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Our son has Encopresis since many years (the history is described here: How can we potty-train our pre-schooler outside the home? ).

He is now 6 years old and in some phases (which often last 2..3 weeks), it happens 2..3 times a day nearly each day that he has stains of poo in his underwear, sometimes even a large amount of poo. It is already difficult in the Kindergarten to get the different kindergarten teachers on our (and his!) side to support him and help him with understanding ... he just is not able to really clean himself alone in such a situation.
He sometimes/often tries to avoid getting cleaned by the kindergarten teachers and hides until he gets picked up by his parents, so it is even more difficult to clean him if it's dry already and he has been running around smelling strongly for some time...

Anyway, soon he'll go to school and the situation there will be even more difficult:

It seems that nobody there feels responsible for such a child:

  • the kindergarten teachers have asked the school teachers what they would do in school, if he poo'd in his pants: they would call the parents to come and clean him.
    This would be very difficult, as we are both working some kilometeres away and can not get easily and quickly to school at each time. Also if I imagine how it would be if that happens 2 or 3 times a day... it's impossible to deal with...
    • school seems to have proposed that he wears a diaper... that only avoids underwear getting dirty, but cleaning himself will still be a problem (as the bowels are often very loose and nearly fluid in such situation) - he won't be able to do that alone - and he also can not sit in a dirty and stinking diaper in classes for hours ...
    • the other children will probably josh him

I know that this is a really difficult question and maybe there is not "the" answer, but I'd like to know if anybody else has similar experience and found a way to get support and help from school or somewhere else to avoid that the parents have to be available all the time in case of such an "accident" or that the child is left alone with his problem and the dirt and misses his classes waiting for someone to come and help him...

Finally, encopresis is an illness.. shouldn't there be some help for such children?

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    If he's potty trained, why can't he clean himself? Keeping backup clothing at the school nurse. By the defn of the word, the disease is about the bowl movement, not additional aspects. I feel for your situation, but from a teacher's perspective I can see them asking, "I have to do what!? I teach!" A non-confrontational conversation with the principal may be the best starting ground.
    – Sylas Seabrook
    Mar 12, 2014 at 14:11
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    If he has loose bowels (and that is very often the case, especially for those stains in his underwear - small amounts slipping out) and might even have been sitting while it got out, the dirt is distributed everywhere and experience shows, that then he is not yet able to fully clean himself without making an even bigger mess (e. g. by having his t-shirt hanging down and getting dirty in addition...) Cleaning is easy, if bowels are quite hard and not sticky/sleazy, but if it's soft or nearly fluid, things get very difficult.
    – BBM
    Mar 12, 2014 at 17:44
  • Thanks for the clarification. I posted as a comment b/c I know that I don't know enough about your particular situation, but do appreciate the opportunity to learn. I wish you the best in finding a solution which best-assists your son!
    – Sylas Seabrook
    Mar 12, 2014 at 18:19
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    @BBM does the school he will be attending have a shower? Perhaps in the nurse's office? A shower is the quickest and easiest clean up that he can probably do himself- and his t-shirt would not end up as collateral damage.
    – Jax
    Jul 27, 2014 at 19:34
  • @Jax: thanks for your suggestion! I'm not sure, but we will check. In fact, the school's director does not want primary schoolers to wander around alone in the building(s) and unfortunately, that makes sense. So we need a person, who cam help him in case.. We're working on a solution - I'll update my post soon.
    – BBM
    Jul 29, 2014 at 3:12

2 Answers 2

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My son has had the same issue since he was born basically. He never really used to the toilet as his large bowel movements were very painful. He is now 10 years old and is going into 5th grade. I can finally say that I can see progress now.

We seen tons of doctors, specialists and a lot of trips to the ER and urgent care because he had not had a bowl movement is 3-4 weeks. In the end, all we did was keep him on miralax. It started with a capful a day and he was around 7 years old when they gave him the prescription. Now that he is 10…and starting to understand what the feeling have needing to use the bathroom, I am down to half a cap of miralax a day mixed with 8 oz crystal light.

I thought he was doing great so I just took him off the miralax. That was the worst mistake EVER. It was like we started all over again... another trip to the ER and his pants were soiled a few times a day for a month or two before the medicine started working again. All I can suggest is keep with the medication... one doctor told me once it took him 8 years to get this backed up it will take him AT LEAST 8 years to be normal. He may never be off the miralax, but at least he is able to go and control it easier than before. To be honest I am the one who did all the research to see what was wrong with my son, and the doctors just agreed that he had an issue.

Good luck to all the families out there that are going through this. As a mother who has been dealing with this for the last 8 years, I am starting to feel some relief.

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    Dear Amanda, thanks a lot for sharing your experience! I wish you, your son and your family all the best for this difficult way!
    – BBM
    Jun 20, 2014 at 20:39
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    As a European living in the US, this is very relevant. I have found that in the US, doctors are more likely to prescribe and use medications. Our son (who is 5) and diagnosed with encopresis was told to use Miralax and ExLax as a starting treatment. We were also told he may need continue to use one or both medications for a long while. FWIW, we saw a pediatric GI specialist which was very helpful. After being on enough Miralax he has very few accidents in school.
    – Ida
    May 20, 2016 at 21:57
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    @BBM this note about seeing a pediatric GI specialist should be a suggestion/answer, I think. If BBM's son is not already being seen by a doctor of this kind, I'd say that is step 1.
    – MAA
    Aug 5, 2017 at 3:22
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Not sure where you are but have you escalated this up to the school's governing body? Gotten his physician involved? And if nothing else works, can you get the local media involved to shame the school into doing the right thing? "Local school refuses to help adorable kindergartner with illness" can be the headline that most schools will do anything to avoid.

Wish I were in your area; I'd be glad to stand on someone's desk if it were required. Just the thought of someone not helping your kid is making my mama bear instincts kick in...

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    we are in Germany. I have to emphasize, that the situation has not occurred yet. Our son is still in kindergarden and there is a tiny little hope that he could learn to control his bowel movements better during the next months (but it's not very probable). So at the moment this is pure theory and we'll see how to manage that in practice.. (and I fully understand your mama bear instincts - I feel the same Papa Bear, but it seems that our case is just not considered in the "system", as it is very rare. Our future school seems to only have had one single case ever up to now. :-( )
    – BBM
    Mar 12, 2014 at 17:40

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