ODD and Encopresis

[PunkParents]

Hi,
I am a newbie and so very glad to have found this site. We are at our wits end and loosing all hope. Our difficult child was diagnosed with ODD and Encopresis (not at the same time - about a year apart). Our pediatric Psychologist says that there is a corrolation between the two but other than the laxative therapy for the Enco, he is not helping much. We are searching for alternative therapies, something that can aid with both issues. Is there anyone out there dealing with the same? Any ideas?

 

[LittleDudesMom]

Hi Punks!!

Glad you found your way here. Great to see you did a profile signature on your first post!

I don't have experience with either ODD or encopresis, but there are several members here that will be along with support and advice from personal experience.

Look forward to having you here.

Sharon

 

[smallworld]

Welcome!

Sorry for all the questions, but your answers will help us help you.
Has your son been evaluated by a pediatric gastroenterologist to rule out physical causes for the encopresis?
Does he have any sensory issues (for example, sensitivity to clothing tags or food textures)?
Any speech or developmental delays?
How does he do in school, both academically and with peers?
Any mental health issues or substance abuse in the family tree (in addition to your postpartum depression)?
How are his allergies being treated?

Many of us here feel that ODD doesn't stand alone but is more a symptom of something else that's going on neurologically or psychologically so it's important to dig deeper (for example, encopresis and oppositional behaviors can emanate from anxiety). Because your son has some physical issues, you might want to seek a multidisciplinary evaluation at a children's or university teaching hospital. Other options for evaluations include a developmental pediatrician or a pediatric neuropsychologist.

Again, welcome.

 

[Josie]

I don't have experience with encopresis but my daughter was diagnosis'ed with ODD. Her problems were caused by gluten/casein intolerance and now that we have removed those from her diet, she doesn't display that ODD behaviour unless there has been a diet mistake. I have read about encopresis being eliminated on the gluten free diet or that people diagnosis'ed with celiac disease as adults had encopresis as children so trying the gluten free diet may solve both problems.

You could have your son tested for celiac disease but even if it is negative, gluten could still be the problem. My daughter with ODD never had stomach issues, only behaviour issues. We discovered her gluten problem because her sister had the stomach problems but even she had a negative celiac test.

 

[So Tired]

I had huge problems with this with my son. It occured when he was about 7, about the time when his little sister was born. (Any big events going on in you son't life?) It was so frustrating!

At first, I handled it very poorly -- being angry which then just caused him to hide dirty underwear everywhere. OMG it was just terrible to open, say, the bathroom vanity or toy chest and find old, soiled undies. Other times he would just walk around reeking. I could not belive he didn't know! But after some research, I realized that by not going for so long, he had messed up his system and really did not know that he had had an accident, so being angry and yelling was not going to help him.

The next step was reading up on it and going to the pediatrician's. She did an exam to rule out any physical problems and suggested a suppository to clean out his system, and some mineral oil mixed into his juice each a.m. for a time to get his sytem functioning again. Also suggested that during this time period you have a "scheduled" bathroom visit to help him "remember" to go. I also had him sit on the toliet even if he only had to urinate in order to check his underwear. I told him if he had and accident it was o.K. Just clean yourself up, put on clean underwear, and put the soiled ones in a soaking bucket in the basement. I tried my best not to be angry, but to let him know that we needed to work on solving this.

O.K. First the bad news. This continued to be a problem for quite some time. Probably a whole year. It was very frustrating at the time.The good news -- he's 18 now and his underware is not my problem!! Seriously though, they do finally "outgrow" it, even though at the time it seems like the center of your problems (maybe that's why they do it?!)

Good luck. I think a Dr.'s visit is the first thing -- to rule out anything physical. I know it stinks (o.k. that pun WAS intended!) but it doesn't last forever. Just feels like it!

 

[Star*]

Hi there Punk, (lol) not calling you a punk but....ah well here we go.

My son is 17. He started encopresis when he was 4 -4 1/2. Sometime when he was around 16 1/2 he finally stopped. On his own. May have had something to do with peer pressure, or the fact that he was interested in girls.

We took him to a doctor, and the doctor suggested we clean him out with enemas, give him mineral oil and prescribed colace.

We got him on a potty schedule as rigid as anything you have ever seen. We increased certain items in his diet and eliminated others. He was still pooping his pants after 2 years of trying.

The jist of encorpesis is that the bowels get stretched out because the child holds the bowel movement in. When they do this the fecal matter hardens and new fecal matter escapes in the form of watery stool. The idea of enemas, colace, Mirlax (which is no good for encopresis but great for constipation) mineral oil is to keep the intestines lubed so that the fecal matter can't stick or stay. And when it can not stick or stay then lower intestines and rectum shrink back to normal size and allow the nerves to start once again to "feel" the "going" sensation.

For me all that information was well and good. BUT all the laxatives, and mineral oil AND YEARS of Mirlax only made nearly as much mess in his pants as did him going in them on his own.

I can list all the things we tried, and never worked. And that would be just about everything you can imagine, because to my knowledge the only thing you can do is learn to live with it. And I don't know that there is an easy way to do that.

I know that if you belittle him or embarass him about it - it's only going to make it worse and longer. My son did it out of control. He told us as he got older when we made him mad he would poop his pants. And the therapist told us to find a way to deal with it (easy for him to say)

If you have the means to make them wash out their own poopy britches - I'd suggest doing that. Give him gloves and a bucket, a hose and a place for any fecal matter to go. Or make him pick that up with a plastic bag and dispose of it.
Once his underwear are washed out - hang them outside to air dry and /or put them in a bucket of bleach water with a little detergent. To me it's like having to wash out diapers for years, but it beats having to clean it out of your tub or calling a plumber who will NEVER return to your home after cleaning a tub pipe full of poop.

Also keep in mind - if he does bathe in the house (because outside is cold and we tried it) fecal matter will be getting in the drain - if you give or take a bath - before you do pour bleach in the drain while the tub water is running and THEN hit the tub stop. No one in our house can STILL take a bath.

The best laundry detergent you can use for the smell is Tide with Febreeze or Tide with Downy. And Add 1 cup of 20 mule team borax to all his loads of clothes. If he's ditching his underpants he's now pooping in his pants and if you don't pre-treat that or use borax - the smell of hot poop in a dryer will make YOU crazy and make EVERYONE ELSE not want to wash their clothes. I always ran a load of hot water and bleach in the machine after I washed Dude's clothes.

I bought Underpants at the Salvation army. I also had to HIDE my fiance's underpants as Dude would break crawl through the window of my room and get them - because the doors in our house are locked.....and eventually we had to lock up DF's dirty underwear because even those were cleaner than Dudes underwear. (grossed out enough yet?)
Yeah - but these are things you are going to be facing, rather you hear them from someone who isnt' going to go OMG your kid is X years and poops his pants?

In a car - Febreeze sprayed close and Lysol Crisp linen spray worked to get the stink out of upholstery. BOTH have to be used - Lysol to kill the germs and febreeze to cover up the smell of the lysol.

We even at the end finally just said LOOK - You're doing it, we know you're doing it - just scrub the tub when you are done, and wash your britches outside, pick up the mess and then put them in the bucket of bleach and soap - and gave him his own towel, washcloth, and did the best we could not to puke when we used the same bathroom.

WE did work with a cognitive behavior therapy therapist and that seemed to help a lot - not so much that it stopped overnight - but the man was able to give us ideas to stop being so angry about it all and gave ideas to Dude like WHY do you want to sit in your own mess?

For us it was ALL control. It can be a sign that a child was molested, but you'd need to have a therapist determine that. And for us - that is sadly what it was.

I probably painted a grim picture for you - and I'm sorry anyone has to go through this. There are a few of us here that have had to deal with this and it's like I remember at one point sitting in my yard swing looking up to heaven and saying "YOU KNOW.....I could deal with JUST the behavior, or JUST the destruction of my home, or JUST the school calling, or JUST him being so ugly to me, or JUST the poop thing - but noooooo you saw fit to give me patience to deal with them ALL AT ONCE....THANKS GOD - thanks a load." literally.

I can tell you that they'll quit - when they quit. If it's not a bowel problem - you're just going to have to follow some hints here - and do the best you can until he stops.

Hugs -
Star

 

[KarenB]

I just realized that I didn't put encopresis in my sig. I REALLY should change that. You are not alone. Everything Star just said applies, and then some. My difficult child has done this since he was about 5, and is almost 14. We had him checked out by a pediatrician. There is nothign physically wrong.
He sits on the toilet and bears down three times a day for 5 minutes,( when he feels like complying), to try to prevent "accidents." But his psychiatrist said most of them stop when they are interested in girls/boys. We hold him accountable for it, although he hides his underwear anywhere he can, including clean clothes drawers, linen closet, under beds, under dressers, in between our fence and the neighbors, etc.. When we actually find out he did it, he has to wash his clothes out in a 10 gal bucket outside with laundry detergent and hang them on a clothes line we put up sepcifically for this. The anger comes in when he lies or hides it, but I realize it's probably either due to shame, or laziness. Either way, for a long time I felt this was a nightmare and didn't understand one bit. He was in class(in Middle school) sitting there with poop in his pants, kids smelling it, and the teacher asking him about it. of course he lied! I had to take clothes to school many times, until we just decided to keep a change of clothes with the nurse. I can't tell you when it will end, but I have been told that if it goes on into the 20's it can cause them to have to have surgery on their colon, a colostomy. His previous psychiatrist told me that. I HONESTLY empathize with your situation. If you ever have any questions please ask. I can at least tell you what we have tried and what hasn't worked. Hang in there!

 

[Estherfromjerusalem]

Hello Punkparents,

Well, as you can see from all the replies, you are certainly not alone. My difficult child (now aged 21) started encopresis at the age of four and a half, and stopped some time between 13 and 14. I used to be what this site jokingly calls the "resident expert on encopresis," but quite honestly I don't think I have anything to add to all the good information you have received from everyone else here.

Our extended family has a history of sensitive digestive tracts, from chronic constipation (my father) to Crohns disease (my sister) to just sensitive (me), so I suspect that my difficult child also falls in that category. But the actual cause of encopresis is constipation -- what causes that constipation is another matter, but it leads to the condition called encopresis.

I learned the hard way, because I had no help and no support until he was about 10 years old, when I discovered the internet at work. Our local pediatrician had said to just ignore it and it would pass on its own, and how wrong she was! To this day I can't forgive her. You have to get your child to a pediatric gastroenterologist just to make sure that there is no physical problem causing the encopresis, such as Hirshprungs disease, which is very rare.

It was a support group on the internet that taught me that it was totally NOT his fault, that he truly had no control, and that anger would not help at all, but would have the opposite effect. So I learned to love him and accept him the way he was. That was so important, because he was being rejected at school, in the neighborhood, and even by close family members, because he always stank (he could soil himself 10 times a day quite easily). I learned to have a really good supply of pants and underpants. Underpants were always white cotton so that they could be soaked in bleach solution -- that was how I coped with the laundry.

I made a load of mistakes along the way, but here we are today, he is clean. He still has a tendency to constipation -- only goes about twice a week, if he goes three times then that is a really good week. He still is super duper extra sensitive about it, and has to have a shower immediately after "going" -- but that's fine with me. He is quite fastidious about cleanliness and clothes now, and I do an awful lot of laundry for him.

I often wonder, what came first, the ODD or the encopresis? I'm still not sure!!

What I do know is that when I do my arithmetic, since my difficult child is the youngest of eight children, and the oldest is 17 years older than him, I was dealing with poop problems for 30 years more or less non-stop!

Anyway, I just wanted to say hello and welcome, that you have come to a really great place, and to give you a hug.

Love, Esther

 

[wakeupcall]

Hi

I sure wish those of us who have this experience could be more encouraging, buuuuuuuuut we can't. My difficult child has always had encopresis and he'll soon be thirteen. I've had him to a pediatrician for it and a gastroenterologist. They didn't help. I wish I could tell you some things to try to help, but nothing has worked for us. Once in awhile he'll get a little better for a short period of time, then he's right back to square one. He argues (ODD) that he did NOT go in his pants...when I can smell him perfectly. SO the fight is on! Then his room....it has an odor that I can't get rid of no matter what I try. Others have suggested white underwear so you can bleach it and I suggest colored because the bleach never worked anyway and at least you can't see the stains so well. I DO hang his underwear on the clothesline because that seems to help get rid of the odor. This problem is ongoing for us...I'm afraid you may have just begun a long journey. Gotta go, MY difficult child just plugged the toilet with so much tp that its overflowing....aaaaaaaaaaaahhhhhhhhhhhhhhhhh!

 

[Adrift]

My difficult child dealt with this from the time he was four until he was 11. It was SO difficult and we didn't have it half as bad as the above folks did. What worked for us was compassion and empathy always. We helped him deal with it and treated it like a medical problem which it is in many cases (the stretched bowel). In the end what worked best was miralax and ducolax. One dose of miralax a day plus one or two ducolax depending on when he had had a bowel movement last. They VERY slowly we tapered off. In end, he was ready for it to stop as well. Good, good luck, this is just such an AWFUL thing to deal with!

 

[PunkParents]

Thank you all so much. I can't believe that so many of you know EXACTLY what we are going through. God Bless you all.
To further our story......we have had him at both a Pediatrician and a Gastroenterologist. Both of whom were very understanding and suggested alot of what was recommended here. There is no sign of physical illness (thank the Lord) and were given a decent prognosis. His colon is still in relativley good conditiion so we do the Laxative treatments about 3 times a month and 10 minute potty sits twice a day. There are good weeks and bad as I'm sure you know!
It's funny that neither doctor suggested the fact that there may be some sort of genetic/family history connection. Our daughter suffered from GERD until she was 2 and my father has a duodenal ulcer and a very tempermental stomach. difficult child's uncle also has a severe dairy allergy.........makes me think that the gluten free diet might be something to try!
I guess we were just looking to see how long we can expect this to last. I suppose we should prepare for a few more years of poopy pants! It's all good.....he's worth it!
Again, God bless you all!

 

[Marguerite]

I would also check out whether he has any sensory integration problems. difficult child 1 does, connected to his Pervasive Developmental Disorder (PDD) (Asperger's Syndrome) and this was causing us problems for a while. He was compliant, but we needed to remind him to "go". When toilet training, difficult child 1 would get very anxious about where to put it - he didn't want to put it in his nappy, and he didn't want to sit on the potty or toilet. He would instead try to hold on to it, hoping that maybe the day would come when he would never need to empty his bowels again. In his case, the acute part of the problem only lasted a few months. On the chronic level - we had to remind him to go, for about ten years or more. He just wouldn't notice the smell coming out of his skin, he had left things for so long.

difficult child 3 was a problem of a different sort. Again, Sensory Integration Disorder (SID) issues meant he wouldn't be aware of soiling or of the need to go. Also, he too felt that excretion in general was something he would grow out of.

I've told this story before, but it is classic - difficult child 3 got up in the morning one day and barged noisily through the bathroom door as he always does as he heads to the loo. As I heard the sound of Niagara Falls (something about male bladder capacity that astounds me) I heard him exclaim in exasperation, "EVERY MORNING there's wee!"

He also would refuse to use any toilet away from home. He was phobic about hand dryers and also about anyone else using the same facility at the same time. After a while we were able to persuade him to use the disabled loo. Now, he's fine.

Marg

 

[Adrift]

You know there was definitely sensory issues for my son. Until he was almost 7 he literally gagged everytime he peed! We'd have to hold lotion under his nose and his dad taught him hold to hold the seat so it would block the smell a bit. I think the smell of a BM was just too much for him! He's thirteen and he still has a cow when someone forgets to flush the toilet!!