, he has a specific protocol that allows the enemas to be diminished and eliminated, and it certainly sounds right to me that the child would be relieved and happy to regain control of his own bowels.

As I say, enemas are invasive and traumatic, so I would not take this path lightly, but since this is such a challenging problem to solve, his approach is good to know about if your son does not respond to my more gentle recommendations.  I want to add that when you buy Collins' book (which costs a hefty $75), you get access to the forum of parents using his approach that I have been reading.  That seems invaluable to read BEFORE trying his approach, to make sure you really want to do it.   You can even just pay a lesser amount and get access to the forum, which has archives.  Collins' website is  http://www.encopresis.com/.  Just so you know, I have nothing to do with Collins and am recommending his approach as a last resort, not a starting place, once you do your own research.  I am also a psychologist, not a physician, so I am giving you my opinion as an informed mental health professional only.

I wish you luck in solving this very challenging problem.  Please remember to be patient with your son, and to love him as much as you can, unconditionally, through this.  Your love is what will help him get through this with his self-esteem intact. Whether he responds to my mild approach, or you end up using the Collins approach, he will eventually be able to use the toilet normally.  Your goal is for his self esteem and your relationship to come out stronger for this experience.

Please let me know how this works out.

All blessings,
Dr. Laura

p.s.  Please note that I have revised the above advice now that I have had the opportunity to follow the Collins forum for a few months.  I am impressed with all the success stories from parents, and want to be sure that folks who read my response hear my opinion.  Some of the comments below were in response to my original advice, which was not informed by any direct knowledge of the Collins approach.

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Mother and Son with Enco commented on 11-Dec-2010 08:25 PM
I developed enco when I was little and it was because I went inside my home to go #2 and when I came out from going, my dog was hit by a car. Therefor to me, pooping = something bad was going to happen. That started me holding. My parents let me hold. I stunk, would clog the toilet, and had no friends. My Grandmother had enough and took me to a GI doc. he said I was severely impacted. I had to have a surgery or else I was going to die. I was scheduled for the surgery and my mother intervened. I was sent back home and my mom took me to my pediatrician. He immediately put me on enemas. I needed them to get all that poop out asap!!! My Grandmother gave me and enema one summer everyday for at least a week. I finally started feeling better and my brain to butt signal was retrained. Not to mention all my insides went back to the right size. From then on I have been pooping normally. Now for part two of my story. My son was born premature and developed enco around the age of two. He was very allergic to dairy from three months old. I tried him on dairy at two (I gave him very little by the way) and he had the worst poo ever. It was so hard and it hurt him so bad! From then on he started holding. My ped tried Miralax, Lactulose and Mineral Oil...all of which did NOTHING but make the behavior worse! If you think about it, if you take a stimulant to do a behavior you hate doing, that will only make you stronger at not doing that behavior!! Finally I thought I had to do something else! I found Soiling Solutions online and that has changed our lives!!!!! My son now goes potty and no longer holds!! I have been doing SS since May and we have now been able to do so much. He has been able to go to school two days a week, he is clean, he has friends, we have joined a mom's group, and he is POTTY TRAINED!!!! This last week my three year old baby boy needs no more pull-ups at night. Whoo Hoo!! I never thought that would happen to us. He is better and I can not be more thankful to the SS program. A similar protocol is what finally helped me and I knew it would help my son too!! As far as enemas and suppositories, I am not scared from them and they are helping my child stay healthy and not die from impaction or develop mega colon! Why would I not do ANYTHING possible to help him. As a mother you need to look past your uncomfortableness and give your child their health. What is worse I ask A) giving your child an old school non damaging medicine or B) letting your child develop major medical issues and get tormented/bullied by other children? I am so extremely thankful to what my mother, grandmother and pediatrician did for me. Especially I am thankful that they gave me enemas and NOT ORAL MEDS that would have made me constantly crap my pants and stink so that I would have been even more psychologically damaged as a child. I am in a strange way thankful that I had enco. It made me able to help my son far sooner in life. BTW, he RARELY needs any intervention to poop!
Anonymous commented on 11-Dec-2010 10:07 PM
Dear Mother of Four, If your son has had enco since age 3 (or before) and is now 5, it is time for "drastic" (effective) measures. You don't have any more time to waste. If you want to become more and more frustrated about not finding a solution, follow the status-quo with high doses of Miralax, top-down approaches, and potty charts with stickers. There is a stigma that the bottoms-up approach will scar your child for life. It won't, by the way. Enemas have been around for a very long time… and the wonderful thing is, they are inexpensive and do not require a prescription. My 6 year old is finally clean thanks to Dr. Robert Collins' Soiling Solutions program mentioned above. We have been on the protocol for a few short months and it is the only thing that has helped my son's colon heal giving him back the ability to poop daily without holding it in. If only I knew he had encopresis when he was two and had found SS earlier. I don't know why this program should ever be recommended as a "last resort" when your child has already been diagnosed with encopresis. Even if it is a mild case, the SS protocol would very likely resolve the issue within a few short weeks. SS is the best $75 I have ever spent to get my boy back on track, full of self-esteem and vigor — just like little boys should be. I HIGHLY recommend it. Sincerely, Meredith (Mom of two)
Cristina commented on 11-Dec-2010 10:22 PM
Hello, Thank you for posting on this issue! I am a parent of two children with encopresis. I have a Yahoo Support Group at http://health.groups.yahoo.com/group/encopresis_kids/ I hope you will post this link as it may be helpful to parents who would like to talk to other parents who have children with this condition. I would also note that, having moderated this Yahoo group now for over a year, I have seen many parents at the "end of their rope" so to speak, having tried the top-down approach with Miralax with no lasting success, finally try Dr. Collins' Soiling Solutions program and they wish they had tried it years before. I hear this from parents over and over again. If the readers' child is 5 years old, then I'd highly suggest trying his bottoms up approach. Sincerely, Cristina A.
Name withheld to protect my child's privacy commented on 11-Dec-2010 11:30 PM
Dr. Laura and Readers, My child suffered from severe encopresis and we tried all of the recommendations that you suggested above. They were completely unsuccessful, traumatic, stressful, and took precious hours away from our family. After having our child submit to invasive GI testing all with negative results, we knew it was time to look outside of the traditional Miralax based methods for treating encopresis. After hours of internet searching I found the soiling solutions website and spoke to Dr. Collins immediately. I ordered his book and started the program with our son that day. My husband is a dentist and I am a psychologist and we were very comfortable with both the emotional and physical requirements of an enema based program. Never was our son traumatized by receiving an enema. It was given in the same loving manner that parents give their children medicine and other medical treatments. The program was one of compassion and love because it allowed our son to be free of soiling accidents and encopresis for good. Now as a practicing therapist, I teach other parents the soiling solution program to outstanding results from almost every family that has seen me. Not only do I recommend Dr. Collins program as a mother and a psychologist, I also strongly recommend it as an early intervention rather than a last resort. $75 is a minimal cost in comparison to the cost of excessive laundry, new clothes, and extensive medical costs related to symptoms of encopresis.
Ingrid Blokhus commented on 12-Dec-2010 04:18 PM
I am so glad to see Soiling Solutions mentioned. Thank you. It has been a lifesaver for my child. My encopretic child did not experience enemas or suppositories as traumatic. It was a relief not to soil and the protocol gave him control of his body. He thinks needles are traumatic. Healing of intestinal damage takes time and Collins' protocol prioritizes both healing and rehabilitation. The parent's forum has made me realize how my child's behavior is connected to being backed up, early symptoms of a back up and what to do, and that we are not alone! I also feel that 75 dollars is not hefty if you compare it to the price of doctors visits and all the miralax etc. one buys to try and fix this problem. Thank you again for mentioning Soiling Solutions and please please check it out more thoroughly!!! More desperate parents should know about this option.
Abbey B commented on 12-Dec-2010 07:30 PM
I just wanted to let you know that although Dr. Laura seems resistant to Dr. Collins' approach, I have gone through the program with my son and I can tell you it's almost a miracle! There are many other parents on the forum who would agree with me. It is an intensive approach whose benefits far outweigh the horrible daily struggles and emotional problems that encopresis brings.
Jana in California commented on 13-Dec-2010 12:52 AM
Hello, I would like to chime in! I have purchased Dr. Collins book and I am also on the forum, which in invaluable! There are lots of people out there dealing with the same issues as your son. It is such a relief to be able to compare notes - whats working, whats not working. As far as the enemas being traumatic. Maybe I'm lucky, but my daughter is not at all traumatized. She was in such pain, she literally asked me for the enema. This was before I even heard about Dr. Collins or purchased his book. Some kids are literally turned around within a few short months. Others don't have lasting results for years. Most of the kids do stop soiling immediately. This alone is of such a relief to both the kids and the parents! It's also more healthy for our kids to be cleaned out. After being at my wits end and cleaning up to 6 undies a day - many soilings happening just after I asked her to sit on the potty for 10 minutes - I found Dr. Collins, ordered his book and got plugged in to a whole community of people working together to help their kids beat this thing. My daughter is still in process, and we are working at it everyday, but we know what to do when she doesn't produce and begins getting backed up. We are not dealing with soiling like we used to. We live a normal life now, without the worries of an accident. I believe if we are consistent we will beat this thing! I hope this input helps. $75.00 is a bargain for the health and well being of your child and your peace of mind - I would highly recommend purchasing Dr. Collins book.
Andrea commented on 13-Dec-2010 10:19 AM
Dr. Collins Soiling Solutions is the ONLY thing that has worked for my son. Over the course of 2 1/2 years, we sought the help of 3 doctors (including a Pediatric GI) before we found this program. The standard "top down" Miralax routine that all 3 doctors advised did not help. With Soiling Solutions the accidents stopped almost immediately and 3 months later, my son is able to use the restroom on his own with just a daily reminder from me. This program changed our lives. My son is now able to play sports and have sleepovers and all the things that 10 year old kids love to do. Please do yourself and your child a favor and make this your next step and not the last resort. The $75.00 is a very small fee to pay to give your child his self esteem back.
Anonymous commented on 13-Dec-2010 11:46 AM
I am very grateful that you recommended Dr. Collins approach. I sent away for this info and have been using the protocol on my 8 yr. old. It has been very successful. I thought I would be unable to give him suppositories or enemas, but I have done both, with a great outcome. He is pooping daily, not on a regular regime of miralox, and has very little soiling issues. The only thing that is not happening regularly is feeling like he has to poop on his own. I still require him to sit for 5 minutes 2 times a day. Once in a while he will feel like he has to poop and tell me this, but I'm waiting for the day when he does it all by himself, like an adult would. At this point I'm very happy with the results, and not having to wash out his underware daily. I highly recomend to all your readers that they check out the website. 2 Soiling solutions, to educate your self on Dr. Collins protocol!!!
Tess Shashyan commented on 13-Dec-2010 10:16 PM
Dr Collins protocol saved my 3 year old (nearly 4 year old) daughter. It is the best and SIMPLE! I am a Psychologist and support using suppositories and enemas 100%. You will need to read the book why. I just cant believe how easy his program is and how effective. Every week on the forum many parents write in about their success, in fact his success rate is like 95% or something! Dr Laura I think its wonderful you have added Dr Collins information and I wish more specialist would do this. I almost cry at night knowing how many parents are scolding their children for this horrible, misunderstood problem. The problem with the Miralax approach for some kids is it only encourages more holding behaviour - we want to break that habit. Kids will withstand chronic tummy aches because they fear pooping so much. My daughter often comments now "my tummy doesnt hurt any more". She had forgotten the connection because she spent over a year holding. Enemas and suppositories are used to encourage your child to stop holding. You dont need them for ever, some kids are off them within 2 weeks. My daughter rarely needs them after 1 month on the protocol. I had my daughter on Miralax for 4 months and while it helped her poop, she was also always hiding and holding - and smearing. The problem was so out of my control I felt helpless and awful for her. She was the last one in nappies at kinder because she would sometimes smear up to 10 - 15 times per day. My daughter doesnt have Miralax at all now or any laxatives. The protocol also gives your child an opportunity to go his/her self. I was scared to begin with but with the support of Dr Collins and the other parents, we now have a happy, hungry, healthy child who LOVES doing big poops! If you are a parent with a child who has this problem, please goto the encopresis website now and order the manual. You will be welcomed with open arms to a community of people who have experienced and are experiencing the same issues and concerns as you. Your child deserves it and so do you.
Ali Mendelson, MD commented on 05-Jan-2011 11:56 AM
When my daughter was 2, she ate alot of matzah during the Jewish holiday Passover. Matzah, as you know, is very constipating, but we didn't think anything of it at the time, because she was, well, 2! Unfortunately for her, she became constipated and had a painful bowel movement. In her smart little 2 year old mind, she decided she didn't want that anymore, so she decided to stop pooping! She would feel the urge to go, and the prevent the poop from coming out by squeezing. By the time we figured out what what was going on, she got really good at not pooping. We were able to help her through it with diet and relaxation techniques, but that summer, she got a terrible diaper rash and decided nothing should touch that area again.

Unfortunately, she connected having a bowel movement with pain and went to all sorts of efforts to prevent having a bowel movement. We saw our pediatrician and a pediatric gastroenterologist, and found that our sweet little girl had an acquired megacolon. As a pediatrician, I knew exactly what was going on and I was totally powerless to help my daughter. She was not willfully holding in her BMs, she couldn't help it. She had been holding it in for so long that she no longer knew how to go. Of course, I didn't really understand this, and it was incredibly frustrating to watch my kid NOT poop.

The current pediatric treatment for encopresis is the "top down approach". This involves giving kids enough Miralax and other oral laxatives/stool softeners etc. to give them soft stools so that in theory, they will pass the stool and eventually see that it is not scary and get over their fear of toileting. Nice in theory.

Here's the problem. All of these oral laxatives are nearly impossible to titrate and every kid/colon is different, so you never know when the medication will start working. What ends up happening is that the child feels like they are going to have diarrhea all the time, but they don't want to go to the toilet. SO, they hold more and strenghten the external anal sphincter. Over time, they create a neurologic connection telling their bottoms to squeeze shut when they feel like they have to go. Over time, it becomes so strong that they cannot overcome it.

My daughter was on miralax, benefiber, mineral oil and ex-lax. The ex-lax wasn't working so the pediatric GI at a top pediatric hospital put her on oral dulcolax. Still didn't work, but my poor sweet girl was miserable all the time and physically uncomfortable. She had a megacolon and megarectum and her doctors kept telling me to hang in there.

For what! I was desperate. We went to the loveliest therapist who couldn't help Sophie poop, but she helped us deal with it better as a family. I was as miserable as a mother could be. My child didn't have cancer or some other well known horrible disease, but she suffered daily and there wasn't a damned thing I could do about it. I was depressed, miserable, cranky and probably not a very nice mom to Sophie-who was pretty miserable herself.

I was a pediatrician who couldn't help her own child poop! There was no one I could talk to about it. My marriage was suffering. I couldn't take Sophie on playdates because she was miserable and I was afraid she'd have an accident. I refused to let her be "poopy pants".

Out of sheer loneliness and desperation, I found the yahoo encopresis support group. It was pretty depressing reading about kids much older than Sophie with the same problem. The one thing people seemed to talk about with any hope was "Soiling Solutions"-a book by a neurobehavioral psychologist online.

I went to the website and thought it sounded drastic, scary and probably way too hard to do. I also felt that as a pediatrician, I was crazy to look to this guy for help when the medical community was at a loss to help my 3 year old girl.

And then I read it. I must say, you should too. It is completely brilliant. Dr. Collins, my family's personal hero, has come up with a treatment plan that actually works. Basically, he says you have to retrain the body how to poop. It takes one hour of our day, often less, and my 4 year old poops on the toilet. She never soils her underwear. She is happy, she is lovely, we are happy.

I am a pediatrician. My colleagues could not help my daughter, but Dr. Collins did. This poor, generous, man has been fighting for the medical community to look at his protocol to help kids suffering with encopresis, but because he is not an MD, they won't. Imagine having the cure for cancer but nobody will listen! That must be how this man feels. My pediatric GI has read the protocol and has actually joined Dr. Collins' online forum and has been an incredible help to so many families suffering. But initially, she thought I was a little crazy to do it.

Success speaks volumes I guess.

Encopresis is a horrible unspoken disease. It is all the kids who soil their underwear and get made fun of for smelling badly. It is destructive to the self esteem of so many wonderful little children. The medical community has failed these kids. More sad is that there is a really great solution that you have to be lucky to find!

I am in no way affiliated with Soiling Solutions or with Dr. Collins, except that I paid for the book and it is the only thing that has helped my daughter have a normal life. Friends call me asking what I did for Sophie all the time and I am so happy to tell them. If you ask Sophie, she will tell you that she loves her "hour" because she feels better!
Tanya Z commented on 31-Jan-2011 12:40 PM
I am writing to express my deep gratitude to Dr. Collins. After 11 months of frustration, sadness, anger and confusion, the CKM is helping us overcome encopresis. What I appreciate most is that this approach helped clarify what we as parents can do for our daughter and how we can step back and let her make progress on her own, as opposed to being overbearing and always asking, “Do you have to go? Are you holding?” Claire (age 5) has been on the protocol for 5 weeks and we have seen tremendous progress. We went to enema for the first 2 1/2 weeks, but we were still thrilled to be able to send her to school in underwear (not a pull-up) again. Then the suppository started doing the trick. And this week, we had 2-3 days with her going on the first or second sit. While I know we will need to monitor and provide oversight, and that there may be setbacks, I must say that I am astonished. There were times that we thought her soiling was purposeful bad behavior, even though she is otherwise a sweet and obedient child who loves to please. It was mind boggling how she would sit in filth for hours without telling anyone. But with the CKM approach, Claire is in control of her body again and understands that the protocol helps her. Yesterday, while we were playing chess, she ran off to go sit on her own and went without any prompting. It’s been a long time since that happened. So long that we couldn’t remember the last time she went on her own. I burst into tears of happiness. So we are sending you perpetual gratitude and good karma, Dr. Collins. We were at the end of our rope when we found the CKM and you’ve made 2011 WAY better than 2010 already. To those just starting or still working to find your routine, hang in there! We are here for you. PS. Our pediatrician was cautiously supportive when we started. I cannot wait to give him an update next month!
Janae commented on 02-Feb-2011 10:27 AM
I know many people are unsure when beginning the Collins Soiling Solutions protocol. Does it work and are we doing this right? Many people need some encouragement and reminding that they are not alone. I too, had a fighter on my hands when it came to the
suppositories and enema. It took my husband and I both to hold him down for the first week. It was horrible, but as soon as the insertion part was over, he was fine. That was 3 weeks ago! Tonight I gave him some Scooby Doo underwear as a reward for no accidents
for 2 whole weeks and he is so proud of himself. What a difference I've seen in his attitude, interactions with others and just his overall self esteem. He tells me every day how much he loves me (to the moon, all the neighbors houses and Texas and back) every
day and that I'm the best mom ever. I do not think this has traumatized him and I know someday he will thank me. I think we were on our way to some significant emotional problems before we started the protocol. I think being the poopy kid at school might have
been much more traumatic. Fortunately, I think we're going to be ok in time for kindergarten. Hang in there parents! Your child will thank you!
Jane commented on 01-May-2011 11:05 PM
I am a parent of a beautiful 10 year old girl who has been suffering from encopresis since she was 3. It has been a real trial and error and stessful for the entire family. We have been to multiple peadiatricians, continence clinics, naturapaths, accupunturists
and the childrens hospital all with limited help and understanding. She has been on movicol (miralax),parachoc, lactulose, metamucil, coloxyl with senna, and has even had picoprep which made her vomit. My husband and I are frustrated with the lack of support
we have recieved from the medical proffession. My daughter seems to have lost alot of her self confidence and I have great concern for her mental wellbeing. I am hoping that soiling solution will be our saving grace. I haven't read of it's success with older
patients and I am keen to hear of any.
Laura Markham commented on 02-May-2011 10:46 AM
Jane- I HIGHLY recommend Soiling Solutions if your child is ten and still suffering from encopresis. I have not heard of another solution that works. On the SS forum, you will see parents of ten year olds, who do indeed have success. It takes longer, because
their bodies have to relearn how to feel their own natural urges. But it definitely works. Good luck, have courage, and hang in there! blessings, Dr. Laura
Anonymous commented on 23-Apr-2012 08:50 PM
My son is 7 and there is no way on earth he would allow us to give him an enema. We did that when he was about 3 and he is totally traumatized. He is too big for us to force him. Miralax causes him to mess his pants. Yesterday we had him drink the magnesium
stuff after he had gone 7 days without a BM. had had an extremely large BM, but today, he is soiling again but refuses to sit. We had an ugly scene with that tonight. So I guess we are stuck with this problem until he is old enough to want to solve it himself.
I will continue to wash dirty underwear for as long as he lives with me and hope and pray he doesn't have an embarassing accident at school. That's all I can do. We have battled this problem on and off for 4.5 years and I give up. This may not be fair to my
son, but neither is all the conflict this is causing our family. Please don't suggest I try this Collins method because I cannot possibly get near him with an enema.
Laura Markham commented on 23-Apr-2012 10:01 PM
If your son is 7 and holding (going 7 days without a bm) then he has a major problem that could ruin his life unless you address it. You don't have to give him an enema, you can get him a total cleanout at the hospital. please take him to the doctor and
have his rectum x-rayed. You will see a mass of poop in his rectum. They can do a cleanout at the hospital. Then you will have to do sits with him, and enough miralax to keep his poop soft, so that he does not start holding again. Good luck!

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