iVillage Member
Registered: 09-07-2005
Mon, 08-31-2009 - 8:53am
My little girl is 3 1/2 almost and was very early to do almost everything as far as milestones go and is doing great. We got as far as her peeing all on her own with almost no accidents for month during the day at home. I even was able to take her out for a short drive with no accident. BUT POOPING IS A WHOLE OTHER NIGHTMARE! She has had a bloody rash for almost 3-4 months now! It comes and goes and at first we thought she was withholding and so she had a constant smudge of poop all the time and maybe that was causing the rash. We have been to the doctor 4-5 times now for this rash. I have used prescript and non prescript for everything. She will not poop on the potty. Doctor says if she poops on the potty the rash will go away. I left her in undies for a whole week and changed them all day long everytime they were smudged but rash was still there. Now imagine every single diaper change with SCREAMING and Shrilling and kicking and more screaming and I MEAN SCREAMING BLOODY MURDER to the point where you are afraid somebody is going to call DSS if they have not called already!!!!! Anyway we took a breaklast week for vacation. Now all diapers all the time again. Still the rash is there and still the pooping smudges. We went the laxative route as well but it did not help it just made her go more and therefor more smudges and more irritation. Preschool wont take her unless potty trained and even if I found one that did not require potty training, how would I ever send her screaming from diaper changes. Anyway I am sure there are more details I should add but can someone guide me a little?
iVillage Member
Registered: 08-31-2009
Mon, 08-31-2009 - 11:58am

It was like I wrote this myself..

iVillage Member
Registered: 09-07-2005
Mon, 08-31-2009 - 12:19pm
maybe that is the key? I keep thinking good she pooped and it is very soft and squishy so I back off on the Miralax as it makes her go constantly.....but maybe she is never cleaned out fully to allow everything inside to get back to normal? I think I will do it for a week straight and see what happens....The worst part is to know she is obviously so uncomfy and it is getting in the way of normal life for her....she just stops in random places and clentches her whole body or gets on her knees and makes these terrible faces ect....its crazy! Her rash seems to be getting better again today so maybe I will keep up with the
iVillage Member
Registered: 08-31-2009
Mon, 08-31-2009 - 1:00pm
Good luck..
iVillage Member
Registered: 06-25-2005
Mon, 08-31-2009 - 11:43pm

I agree with PP. The little poop smudges are most likely little smears of poop that escape without control as a result of encopresis.

When the bowels get overfull -- whether due to constipation or due to withholding poop -- the bowels get stretched out and lose muscle tone. Without muscle tone, poop often leaks out uncontrolled. This is called encopresis.

The more time that poop stays in the intestinal tract, the more water is pulled out of the poop through the intestinal tract, so the harder and drier the poop gets. Additionally, the longer hard/dry poop stays in the intestinal tract, the more it stretches out the colon, and the bigger/wider the poop gets, which makes it more difficult and painful to eliminate. Of course, since it's painful, the child tries to withhold it which only makes the cycle worse.

When encopresis is very bad, sometimes a hard blockage can form in the intestinal tract, and only thin poop can seep around it. That gives the illusion that the child is not constipated when in fact they are tremendously constipated.

Typically a doctor would recommend you clean out the bowels by using a stimulant laxative. Depending on how full the bowels are, it may take a 2nd or 3rd dose. Stimulant laxatives force bowel contractions to semi-quickly eliminate stool. Stimulant laxatives are habit-forming, however (the body can become dependent on them), so they are for occasional use only. Stimulant laxatives are often senna-based products (such as senekot, ex-lax, and the root beer flavored Fletcher's), tho' there are other stimulant laxatives, too.

Then, a doctor would typically recommend you begin a DAILY regimen using a non-stimulant laxative. Non-stimulant laxatives (stool softener type laxatives) help hold water in the stool to prevent it from getting as dry/hard/difficult to pass. It also makes it more difficult to withhold poop. Non-stimulant laxatives are not habit-forming, so they are safe for long-term, daily use. Some good non-stimulant laxatives are products like Miralax, Benefiber, Milk of Magnesia, Fiber Choice (with inulin), and mineral oil (the oil can deplete the body of some nutrients, so a multi-vitamin should be taken at at different time of day than the oil). If one type of non-stimulant laxative doesn't produce good results for you, then try a different one.

When you develop encopresis and the bowels get badly stretched out, it takes approx six months with no constipation and no soiling accidents before the bowels can shrink back down to normal size and be considered healed. While they are stretched out and don't have much muscle tone, it is very easy for the bowels to get overfull again. Any time you get re-constipated or have a soiling accident, the six-month time frame for healing starts over again.

Don't be afraid to use enough laxative to do the job. You should give your child as much laxative as YOUR child's body needs. The dosing guidelines on the laxative containers are for an average child. Some children need much less, and other children need much more. You want your child's poop to be about pudding-like in consistency. That enables it to flow through the bowels more easily without getting re-impacted. You just don't want to give your child so much laxative that they get chronic diarrhea and get dehydrated, but otherwise don't be afraid to use enough laxative as your child needs. (At one point my dd was using six laxatives a day -- under a doctor's supervision -- and it still wasn't enough laxative for her. That would have killed another child, but it wasn't even enough for my child.)

Your child should be pooping every day -- every other day at the very least. If she is not pooping every day and/or if missing one dose of laxatives causes her to get re-impacted, then she is not on a high enough dose of laxatives.

If you want, you could ask your pediatrician to order an x-ray of your child's abdomen. It will give you an idea of how severely impacted your child's bowels are so how aggressive you need to be in treating the problem. Many doctors want to feel/palpate the belly to check for poop in the bowels, but it is NOT an accurate indicator.

As far as rashes go, I don't have a perfect solution, but I did discover that I preferred the original Desitin or the Walmart generic. They were thicker and stickier so stayed on the skin better than creamy diaper ointments. I'd use a very liberal application, both so it covered the rash well and also so I didn't have to put much pressure on a sensitive rash.

Best wishes.

iVillage Member
Registered: 09-22-2005
Wed, 09-02-2009 - 1:05pm

Have you tried suppositories? I agree with others it sounds like she's holding it in and then having overflow "issues". Suppositories can help get her on a pooping schedule... maybe read a certain book and sit with her on the toilet till the suppository does it's work.

Good luck!

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