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Bowel Tic Resulting in a Little Stool?

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  • Bowel Tic Resulting in a Little Stool?

    Our 6 y o son with TS has been not making it to the potty for a month and a half, often with just a smear of stool, and not an actual urge to defecate. Never an issue with bowel control before. Has had me wondering if a motor tic could do that and some postings on the internet describe exactly what we are experiencing with him. Just wondering if anyone else has had experience with this? Hoping it passes for him quickly as grade one is in three weeks :\ Don't want him humiliated. Thanks for any input--thinking of sending him with liners in underwear and spare underwear. He's too young to recognize an urge before he tics.
    --Laura

  • #2
    Re: Bowel Tic Resulting in a Little Stool?

    Hi ElleEm,

    As far as I know, none of my kids have had tics involving bowel movements in the past. We have dealt with problems with toileting accidents, which I attributed more to their lack of awareness of bodily functions or ADHD "hyperfocussing" (i.e. getting too wrapped up in something fun and missing the cues to go to the bathroom).

    When I brought this up with my doctor, she really emphasized the importance of trying to maintain regular bowel movements. She suggested actually planning bathroom time at the same time each day (if I recall correctly, it was suggested that morning was best). So whether the child has to go or not, have them sit on the toilet for about 10 minutes at the same time each day. Eventually the bowel gets used to emptying at a regular, predictable time, which decreases accidents.

    This seemed to work well for us, but again, I don't think there was any tic involvement. So I'm not sure if it would work as well in your case. Does anyone else have any suggestions?




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    • #3
      Re: Bowel Tic Resulting in a Little Stool?

      Here's an article I found that speaks to this:

      Kids With ADHD Often Prone to Bowel Problems: Study


      Comment


      • #4
        Re: Bowel Tic Resulting in a Little Stool?

        Thank you so much Jen! We haven't seen ADHD in our son but he does hyper-focus and we had been thinking he was just missing his cues. I likely what your doctor suggested, it's exactly what I've been trying to implement along with drinking a big glass of water for stretch receptors in stomach to trigger bowel-excavation but he hasn't been cooperative yet to try it. Shall continue to pursue that avenue and see if it works. He isn't a morning kid so trying to get out the door for school was hard enough without waiting for a BM his body is trained to do and is coming at a time we are trying to go, so thought to train bowels for after home from school. So interesting. Again, thanks for your input, we will try that. And I'm interested if anyone else has seen/had an actual bowel tic and replies

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        • #5
          Re: Bowel Tic Resulting in a Little Stool?

          Yes, it makes so much sense to tailor the training to your son's natural body rhythms. And who wants more stuff to do in the morning before school?

          Two of my kids also used a raspberry laxative jelly call Lansoyl . It's mostly mineral oil and tastes pretty good. You keep it in the fridge. It softens the stool but apparently doesn't contract the bowel.

          Can't remember if it was the family doc or the psychiatrist who first recommended it to keep my kids regular. It was a mainstay in my fridge for years.

          (Of course, talk to your doc or pharmacist before adding anything like this).

          Great idea to send a change of clothes to school with your son. A candid chat with the teacher about what is happening was helpful for us too. If the teacher can respond quickly with support and without judgement that makes it so much easier. It may also be reassuring for the child to know that they can turn to the teacher for support if an accident happens at school. There is no hiding a BM accident. Everyone quickly realizes when one has happened!

          Good luck


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          • #6
            Re: Bowel Tic Resulting in a Little Stool?

            Thanks Jen, appreciate it! Didn't mean to unsubscribe myself from this thread but appear to have accidentally. Hope admin can help direct me to resubscribe.
            Last edited by Steve; September 8, 2016, 01:34 PM. Reason: Re-subscribed

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            • #7
              Re: Bowel Tic Resulting in a Little Stool?

              Hi there! I am brand new to the forum - I just joined after coming across this thread when I did a Google search for "bowel tics"! My son is also 6, diagnosed with TS and ADHD. We have had toileting challenges ever since we tried to start potty training. We did make progress, but suddenly halfway through grade one last year he started having soiling/smearing accidents once again. I've been ascribing it to his ADHD and hyperfocus, but am now wondering if it could be a tic. How can I figure it out? And how do we deal with it?! Have you had any progress since you first posted the question? Thank goodness I found this - it is so nice to feel less alone in these struggles!

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              • #8
                Re: Bowel Tic Resulting in a Little Stool?

                By the way, last year was such a hard one in terms of school support. They will not provide any support in terms of helping him get cleaned up at school. They call me with each accident and make him wait in his soiled underwear in the office for me to arrive and change him. They also won't allow him to try to clean himself, as they say he could make a mess and pose a health risk to other students. It is so disruptive for everyone, and I have to think it's against his rights. Luckily I've been home on mat leave, but now I can't go back to work with this situation - it's like I'm on call every day in case he has an accident. The challenge is that they say their hands are tied - there are limited resources and limited funding, and they have to prioritize who gets the support. I get that, but I've got to think that there is something more they can do. Phew, I needed to get that rant off my chest! I'll be curious to know how anyone else in a similar situation has dealt with it at the schools. It's hard to know where to start in advocating for support...

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                • #9
                  Re: Bowel Tic Resulting in a Little Stool?

                  Hi Juliward! WELCOME! Glad you're on here now,
                  I'm sure we can help each other! My son Dane actually never had toilet issues other than starting to pee before making it to the potty in kindergarten, but after about 7 months of vocal tics, the soiling began. Yes hyperfocus may play a part! See other comments on this thread, and here's what we've been trying (so far mostly success!!): Trying to train his bowels daily with psyllium Husks (1tablespoon in 1 tablespoon elderberry syrup [read it may diminish tics!] and water enough to get the mix down, then pound another two cups of water to let psyllium bulk up and not get stuck), we set a timer for 15 after drinking psyllium then have him sit on potty and so relaxing things (he's a gifted reader, so he reads, or watches YouTube videos on science experiments). He sits for 15 min or til he knows he can't go then. It's not that he completely goes regularly now, but instead of on day three, he will go every other day. We train his body for "after school hours" and are making it be like 1/2 hour before bed so he's the best luck having empty bowels the next day for school. I line his underwear with thin winged panty liners, without him knowing they are called anything other than "liners." The wings have SAVED smears that run over, and it's all so thin no kid knows it's there. He is sent to school with a bathroom kit, complete with spare underwear that are pre-lined (he has boy shorts style underwear that work great with winged liners). And wipes for cleaning his butt and cheeks off. This way he has four stages of protection: 1) lined underwear, 2) remove soiled liner for clean underwear 3) prelined new underwear 4)liner removed if soiled and clean underwear left behind. This has given all of us reassurance that humiliation at school isn't such a concern. The teacher knows and there is a plan for him to get to leave class immediately by having private sign between them (he will sign language "T" letter shaken in air like he did in kindergarten), there's a private bathroom he has permission to use (so access to sink without leaving room). Granted we are only third day in, but NO ACCIDENTS!! Yay! I also give him easily absorbed iron with vit C to help absorb it as Steve's article on this forum pointed out studies showing iron for kids can diminish tics. Pediatricians apparently recommend 3 times on potty a day trying to have BM, I find total non-compliance with one time (doesn't want to go SIT and TRY), and the one big gusto an evening works for us. Also, physiologically there's a great trick that can help too, it's pounding back a whole bunch of water at once as it stretches receptors in stomach that tell bowels "empty, more food is coming!" We in essence hit this one with the psyllium and water trick already. If we smell poo, say he has passed gas, it's time to "go try" whether he feels the need or not. He often says not, but sometimes has a BM then. I think this covers it! Of course, getting as many veggies and fruit in a day and avoiding junk food only helps too! Don't know if we have a cure yet or just a stroke of good luck going on, but at least the training his body same time every day is a help. Let me know how it goes!--Laura PS: psyllium husks are found at a health food store
                  Last edited by ElleEm; September 8, 2016, 02:34 PM.

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                  • #10
                    Re: Bowel Tic Resulting in a Little Stool?

                    Welcome to the Forum Juliward and thank you for joining us.

                    I've been ascribing it to his ADHD and hyperfocus, but am now wondering if it could be a tic.
                    There appears to be a close relationship between Tourette and ADHD, and it's often difficult to draw the line between symptoms caused by one disorder and the other. Kids diagnosed with ADHD can have difficulty with constipation and fecal incontinence, and kids with Tourette can express tics internally with similar results.

                    Please see: Common Tics of Tourette Syndrome (download the attached PDF and see "Internal")

                    We did make progress, but suddenly halfway through grade one last year he started having soiling/smearing accidents once again
                    The fact that your son was making progress, and suddenly regressed might be the place to begin your investigation by assessing what may have changed in your son's environment that could have exacerbated his symptoms.

                    The situation with lack of support at school you described might well be increasing your son's stress and anxiety, thereby causing his difficulty.

                    Tourette tics, while involuntary are influenced by both internal and external environmental factors. Internal factors would include stress, anxiety, fatigue and excitement while external factors are people, places or situations that exacerbate and maintain tics in a predictable way. The environment does not cause tics, because tics are involuntary, but the environment influences tics.

                    You may find some insights in the following articles:

                    Kids With ADHD Often Prone to Bowel Problems: WebMD

                    ADHD Medications and Presciptions Problems: Why ADD Medicine Prescription May Not Be Effective | Attention Deficit Hyperactivity Disorder Help & Info - ADDitude

                    Disturbing bathroom related issues: Parents of ADHD Children ADHD Support Group Discussion Topic - ADDitude

                    ADHD: Increased Risk for Constipation, Fecal Incontinence | Medscape

                    Is your son receiving any form of treatment for his symptoms at this time?

                    Have you approached the school to arrange for accommodations for your son's special needs?
                    Steve

                    Dum spiro spero....While I breathe, I hope

                    Tourette Canada Homepage
                    If you enjoy the TC Forum, please consider a Tourette Canada membership
                    Please visit our sister Forum: Psychlinks Psychology and Mental Health Support Forum

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                    • #11
                      Re: Bowel Tic Resulting in a Little Stool?

                      I don't know all the criteria for diagnosis of ADD/ADHD but I thought our son who hyper-focusses meant he wouldn't have ADD. He is not hyper. But now I am seeing "hyper-focussed" associated with ADHD and when I google search I am thinking oh man....its rampant in ADHD (likely ADD then too?)....I have all new concerns of Dane having ADD too because the kid only focussed on what he wants to, and literally sits blankly with one shoe on not remembering to put the other one on, not even when directly told to more than once. He has to be told to do every next step and repeatedly told the things he is to do. Sigh...........BIG sigh....what can others tell me about ADD?

                      ---------- Post Merged at 05:00 PM ---------- Previous Post was at 04:28 PM ----------

                      Juliward here's a cool link I found too that parents' post answers are helpful for our situation: Disturbing bathroom related issues: Parents of ADHD Children ADHD Support Group Discussion Topic - ADDitude
                      And so far our school is acting supportive, we are only two days in but they want a meeting with me to discuss further. And I think the bathroom kit and underwear liners I send are a help 😊

                      Comment


                      • #12
                        Re: Bowel Tic Resulting in a Little Stool?

                        ElleEm, thanks for describing your program. It sounds very effective. And best of all you've been able to negotiate things with your son. Here are a few thoughts.

                        1. If he can swallow a small gel cap, you might want to give a daily over-the-counter stool softener (assuming doctor okays it). Your description of the minor accidents reminded me of a nice children's health article that says constipation in children can result in a little bit of smearing ("It's also common for kids with constipation to sometimes stain their underwear with bits of stool").

                        2. Fruits high in vitamin C such as strawberries and citrus seem to encourage regularity in my children. Cooked prunes can be very helpful. I'm not sure, but maybe cooked dried apricots would have a similar effect.

                        3. Eating is a natural trigger for peristalsis (that means the contractions that get things moving through the lower intestinal tract).

                        4. In the long run, sitting for 15 minutes might be a little bit more than ideal (I'm thinking of hemorrhoids, for example) -- maybe time you can reduce the amount of time needed a little bit.

                        5. For some people, every other day seems to be a comfortable rhythm. I suppose it all depends on the consistency, the amount of discomfort when pooping, and how often the smearing incidents occur.

                        6. It sounds like the liners are working well for you guys. You may also want to consider sometimes using a pull-up. It all depends on how the child feels about the idea.

                        7. TS is a whole spectrum of stuff. It is quite possible to see some signs of ADD without meeting criteria for an ADD diagnosis, especially in a person with TS. By the way, ADHD or ADHD combined type are specific types of ADD. In general, I tend to think of two types of ADD -- the dreamy type and the very active type. Maybe that's an oversimplification, but it helps me understand why my child, and another child whose behavior seems completely different, would both have some type of ADD diagnosis. Mine has trouble sitting still and is "combined" but a friend of his is pure ADD and has no trouble sitting still, but it's his mind that is constantly wandering off.

                        8. Although there is a higher incidence of toilet challenges in ADD, non-ADD children can have toilet challenges too.

                        9. Speaking of which, my non-TS son (genetically unrelated ot my TS son) was ending the day with stinky underwear for a while when he was 6. He was constantly waiting just a little too long to go pee. His doctor suggested a chart. If his underwear still smelled pretty good at the end of the day he got a sticker. After six stickers he got a treat. It worked! Now, compare that experience with my TS-ADHD son, who was still in night-time pull-ups at age 8. The only way he was able to become dry at night was by using the alarm training system. The chart approach would never have worked for him. The two children were just wired differently. But if your son's smearing is primarily related to some constipation (I don't know if this is the case, I'm just saying "if"), then a chart-and-reward might be helpful. This really varies from child to child.

                        10. As to whether it's a tic in your son's case, my two cents: it could be. Or it might also be something related to his TS, but without being a tic per se.

                        I will write a separate note to Juliward. Sorry if this was a bit long -- I wanted to share all my thoughts on this topic, hope I didn't over do it.

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                        • #13
                          Re: Bowel Tic Resulting in a Little Stool?

                          Last year was such a hard one in terms of school support. They will not provide any support in terms of helping him get cleaned up at school. They call me with each accident and make him wait in his soiled underwear in the office for me to arrive and change him. They also won't allow him to try to clean himself, as they say he could make a mess and pose a health risk to other students. It is so disruptive for everyone, and I have to think it's against his rights.
                          I don't know what's required in Canada, but in New York you would get a one-on-one aide to help with toileting. You would put a goal in the IEP and you would write that support with clean-up would be phased out ("faded"), for the clean-up. The point is that the child should not be excluded from the regular education classroom just because he needs some help with toileting. He should be given the support he needs so that he can participate to the fullest extent possible.

                          If you can find the right law/regulation to quote, your advocacy will be more effective. Sorry I don't know where to look for Canada.

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