On Older Kids Shitting on Themselves-The Medical Diagnosis (for the morbidly curious)

We've had several "kid shitting on themselves" topics of late, which sparked my curiosity. I did a quick search about it and ran across numerous sites and article about it. Overwhelmingly, blogs, sites, and articles by and for parents blame it on the known physical reason which is basically the kid becomes constipated, holds in his poop, and then suffers from involuntary leakage causing the soiling. It's known as "encopresis". The gentle discipline approach is the norm and they generally claim that shaming and punishing the kid is ineffective and the treatment mostly involves laxatives, diet high in fiber and water , positive reinforcement, LOTS of hugs and kisses, and other things like keeping a poop diary.

The information geared by and written by predominantly parents nearly completely ignore it is generally thought to be a behavioral behavioral problem and instead focus on the physical problem allegedly causing it. Articles like this one on a Moo forum below are typical. I have included excerpts under the link to the article: My commentary in red:


Kids shitting themselves from a parents' point of view:

http://kidshealth.org/parent/general/sick/encopresis.html

Most encopresis cases (90%) are due to functional constipation — that is, constipation that has no medical cause. The stool (or BM) is hard, dry, and difficult to pass when a person is constipated. Many kids "hold" their BMs to avoid the pain they feel when they go to the bathroom, which sets the stage for having a poop accident. They too say it's "functional" without a medical cause, but it's a different take on it than the expert opinion below.

Well-intentioned advice from family members and friends isn't always helpful because many people mistakenly believe that encopresis is a behavioral issue — a simple lack of self-control. Frustrated parents, grandparents, and caregivers may advocate various punishments and consequences for the soiling — which only leaves the child feeling even more alone, angry, depressed, or humiliated. Up to 20% of kids with encopresis experience feelings of low self-esteem that require the intervention of a psychologist or counselor.

Punishing or humiliating a child with encopresis will only make matters worse............... So, what causes the hard poop in the first place? Any number of things, including diet, illness, decreased fluid intake, fear of the toilet during toilet teaching, or limited access to a toilet or a toilet that's not private (like at school). Some kids may develop chronic constipation after stressful life events such as a divorce or the death of a close relative. Whatever the cause, once a child begins to hold his or her BMs, the poop begins to accumulate in the rectum and may back up into the colon and a vicious cycle begins.

After they go on about using stool softeners and adding fiber and water to the kid's diet, they start in on crunchy moo "treatment": A good way to keep track of your child's progress is by keeping a daily poop calendar. Make sure to note the frequency, consistency (i.e., hard, soft, dry), and size (i.e., large, small) of the BMs.
Patience is the key to treating encopresis. It may take anywhere from several months to a year for the stretched-out colon to return to its normal size and for the nerves in the colon to become effective again.......Provide a small incentive, such as a star or sticker on the poop calendar, for having a BM or even just for trying, sitting on the toilet, or taking medications.

Whatever you do, don't blame or yell — it will only make your child feel bad and it won't help manage the condition. Show lots of love and support and, assure your child that he or she isn't the only one in the world with this problem. With time and understanding, your child can overcome encopresis...."



THEN, we have an article written by a kid medical professional and get a MUCH different perspective on this kid shitting on themselves phenomenon, excerpts included below as well as the link:


Kids shitting on themselves from an expert point of view:

http://www.encopresis.org/

"...Encopresis is behaviorally defined as fecal soiling in inappropriate places in children at four-years-of age or older.

Dr. Robert W. Collins, PhD, PC
Soiling Solutions®
P. O. Box 293
Spring Lake, MI 49456-0293

"...It is most commonly associated with children who avoid the toilet stool, hide to toilet, and become overly dependent on wearing diapers or pull-ups. Encopresis is a functional disorder in 95 percent of cases with no physical basis.This is very frustrating for both physicians and parents as they seek physical causes. Indeed, Encopresis, in and of itself, may result in severe medical and psychological consequences which can then negatively affect future treatment.

The best known medical consequence of encopresis is an enlarged colon or megacolon due to an overlearned
dependence on the holding reflex for attempts to avoid accidents. This compromises the colon's ability to function
properly. The major medical specialty for encopresis is Pediatric Gastroenterology (PedGI). The PedGI can
diagnose this condition which is also known as Functional Fecal Retention or FFR. The favored treatment today
is to medicate with stool softeners and laxatives to attempt to keep the stool soft and promote passage (and
leakage for many children).

The rationale is that under this condition the colon will shrink back to a more normal condition and regain its
functionality. This can happen in 40 to 60 percent of children with Encopresis within one year .... up to 80 percent
in one study after eight years with lots of encouragement insisting that a child will grow out of it.

Effective alternative treatments have now become available giving parents more choices and more rapid results.Â
The leading alternative and only home-based treatment is Soiling Solutions ® (SS) which is detailed in the Clean
Kid Manual (CKM) authored by Dr. Robert W. Collins. The CKM is available from the store at
http://encopresis.com/zencart/. Purchase of the CKM results in an automatic registration on the SS Parents’
Forum which includes other parents using the manual.Â................... This sounds like the majority of shitters, a whopping 95%, have behavioral problems causing it rather than physical medical problems. This doctor appears to believe the symptoms and consequences of it are the RESULT, not the cause, unlike the parental point of view. If I had money to burn I'd order that "Clean Kid Manual" to see what advice and course of treatment this doctor recommends. I'd be willing to wager it is quite different than what we see recommended in parenting magazines where breeders absolve themselves of blame and/or flock to "experts" who back their theories of the kid shitting problem.

I'd like to add that in most of these kids shitting on themselves cases, it doesn't seem to simply be "leakage" from being constipated, but instead it's outright shitting normal turds.

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If YOU are the "exception" to what I am saying, then why does my commentary bother you so much?
I don't hate your kids, I HATE YOU!

You know, I really don't care why or how the little fuckers have this problem. What I want to know is, when they finally get to the point of shitting, why aren't they going to the goddamned toilet to do it? Adults get constipated and use laxatives and stool softeners, and when they work, gee, we go sit on the fucking toilet! A kid who "holds it in" until it can't anymore is, as far as I'm concerned, playing some sort of defiant game - not only am I not going to shit for days and days, when I finally DO, it's going to be all over the floor like an un-housebroken dog. It's some sort of mental problem at the root of this, you can just bet on it.

Also, in the Moo article it claims the kid gets used to the smell of his own shit which is why it doesn't appear to bother him, but on the other hand they go on about how ashamed the kids feel. EVEN IF he can't help it when the shit slides out in time to make it to a toilet, which I do NOT buy into, that doesn't explain why he would hide the shit under his bed rather than rake it out in the toilet, wash or throw the under wear away, and put on a clean pair. Even if he can't smell it, which I find VERY difficult to believe, he HAS to know it stinks and is nasty or otherwise he wouldn't be hiding it.

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If YOU are the "exception" to what I am saying, then why does my commentary bother you so much?
I don't hate your kids, I HATE YOU!

If I was nine years old and needed a shit calendar I would have killed myself.

So when daddy leaves moo to marry his secretary, kid starts clenching up. No wonder it happens so often, as these pig moos can't keep husbands around due to extended BF'ng and cosleeping.

If I was nine years old and needed a shit calendar I would have killed myself.

larious

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"[GFG's pregnancy is] kind of like at the stables where that one dumb, ugly-ass mare broke out of her corral one day and got herself screwed by the equally fugly colt that was due to be gelded the same afternoon."- Shiny

moo doesn't explain why, once the kid shits his pant, he doesn't attempt to clean it off. that's what really gets me. how many posts have we read on moo forums where moo is lowing because her kid refuses to wipe his/her ass and stinks?

all kids have "accidents" when they are little, even when they are in grade school in extreme cases, but sitting around in their own filth = mental defective.

sorry, moo.

The most telling thing to me is the actual physical and medical symptom of this "encopresis", which the common keyword among ALL of the published material I found is, "LEAKAGE", from constipation.caused by whatever reason. The kid is holding in his shit until it seeps out involuntarily around the lodged turd. "Leakage" is a FAR CRY from these "crunchies" and underwear full of well formed turds we keep reading about. I'd like to share a personal story of my near close encounter of this shitting problem in order to illustrate what a NORMAL kid would do:

My first constipation story
I was five years old and playing kickball with a bunch of neighborhood kids in my front yard and knew pretty early on I needed to take a dump, but I held it in because I wanted to keep playing AND because we were winning.(back when keeping scores was allowed) Anyway, it got to the point it started to hurt and my mother noticed and scolded me to go to the fucking toilet and when I wouldn't, she made us stop playing and take a break like a NORMAL parent would do who is in charge rather than a molly coddling crunchy Moo.

I sat on the toilet and the struggle began and it hurt SO MUCH I don't think I will ever forget the pain. I have only been constipated three other times in my life to that degree and each time I suffered temporary PTSD from recalling that first lodged turd incident back in 1967. It seemed like an eternity as I pushed and cried in pain, but my mother and uncles standing outside the bathroom door asking, "Are you okay?" only made it worse. I finally yelled, "GO AWAY!" and right after they did I FINALLY birthed the turd. I can't EVER remember anything feeling so wonderful, but that isn't the moral to the story.

The moral of it is that NEVER again did I attempt to hold in a turd for any reason. I learned a valuable lesson at age 5 and unlike the pants shitting kids of today, instead of continuing with the bad behavior and adding to it by shitting on myself and hiding it, I simply STOPPED holding it in and went to the bathroom from that point on. WHY can't these kids do the same?

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If YOU are the "exception" to what I am saying, then why does my commentary bother you so much?
I don't hate your kids, I HATE YOU!

Kidless Kim, that sounded like an awesome birth story there for a second. You should have made it a hat like the creepy stillborn pic that was going around for a while..... :spin

I had a couple similar problems when I was younger. I had a poor diet (high carb and high protein, not enough fiber. I would eat tons of bread as a snack but hated salad. I was a weird kid...lol) and it led to some bad tummy troubles. But I figured it out without having an incident anywhere near anything we have seen on the moomie boards.

I had problems too as a kid. My mom did the laxitive thing to me to make me stop holding it. I think it's just something that kids do... but it's how the parent's handle it that's the problem. Mine would grab me from what I was doing an plop me on the pot. I can still remember some of my extended potty visits where my mother wouldn't let me off till I'd done what she knew I had to do. She was usually right. If I ever DID have an accident... I got read the riot act and told it was bad and nasty and it was just not acceptable. End of discussion! Not acceptable!

Nasty Nasty Nasty.

There is only one or two excuses for an older child shitting themselves: bad stomach bug or Crohn's disease (or other similar problem).

If a kid wants to hold it in until their rectum explodes I say let them, and then make them clean it up.

Now I'm thinking back to psych class and the stages kids go through - the anal stage occurs around when kids need to be potty-trained. I bet Freud would have a field day with today's pants-shitters. According to him, children who are toilet-trained with positive reinforcement (praise, rewards, etc.) and I'm sure a little shame are more likely to grow up to be competent and productive. But when Mommy is too lenient with toilet training (and doing things like elimination communication) and Junior is overindulged, the child grows up to be anal expulsive, which is a personality characterized by being a wasteful, defiant, destructive slob that derives pleasure from shitting.Sound familiar?

Meanwhile, anal-retentive people are the obsessive, rigid ones. And they are also the ones who, as children, find pleasure in holding in bowel movements because I guess the pressure on the rectum feels good? These modern pants-shitters are like a combination of the two personalities - the shit-retaining of the retentive type and all the characteristics of the expulsive type.

I know no one really uses Freudian psychology anymore, but it's a thought to ponder. From what I'm seeing about encopresis, it's basically fear of painful constipation? But then you pump the fucker full of laxatives for a while and he'll never learn to shit on his own because he'll be letting the magic medicine decide for him. WHY are little kids now so fucked up when it comes to taking a dump? This is a basic body function and it should not require this much effort. And then if the little bastards still can't shit despite enemas and laxatives and all that, they need surgery to disimpact their bowels.

I'd let the kid suffer for a while if he chose not to shit, then say, "See? This is what happens when you don't use the potty. It hurts a lot more, doesn't it?" My gods, kids are fucking disgusting; I can't imagine having to teach them to shit in a toilet and then re-teaching them to shit in general.

I don't understand why these Moos are comparing leakage from around an impacted turd due to constipation to the kids who simply take a regular dump in their pants instead of going to the toilet. "Leakage" from an impacted turd would have symptoms like severe stomach ache and NO shit, whereas the typical pants shitting kids from their stories don't seem to have ANY problem with dropping a load.

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If YOU are the "exception" to what I am saying, then why does my commentary bother you so much?
I don't hate your kids, I HATE YOU!

That's what you get for making your kids completely dependent on you, moo. You wanted to extend infanthood because you were not ready for your 'baby' to grow up. And now you're surprised when the kid is still shitting his pants?

I'm only 29 and I don't remember this type of thing when I was a kid. The only time I remember ANYONE having an accident was not even in my class at school, but my brother's class in the 3rd grade. It was so unusual back then that nobody let him forget about it for years. And because of the shame and embarassment, it was the only time it ever happened. I think the problem is now that moos don't teach their kids to be ashamed of anything, even if they should be.

These stories remind me of a hilarious Hustler Humor cartoon. A moo has her son (about age 8, I guess) in a doctor's office, and the kid is leaving turds everywhere in the office. The doctor is telling the moo (paraphrased), "Mrs. Johnson, Timmy has what we call 'lazy sphincter'."

There could be a bigger reason for all this. Breed Hills is having a hard time with their sewer system, so much they are in trouble with the federal EPA. I guess their wastewater treatment plants get so full of shit (from so many large families) that it gets through the process. One way to solve the problem: Have the kids shit anywhere but in a toilet! Think of all the money we could save as a nation not having to build more sewage treatment plants!

Cambion, when your psychology teachers would teach about Freud could they do it with a straight face? None of the teachers I had could.

tl;dr and tmi, too.

Forget fiber-high diets, hugs 'n' kisses, and poop diaries; Mr. Hand can deal with the untamed animals VERY FAST.

Quote
blondie
If I was nine years old and needed a shit calendar I would have killed myself.

Yep. i have no recollection of thinking about, discussing or publcizing any toilet behavior as a toddler or child. Nor do i recall ANY toilet habits of my parents -- my father would have died of uremic poisoning before urinating around anyone else, i am sure, let alone talking about it to his wife and daughters. my mother was fastidious too and none of us seem to have acquired any hang-ups, just discreet personal hygiene habits.

@mr. neptune, my psych professor was kinda nuts herself, so maybe it was easier for her to keep a poker face when lecturing on other nutters. For some reason, Freudian psychology was my favorite part of intro to psych and out of all the famous psychologists we covered, his stuff sticks in my mind best. Hell if I know why. I gotta dig out my Freud book and read it again someday - I left off on the part where he suggests men all drink together in bars because they're harboring secret homosexual desires to be near one another.

Let's see what our friends at Wikipedia have to say about anal fixations:

http://en.wikipedia.org/wiki/Anal_stage

The anal stage, in Freudian psychology, is the period of human development occurring at about one to two years of age. Around this age, the child begins to toilet train, which brings about the child's fascination in the erogenous zone of the anus. The anal stage coincides with the start of the child’s ability to control their anal sphincter, and therefore their ability to give or withhold gifts at will.larious

This is the second stage of Freud's psychosexual stages. This stage represents a conflict with the id, ego, and superego. The child is approached with this conflict with the parent's demands. A successful completion of this stage depends on how the parents interact with the child while toilet training. If a parent praises the child and gives rewards for using the toilet properly and at the right time then the child will successfully go through the stage. However, if a parent ridicules and punishes a child while he or she is at this stage, the child can respond in negative ways. The child can respond to the harsh demands by refusing to use the toilet or by excreting maliciously. This behavior from a child can lead to an anal expulsive character. A child who has not successfully completed this behavior will become an adult who has an anally expulsive character. His or her personality will be characterized as disorganization, messiness, recklessness, carelessness, and defiance. If the child's tactics are overindulged, then he or she can form an anal retentive character as an adult. The anal retentive character is the opposite of an anally expulsive character. This child will find pleasure in withholding faeces in the body. However, a child who has successfully completed this stage will be characterized as having used proper toilet training techniques throughout toilet training years and will successfully move on to the next stage of Freud's psychosexual developmental stages. Although the stage seems to be about proper toilet training, it is also about controlling behaviors and urges. A child needs to learn certain boundaries when he or she is young so that in the future there will not be contention regarding what is over-stepping the boundaries.

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"[GFG's pregnancy is] kind of like at the stables where that one dumb, ugly-ass mare broke out of her corral one day and got herself screwed by the equally fugly colt that was due to be gelded the same afternoon."- Shiny

Quote
Miss_Hannigan
Let's see what our friends at Wikipedia have to say about anal fixations:

http://en.wikipedia.org/wiki/Anal_stage

The anal stage coincides with the start of the child’s ability to control their anal sphincter, and therefore their ability to give or withhold gifts at will.larious

larious

So... these kids that shit themselves are giving "gifts". How generous of them.

Someone should return the gesture.

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"I have learned that pleasing everyone is impossible, but pissing everyone off is easy and fun as hell"

:eatu