If your child has been potty trained and is having problems controlling their bowel movements, it could be caused by several different reasons. Sometimes a birth defect can cause fecal incontinence or a disease. In most cases, fecal incontinence in children is caused by constipation. Children who are potty trained will become constipated because they do not want to take the time away from play or TV to go to the bathroom. Maybe they feel embarrassed about going to the toilet in a public place or a place that is unfamiliar. If the child continues to hold in the fecal matter, the stool can become hardened and pile up in the rectum.
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The accumulated stool can cause a stomachache and their appetite may decline. They may not eat even if they are hungry. When the child finally goes to the bathroom, they have a painful, straining bowel movement, which can make them more afraid of having a bowel movement.
A child like this may have soiled pants because liquid from further up the bowel leaks past the hardened stool and passes out of the rectum. It is important for parents and caregivers to realize the child may not realize they have leaked into their undergarments, and cannot control that leakage. The child is not doing it on purpose and is often embarrassed to find that it has happened.
Your child’s first step is to pass the built up stool. Your doctor may prescribe a drink that will clean out the bowel such as mineral oil, polyethylene glycol, or magnesium citrate. This will loosen and soften the bowel so it can pass through the rectum. Then a parent should take steps to prevent future constipation. The parents and caregivers will play an important part in the treatment of the child. Your child may need to be taught good bowel habits. You may need to help your child train their bowel movements to happen at nearly the same time each day. Encourage them to sit on the toilet after they are finished eating and at bet time for at least five minutes. If the child has a bowel movement, give them a reward. Remember, you should not use discipline for an incontinent child in this instance. They usually do not know when leakage happens and cannot control it.
Eating habits can be changed to soften the bowels. Foods that have a higher fiber content, drinking plenty of liquids throughout the day, and avoiding dairy products may help stools stay soft and easily passed. Liquids such as water, prune, grape, or apricot juices will also help prevent constipation.
It may take months to help the child break the habit of holding in their stool and the resulting constipation. You can watch for signs your child is suffering from constipation. Signs include pain with their bowel movements, stools that are hard, constipation, dirty underpants, and refusing to go to the bathroom. They may show signs such as rocking back and forth, or crossing the legs, which would suggest they are refusing to go to the bathroom.