If children are stool soiling their clothes, it can be very frustrating to a parent. A child soiling his or her clothes can be regarded as a misbehaving child, and parents may tend to scold the child for doing so, but little do parents know that stool soiling can actually be a problem with the bowel movement of the child.
More About Stool Soiling
Children above 4 years of age who soil their clothes frequently have a condition known as encopresis in which there is a problem with bowel movements due to which the child will not have the urge to go to the toilet, resulting in stool soiling.
There may be leakage of stools from the child’s under wear. The child may also have constipation associated with abdominal pain. The child may be reluctant to pass stools. There can be urinary tract infection with abdominal pain.
Chronic constipation is said to be the main cause of encopresis. In constipation, the stools become hard and painful to pass, so the child tries to avoid passing stools and this makes the situation worse. When the colon cannot hold the stools anymore, it signals the nerves to push them out and then the stools leak out through the undergarments. Constipation occurs due to eating less fiber, not drinking enough water, eating too much of dairy products, intolerance to cow’s milk, irritable bowel syndrome (bowel disorder), birth defects and diseases. Emotional situations like divorce of the parents, birth of a brother or sister or stress due to toilet training is also said to cause encopresis.
Treatment
It is better to start treatment as early as possible. The doctor recommends one or more treatment methods that include using colon lubricants, stool softeners (milk of magnesia, sorbitol, lactulose, polyethylene glycol drink mix), enemas, rectal suppositories and intake of oral fluids. A high fiber diet is recommended and use of stool softener is advised for at least 6 months. Counseling by a psychiatrist regarding passing stools without withholding them can help the child. Psychotherapy will also help the child to overcome stress, depression and shame that may be felt by the child due to stool soiling
Toilet training
Toilet training should begin when the child is between 18 to 24 months. It is advised that one keeps a toilet diary in which the parent or the care taker can note down the patters of bowel movement the child has. This should be shown to the doctor for advice. One must teach the child how to sit on the toilet seat. A foot stool can be used if the child is unable to get on to the toilet seat. The child should be allowed to carry his or her favorite comic books or toys into the bathroom. The child should be allowed to adjust to the bathroom environment and play for some time. One must never force the child to pass stools as soon as he or she is on the toilet seat. It will take some time for the child to adjust. Starting with 30 seconds on the toilet seat, slowly increase the duration to 5 minutes.
The child should be given high fiber diet and less of dairy products to prevent constipation. When the child soils the clothes it is very important for the parent to remain calm and not scold the child. The parent should let the child help in cleaning up the mess.
Once the child starts having healthy bowel movements, he or she should be made to use the toilet at regular intervals. Once a pattern of bowel movements is established it should be noted down in the toilet diary and shown to the doctor. The child should be using the toilet 3 to 5 times daily and duration for each sitting should be at least 5 minutes. A good idea is to reward the child for every successful bowel movement like taking the child out for fun activities or pasting a star on his or her chart. These rewards will encourage the child to go to the toilet and once the bowel movements are regularized the rewards can be stopped. One should also train the child to inform the parent or the care taker when he or she feels like going to the toilet.
Keep the child active
Physical activity of any kind like exercise or any games helps in keeping the stools soft. A parent can try out interesting fiber rich recipes like apples with peanut butter topping; bran waffles with fruit toppings or whole grain pancakes with apricot and peach toppings. These mouth watering treats will be liked by the child and also will help in getting rid of constipation. Above everything, parents should never lose patience and give the child all the emotional support he or she needs.
