How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask beandoctor Your Own Question

beandoctor
beandoctor, Pediatrician
Category: Pediatrics
Satisfied Customers: 332
Experience:  Board Certified; Graduated from top 20 medical school
Type Your Pediatrics Question Here...
beandoctor is online now
A new question is answered every 9 seconds

My 11 year old poops his pants regularly. He has no interest

Customer Question

My 11 year old poops his pants regularly. He has no interest in using the bthroom. He has adhd and some sensory integretion issues but he is very intelligent. He justs seems to not care. I am at my wits ends. What can I do? Note there have been times where he has stayed clean for several months at a time but then he reverts back to this behavior. Please help
Submitted: 2 years ago.
Category: Pediatrics
Expert:  ProExpert37 replied 2 years ago.
Hello and Thank You for consulting Just Answer. I will refer you to Pediatrics.
Expert:  beandoctor replied 2 years ago.

I would love to help with your question... it sounds like things have been very difficult for you all lately!

 

First, I am assuming this is a new behavior? That is, your son toilet trained in the past and was fine for a while but now seems to not care and is having accidents? The reason I ask is this: if he never toilet trained, and has had accidents his entire life, that strongly suggests a more medical cause (like a neurologic problem) versus a largely behavioral one.

 

From the sound of your question, it sounds like he has the capability to stool appropriately... sometimes. If that is the case, then I'll give you my opinion about what may be contributing to this, and what can be done about it.

 

I suspect that there are two issues here: a behavioral one, and a medical one, and the truth is, they are probably related.

 

Without examining your son, or knowing any more about him than you put in your question, I would strongly suspect that he has what is called dysfunctional voiding syndrome. This is a problem that is triggered initially by constipation and reinforced by willfully holding back stool... until the nerves that tell the brain that it's time to "go" don't work so well.

 

Essentially, the problem is that his brain and his bowels do not communicate well any more, and the focus of therapy is to fix that. We have to get his bowels to talk to his brain again - and his brain to listen!

 

The first step in treating dysfunctional voiding is to treat the constipation. Dysfunctional voiders may stool every day and therefore may not appear to be constipated - but even though they poop regularly, on the inside, their bowels are still stretched and distended with stool.

 

Typically, the best thing for treating constipation is a medication called Miralax. It's a powder that dissolves in fluid and is essentially tasteless; you can get it over-the-counter. It is safe and very effective, though it sometimes may take some trial and error to find the right dose for your son. You should shoot for a daily dose that keeps him stooling at least 1-2 times per day.

 

You need to use the Miralax every single day for at least several months in order for the bowel to decompress back to its normal size. If you stop it before then, I can almost guarantee that you'll have problems again (and this may be part of the reason why your son has had problems... then been fine... then regressed again.)

 

Second, once the bowels are cleaned out, you need to get your son to start to re-learn his body's signals. The best way to do this is with a scheduled voiding regimen. That means that after every meal or snack, he goes and sits on the toilet for 10 minutes. He does not have to stool every single time - but he has to try. As you know, after you eat a meal, the body experiences something called the gastrocolic reflex, where there will be some contractions of the bowel and colon, and we need to take advantage of those.

 

At age 11, your son should be fairly upset about stooling himself - most children his age would be mortified! It sounds like your son is... not so mortified. Still, I would focus on giving him positive reinforcement for doing right rather than punishing him or fussing when he has accidents. He is perhaps a little old for a "star chart," but I would do something similar, in which he earns increasing rewards for every day/week/etc. that he goes without stooling himself.

 

You should see your son's pediatrician to talk about all of this. Specifically mention the suggestions that I've made and see what they have to say - most pediatricians see children like your son all the time, and your pediatrician will be your best friend as you work through this.

 

Dysfunctional voiding is extremely common - it's just that parents and kids don't like to talk about it. Don't feel like you're alone.

 

Finally, this problem did not develop overnight - and it is impossible to fix it overnight. It will take weeks or even months to get better, but with consistent effort, a good bowel regimen, and a caring pediatrician, things will get better.

 

If I have answered your question, please click ACCEPT. And if I can help with anything else in the future, please do not hesitate to ask.

 

Best wishes...

Expert:  beandoctor replied 2 years ago.
I hope that this information was helpful to you... please let me know what else I can do to answer your question!

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Yogindra Vasavada

    Pediatrician

    Satisfied Customers:

    2507
    M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr. Yogindra Va/2012-6-10_2618_DSC0039.64x64.JPG Dr. Yogindra Vasavada's Avatar

    Dr. Yogindra Vasavada

    Pediatrician

    Satisfied Customers:

    2507
    M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
  • http://ww2.justanswer.com/uploads/GA/GauravMD/2012-6-9_62959_gaurav.64x64.JPG Dr. Gupta's Avatar

    Dr. Gupta

    Pediatrician

    Satisfied Customers:

    1442
    MD, practicing Pediatrician with 19 years of experience. Member American Academy of Pediatrics.
  • http://ww2.justanswer.com/uploads/edkulich/2010-08-17_171809_doctor.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified Pediatrician

    Satisfied Customers:

    819
    Board Certified, Ivy League educated Pediatrician.
  • http://ww2.justanswer.com/uploads/cbellmd/2009-11-19_013247_CB_PHOTO_2.jpg Raymond B., M.D.'s Avatar

    Raymond B., M.D.

    Doctor

    Satisfied Customers:

    422
    I provide medical care for newborns, children, adolescents and young adults up to age 21 years.
  • http://ww2.justanswer.com/uploads/DA/davhill1/2012-6-6_17340_DLHSittingCropped.64x64.jpg David L. Hill, MD, FAAP's Avatar

    David L. Hill, MD, FAAP

    Doctor

    Satisfied Customers:

    414
    Adjunct Assistant Professor of Pediatrics, UNC Medical School. Vice President, Cape Fear Pediatrics.
  • http://ww2.justanswer.com/uploads/josho33/2009-12-16_0435_php4n8fiy_c2PM.jpg Dr. Davidson's Avatar

    Dr. Davidson

    Board Certified Pediatrician

    Satisfied Customers:

    408
    Board Certified Specialist in Pediatrics, Allergy, Asthma & Immunology
  • http://ww2.justanswer.com/uploads/FA/fabiola.caracseghi/2012-4-12_204829_foto2.64x64.JPG Dr.Fabiola.MD's Avatar

    Dr.Fabiola.MD

    Pediatrician

    Satisfied Customers:

    118
    Pediatric Immunology. General Pediatrics