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Frustration over bathroom accidents

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  • Frustration over bathroom accidents

    Are any other parents going through this or is this more psychological? My 8 year old son has Tourette. He has both motor and vocal tics. Something new has developed about 6 months ago. He is having "accidents" (both urination and feces) during the day. We have resorted to having him wear pullups to school (which, in a sense thank goodness, he doesn't care about). He will sit in it all day and know he is doing it but just says "I don't know why". He will look you in the eye and say yes, he understands it is not appropriate and that he doesn't care. He says he doesn't always feel when he has to go and sometimes the look of pure shock and confusion when I point out he is wet or soiled is sad. Could this be a tic? His pediatrician (we live in a small rural town 2 hours away from Edmonton where specialists are) says medically there is nothing wrong. We can't get into his specialist until the new year. I am at my wits end.

    Jer's mom

  • #2
    Re: Frustration over bathroom accidents

    My son developed encopresis when he started on risperdal. His Family doctor thought it was a side effect of the medication, and he wasn't treated until he stopped the risperdal 2 years later. He has had it for 5 years.

    My son was having foul liquid stool accidents and peeing as well during the day and at night. It is apparently constipation - one spot could be blocked, and so what comes out is what can pass by the blockage. I really found it hard to believe at the time. They can be so full of stool, that the nerves are so stretched, they may not know when they have to stool. If the bowels are really full, it can affect their bladder control too. It affects them psychologically. My son will ignore his accidents and hide his underwear. He did appear not to care when he had accidents. That bothered me more than the fact he was having them.

    I found it helpful to look at encopresis forums for ideas on how to deal with it. I also found out my son had food allergies, so modifying the diet helped with the foul smell. I ended up getting referred to paediatricians and a gastroenterologist to manage this.
    My thought is that you should ask for a referral to a gastroenterologist. The Pediatric GI clinic in edmonton referred me to a pediatrician associated with them. He was easy to get in to, and was very knowledgeable.
    Last edited by Steve; November 20, 2014, 06:25 PM. Reason: Added definition link


    • #3
      Re: Frustration over bathroom accidents

      I've never heard the term "encopresis" before. Thank you! Somewhere I can start...even a term makes me hopeful. Honestly Thank you so much!


      • #4
        Re: Frustration over bathroom accidents


        A couple of similar discussions took place recently on the Tourettes Action (U.K.) Forum, which you may wish to read through for some further insights:

        TA Forum topic - tests and results

        TA Forum topic - Bladder Problems
        TouretteLinks Forum


        • #5
          Re: Frustration over bathroom accidents

          My 11.5 yo son has TS, ADHD and insulin resistance. He had zero bladder control at night, and we thought we saw a pattern, that when his insulin resistance was poorly controlled there was more pee at night. The night-time pull-up couldn't always hold it all.

          The pediatrician told him about the alarm method of self-training at his annual check-up a few years ago, and he said no thanks, he didn't want to tackle that yet, his goal for the year was to get his weight lower, so he wouldn't feel embarrassed at the swimming pool (he loves swimming). Well, he made a lot of progress with that and got his BMI for age down to the 85th percentile, which made him feel better physically (less yoyo-ing of blood sugar) and also in terms of self-esteem. Approaching the December break in 2012 I sensed he was ready to work on bladder control, and ordered the alarm and the book recommended by the pediatrician. I asked my son when his break started if he wanted to give it a try, and he was gung-ho. The book gave information and fun scientific exercises. He measured his urine during the day, for example. He was very motivated and the project was a big success. I will say that the first few nights of being woken up by the noisy alarm were hard on him. But it had to be noisy because he was a very deep sleeper (once he was able to fall asleep!).

          Your son's situation is a bit different from my son's. But I do think that it is natural for the leaky brakes of TS and ADHD to affect bladder control.

          I think the right sort of pediatrician or family practitioner could work through this with you and your son. There is nothing wrong with seeing a different doctor for a second opinion. And you need not take your son to the first appointment. Nowadays it has gotten difficult to have a phone conversation with a doctor before going in for an appointment. It seems the only way to feel out a doctor is by going in for an initial appointment. If you book it as a "second opinion" appointment, the office staff is less likely to hassle you for complete records.

          Here's the book we used: Waking Up Dry: A Guide to Help Children Overcome Bedwetting: Howard J. Bennett: 9781581101560: Books
          There's a preview in Amazon. My son and I both liked the approach. I selected sections of the book to read with him -- we didn't read it together cover to cover, although I did read the whole thing.

          A couple other things I'd like to share. My cat lost his bladder control a couple of months ago after a pulled tail injury. There was some nerve damage. He has regained bladder control now. Here are some things that helped:
          - anti-inflammatory
          - something in the Valium family (Xanax, I think) -- I have a feeling this is the one that helped the most
          - pain medication

          I also read that it can be helpful to provide a second litter box in a different part of the house with a different sort of litter. Extrapolating to a human, maybe it would be fun for him to select and decorate a potty which you could take with you when you're out and about. I did this for our initial potty training -- I'd just take the potty along to the park or a friend's house. (I don't know how to handle this at school -- maybe when you're ready to make a project out of it, he could take a few days off school.)

          When an older man has peeing problems related to, for example, an enlarged prostate, they find it helpful to pee standing up. If the aim isn't very good, a plastic bottle works well. I don't know if this would be helpful for a child.

          A friend of mine uses a timer with her 5yo autistic daughter. Every certain number of minutes, the timer on her phone goes off (quietly) and keeps beeping until she turns it off. Each time the timer goes off, her daughter gets reminded and goes and sits on the toilet to see if anything happens. I think there is an aide at school who implements this at school as well.

          You never know who might turn out to be helpful in something like this. Some school nurses are amazing. Some are worse than useless. Sometimes a nurse at the doctor's office turns out to be a helpful resource.

          Good luck!