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Encopresis and school


my boy is 7 yrs old and was dx with encopresis.we have tried evreything thats out there, laxatives, enemas, trying desperately to maintain a regular routine, diet you name it. the problem is still there after a year and making a huge impact on his schooling. he argues with the teacher when she discreetly adresses him when he has an accident. he refuses to go to the bathroom and change. the other students do not know its him, but if continues it will only be a question of time. the main issue is he stays in his poo. we try to explain to him how its not his fault to keep trying to go to the bathroom etc... but he is still very opposing in school. anyone out there with similar situation would love to hear from you. thanks


What happens at this age is that children are very socially aware and want to avoid anything that might cause them to be ridiculed or teased. It may be that the shame, and scale of the problem is so overwhelming that he has disassociated himself from anything happening below the waist. When the teacher points out to him that he needs to change (however subtly it is done) he finds it threatens his sense of security. That may explain the why, but doesnt leave us much further ahead with dealing with how to fix it. Acknowledging how he may be feeling and validating those feelings may be a start. Find out how he would like it to be managed at school and involve him in being part of the solution to the problem. A good book for parents which can help with this is by John Gottman and is called "The Heart of Parenting: How to Raise and Emotionally Intelligent Child", and talks about 'emotion coaching'. This could be useful in your case.

As you are probably aware your son most likely has an enlarged colon and/or rectum and has no idea that the poo is coming. Denial is a common coping mechanism.

Without a full history of everything you have tried it is hard to advise on this, but I wonder if Movicol has been part of treatment? When other laxatives have failed often Movicol (a powder that dissolves in water) can be effective. Clearing out the bowel and keeping it cleared out usually allows one poo at a regular time each day (e.g after breakfast or tea), and often solves the problem of passing motions at school.

Feel free to phone the NZCA 0800 help line if you need further advice or support.