6 year old doesn't want to poop

[natesmom616]

I hope that I'm in the correct forum for this.  I have a 6 year old (7) in June of this year who does not like to poop.  He was potty trained fairly quickly when younger and had no real problems.  A few years ago, I noticed that he would go for days without having a bowel movement.  When I'd ask him about it, he'd tell me that he didn't have to go, though it was obvious that he did and was holding it in. If he was standing, he'd run to a chair or the floor and sit down and rock or shake his legs or something.  I took him to his pediatrician who thought that possibly he'd had a very large bowel movement at one time and it caused some pain. (He is rather small. At almost 7 yrs of age, he is in a size 4)He believed maybe this made my son apprehensive about going for fear of the pain.  He put him on a bulk stool softener.  This did help him go more often, but only because he can only "hold it" for so long.  For a little while it got better.  He hasn't been on the softener for over a year and half.  However, this is still a problem.  I can tell when he has to go, though he will deny it every time.  I've tried everything from trying to explain how it can hurt his body to hold it in, not allowing him to go places if he hasn't gone and I know he has to go, and even rewards for going. On the rare occasion that he does go without holding it, I'm always quick to tell him how proud I am that he isn't holding it in.  Every time he goes, I ask him if it causes him pain and he says no.  He says that he doesn't like the way it feels.  I've explained that he will have to poop for the rest of his life, regardless of if he doesn't like the feel of it.  He's never constipated and his stools always seem soft, though formed.
Then, last week, he said that when he goes, it hurts his stomach.  At first I thought maybe this was his stomach cramping up when he has a bowel movement.  But I asked him to show me where it hurt and he pointed to his lower abdomen and then also pointed up higher in the center of his torso.  
Is this most likely a psychological issue?  Or can it be medical.  It's not that he doesn't HAVE to go.  By his behavior, I would guess that he would have a bowel movement every other day at the very least.  The urge to go is there, he just holds it and holds it and holds it.  If I wasn't watching, he'd hold it for up to 5 or 6 days.  Could this be a medical issue?   Should I take him to a specialists?  I'm at a loss as to what to do.  Any suggestions or comments are appreciated.  

[irishred795]

My four y/o also has this issue and it has been diagnosed as encopresis. We've been struggling for almost a year now. We use Miralax, too, and try to have him sit on the potty at the same time every day. This is difficult because he has oppostional defiant disorder, so getting him to do anything is usually a battle. I'm so grateful for all the posts because he's still having trouble and I was wondering if I should take him back to the peds gastro. I'm hoping it will clear up as we deal with his anxiety issues and ODD. I can definitely relate to feeling so helpless b/c you know he's in pain, but mentioning it just makes it worse. We've set up a code phrase "I'm taking a little break" that tells me he's having belly cramps and wants to be left alone.

[cougarnik]

I just found this forum and I'm so glad to read that other people face this issue.  My daughter is 5 years old and has been on miralax since she was 18 months.  We have battled the "holding of bowel movements" for so long, that I feel like it consumes everything.  Our pediatrician dismisses it as normal(which drives me crazy) and the gastrointernologist keeps saying to keep her on the miralax.  I'm so frustrated with the poopy panties and constant battles to sit on the potty!  My daughter also can become very upset and defensive when she has an accident(which is daily).  It is a battle to even check her panties for poop.  Her friends are constantly telling me that she smells, and she doesn't even care.
I guess I'm not really looking for help, I just wanted to get my own frustration out with other parents who feel the same pain.  My friend always says, "don't worry, she won't walk down the aisle with poop in her pants", but I have serious doubts that it will ever stop.

[Reneerose24]

Wow.  Looked this up after hearing my granddaughter screaming and crying in the bathroom, because she hates going and she holds it for four or five days.  I figured this wasn't as uncommon as you'd think.  I know she'll grow out of this, but she's also been on Miralax since she was a toddler.  We just laugh and figure we'll save these stories for her first boyfriend.  Lol

[christine73]

My four-year-old son spent a lot of last year witholding poo, as I called it. I too was rinsing out smeared underwear several times a day and losing my mind in the process. I put it mostly down to his apalling diet - he eats no fruit or vegetables and exists mostly on peanut butter sandwiches and various carbs - and give him Miralax daily, but pooping is still an ordeal for him.

He's been very good lately (for the past several months) and nearly always goes as soon as he feels the need, rather than holding it in for a week. So he poops every day or two, but it's very hard for him - he sits and wriggles and cries and his legs are pumping pumping and eventually the poo - lots of it - doesn't look too hard or too soft - comes out. It takes a good ten or twenty minutes.

I always thought it was a control issue, which makes sense with the OCD thing. Now it looks as if his brain and his body are at odds - he really wants to go, but his body won't just sit down and do it, so he fights it the whole time, even while it's happening.

I think it goes in phases. I'm just hoping this phase is over soon. And that there isn't some physiological thing I could actually do something about. I hate to see him suffering when he's trying so hard to be good.

[scootytoot]

Hi there - I am just adding to the discussion not because I have a child of my own who suffers with this condition but a child in my class and I am trying to get a bit more info on it. One thing I remembered from my uni days is Freud's Psychosexual stages of which there are five but I think the anal stage is relevant to this... here is a bit of info...

"Anal Stage: 18 months - 3.5 years (approx.)

Physical focus: anus (elimination). Until now the baby has had it pretty easy. Now baby is supposed to control bowels. Freud believed baby?s sexual pleasure centred around the anus at this time.

Psychological theme: self-control/obedience. These things are not just related to toilet training but also the baby must learn to control urges and behaviours (terrible twos). What goes wrong here is either parents being too controlling or not controlling enough (Freud was a great believer in moderation).

Adult character: anally retentive (rigid, overly organised, subservient to authority) vs. anally expulsive (little self-control, disorganised, defiant, hostile)."


It also said that if there is any 'unresolved issues' during these stages, 'fixations' on the stage may occur in later life. Interesting and worthy of taking into consideration as we try to understand this complex issue. Kind regards and best wishes to all who are dealing with this first hand.



...

[Chrismomathenaunt]

Id like to know more about this Freud you speak of I think U just may be on to something here something's you said and some issues that are presently happening along with this issue and I am very interested in learning more on this theory

[natesmom616]

Hang in there!   I KNOW that its frustrating.  This forum is wonderful.  For so long I thought that my child was doing something that no other child did.  It's amazing to me how many parents are answering on this forum thread that I first started over 2 years ago.  This situation is much more common than I ever thought and I'm amazed that doctors aren't more aware of it considering that.
Like all of the other people who posted, mu doctor kind of guessed at what was going on.  My son's ped. dr. put him on stood softeners in the beginning like so many others did.  He advised that if it kept up we would need to see a gast. dr.
My problem with those two things was that I knew that his problem wasn't that he COULDN'T go, it was that he WOULDN'T go.  HUGE difference between the two.  When "spacebound" wrote in and mentioned the OCD aspect, it was like bells and whistles went off in my head.  THAT makes sense to me.  We recently tool my son to see a therapist because he gets frustrated and angry very easily.  After many sessions, they said there was no HDAD, nor any other type of disorder to worry about. Said he seems healthy and well adjusted for a 9 years old but said that he does tend to have some issues with anxiety and worrying about things.  That kind of fits with his bathroom issue.  At least to me it does.  Anyway mrsphips, I know how difficult it is but just hang in there.  Believe me, as hard as it is, staying calm and not making a huge deal out of it seems to be the key.  Not to solution by any means, but it certainly worked better for us than arguing, taking away privileges, and forcing time on the potty.  That just increases their anxiety about the whole issue.  Cant possibly help.   I learned that the hard way :-)   As I posted before, Nate has gotten better and better,  But he still occasionally holds it.  He went yesterday and I know he had held it for at least 3-4 days, even though he denied it.  Plugged the toilet up and everything.  It was only after going swimming all day that he just couldn't hold it any longer.  The swimming thing helps I think.  Even more so than a soak in the tub.  Maybe the chlorine?  Or just the length of time they're in the water maybe.  Dunno, but swimming almost always makes him go.  It will get better, just need to be patient.  Other than the one post, I think most kids slowly get past it.  If indeed it is psychological, which I do believe it is, maybe as they get older, the OCD manifests itself in other ways.  There may not be much help explaining this from the doctors, but there is plenty of help on this website.  As you said, its so nice to know there are others who have gone thru this and can offer help, even if that help is only a small comment of support and understanding.

[lvmom]

WOW, I am so happy to see all of these responses! More information than I got from any of our doctors.

My son is 9 years old and we have been dealing with this for about 4-5 years. He was worse a few years back, but now that we can talk about how its not good to hold it in, he does better. We have been very careful not to shame him but just to let him know we are worried it could hurt his digestive system. When he finally does go after a few days of holding it, it is HUGE! Sometimes we have to remove it from the toilet because there is just no way it will go down. Once we saw the size we knew it had to hurt. So we gave him mild stool softeners - not laxatives. They have helped a lot. It makes it easier for him to go so we know that it isn't the fear of pain that is stopping him. But he still holds it sometimes.

Another idea is regarding the routine of at least sitting on the toilet at the same time every day - like before a bath - even if you don't have to go. This was somewhat effective.

I used to think that sometimes children, certainly boys, are so busy they don't want to take the time to do. But, I agree that it is psychological, and something that they perhaps cannot help from doing. A compulsion. I really don't know what it's about, but our doctor's have all said that its normal and to use a stool softener. It does worry me that it will carry into adulthood. I never thought it could be OCD related until reading these posts. My son also has a habit of biting his nails. I don't understand why he does either of these things. He is not under any abnormal stress. We have a stable home, a large extended family and a pretty basic weekly routine. He has a very happy homelife as well as school. It may be just part of his personality.

It was great reading everyone's responses, now I don't feel that it is very uncommon. Thanks all!