Soiling Solutions Overview

More Aggressive Treatments For Encopresis, part 1

Soiling Solutions

This site is set up to help parents trying to wade through the information about various treatment methods for encopresis. If you are at the beginning of the discovery process, you probably need to start with some more basic steps of treatment listed here. But if you are a few months into it and you want to go to a more aggressive form of treatment, keep reading.

What is Soiling Solutions?
Soiling Solutions is a program designed by a psychologist, Dr. Robert Collins. It is a program designed for children who have encopresis, or are soiling themselves regularly. Dr. Collins designed a "Clean Kid Manual" which outlines a protocol and routine to go through with your child. The manual costs $85 and you can order it on the Soiling Solutions website.*

I don't want to give too much away about the exact nature of the program because I think if you are seriously considering doing this program you need to order the Clean Kid Manual and read it cover to cover a few times. It's important to understand all of the goals for each part of the treatment.

In a nutshell he outlines setting aside a "power hour" every day for pooping with your child. During this hour your child has chances to initiate pooping and if he/she is unsuccessful then you move to a "bottoms up" approach of suppositories or enemas. There is a specific order and timing around the sits and therapies, with an end goal of having the child eventually move towards self-initiating BM's on a daily basis.

This program is often not supported by pediatricians and pediatric GI docs. I think part of the reason is that most medical professionals don't feel you should rely so heavily on the "bottoms up" approach. Parents often react similarly to the thought of giving their children enemas every day. But when Miralax and other basic therapies are not working parents are often left with few other options. Part of the other reasons some physicians do not approve is that the program was designed by a behaviorist and not a gastroenterologist.


Anecdotally I have heard the following good reviews about the Soiling Solutions program.

Clean -- All parents relish in the fact that very shortly after starting the program (often within days) it eliminates the soiling. You don't have to worry about accidents, or pull ups, because every day your child is cleaned out. For a child who is soiling multiple times a day, this part can not be undersold.

Regular -- With the structure of the power hour at the same time every day your child becomes accustomed to pooping at the same time, and also the same time *every* day.

Stops the holding -- Many parents are thrilled to find that at the end of SS, their child is out of the habit of "withholding." Since encopresis can be a tough nut to crack in terms of the cause, this can help you eliminate the holding option.

Support from other parents -- As a part of SS, you get to access the parent support forum where other parents are going through (or have been through) the treatment.


Anecdotally I have also heard the following negative reviews of the Soiling Solutions program

Taxing -- Finding a consistent hour, and getting over the hump of the power hour struggle (which often happens), can be hard on families. A lot of children don't like having to deal with an hour of back-and-forth potty sits and treatments.

Bottoms Up Trauma -- There is a lot of controversy around bottoms up treatments. Some physicians find this unacceptable, and some parents do as well. Children often are agreeable if the parent handles it in a very matter-of-fact calm way, but other children never get used to this type of treatment and can even be very violent. This is a type of treatment that you need to talk through as a family because everyone should be on board.

Doesn't always cure the cause -- I list above that a lot of parents are thrilled that it stops the withholding part of the program. But other parents have noted that it never really got to the root of the cause of the constipation part of the problem. So a few months in they are still having to go all the way to the enema part of the program and maybe there is some other underlying problem that is not being addressed by the bottoms up approach (redundant colon, slow motility, diet, etc).


I hope this information is helpful as you consider ways in which to help your child. I will soon be posting stories and personal reviews of different treatments.

*  I am not affiliated or reimbursed by Soiling Solutions in any way. My goal here is to explain therapies for encopresis and provide you with information to make your own decisions.

What To Do If You Just Found Out Your Child Has Encopresis

Here are a few basic things to do when you find out your child has encopresis. These are first steps for those looking for a place to start.

1. Visit your pediatrician and talk to them about encopresis. Get a referral for a pediatric gastroenterologist. If your pediatrician or your ped GI doesn't listen to you, or they dismiss you and tell you that your child will grow out of it, consider getting a new one. The earlier you treat and deal with encopresis the more chance of success you will have in the battle.
2. Go to Amazon and order the book "It's No Accident" by John Hodges. Have husbands, wives, grandparents and other caretakers read the book.
3. Get your child an abdominal xray. If your ped or ped GI is not doing this, insist that you want a baseline shot of your kids intestinal system.
4. Get your childs colon cleaned out. Do this under the supervision of your pediatrician or ped GI. This can be accomplished by a number of "top down" (meds) or "bottoms up" (enemas or suppositories) methods, sometimes they are used in combination. Ped GI's will have varying qualifications for clean, but you can be sure you are pretty clean if you have clear, totally liquid poop. Most doctors will not push you to that limit because it means you have to dehydrate the system. Listen to your docs here.
5. Get a follow up abdominal xray. I know it seems like a lot to get two xrays, but you will not truly know if your clean out was successful until you get an xray.
6. Keep the colon clean. This task needs an entire blog post, possibly multiple blog posts, but listen to your ped GI about the preferred method of keeping the poop moving through the body. The default choice here is usually Miralax (or PEG3350). Some will use Senna, or Fiber, or combinations of all of those.
7. Research, research, research. Join the Yahoo Encopresis support board. You can find the link here: http://health.groups.yahoo.com/group/encopresis_kids/

Going through these steps can take weeks, sometimes months. You don't want the above steps to take years, however, so if these things don't work and your child is still having accidents a few months down the line then you need to take further action and go deeper in the treatment options.

My 4-year-old Regularly Poops In His Underwear

I titled this blog post as such because this is exactly what I Googled when my son was 3-years-old. I thought he was just slow to potty train but it turned out he had encopresis. I titled the blog post with 4-years-old because technically it's not encopresis until children are four, but I can tell you my son had it at two (and three) as well. If you have a child that's incontinent, welcome to this blog about encopresis.

First let me say that you are not alone. Other kids are pooping in their underwear and it's NOT because you are lazy and haven't tried to potty train your child. Chances are good that if you're online researching this, your child has encopresis, the definition of which can be found on this blog post.

Second let me say that the first thing you need to understand is that it's not your fault and it's not your child's fault either. There's something going on with their system and now they are soiling themselves. This is a very embarrassing problem for your child and you. It's embarrassing because the perception is that the child can control their poop and/or that you haven't done your job as a parent. While there can be a behavioral component of encopresis, you need to realize that very often it's a physical issue that starts encopresis. Ask yourself if you think your child wants to have poop on them, or smell in public places, or disappoint you?

Third, and most important, is to take a step back and have compassion for your child and the problem. I cannot tell you how mortified I am at the thought of what I did to my son before I knew he had encopresis. I was so angry at him about not potty training that I did things that I know made the problem worse. Full disclosure -- I actually took away my sons security blanket until he pooped in the toilet. FOR TWO DAYS! Yikes. Please do not punish your child and try not to get frustrated and angry. As awful as it is to have to clean up dirty underwear, try to go about it with patience and caring instead of disgust and frustration. If you can afford it, buy tons and tons of cheap underwear and toss them out when they are soiled. Don't sit there scrubbing the dirty underwear unless that process doesn't bother you. If it bothers you then you'll probably take it out on your child in some way.

If you have a spouse, please enlist them in this process ASAP. Have them help with the cleaning, bathroom time, research and whatever else you can enlist them for. This is an awful problem and the more you can be a team in helping your child the better off you will be.

What Is Encopresis? What is the Definition of Encopresis?

What Exactly Is Encopresis?

Your child is having some soiling accidents, or they are constipated, or both. And you are wondering what exactly is this strange ailment called encopresis? Does your child have encopresis? Is encopresis treatable? Is it a potty training issue? These may be some of the questions you're asking yourself about encopresis if you are new to the battle.

Here are a few good links that define and explain encopresis:
Web MD has a good overview of encopresis here
Kids Health has some information about how it starts and what to do about encopresis
Boston Children's Hospital presents an overview of encopresis

Here is my definition of encopresis:
Encopresis is fecal incontinence, either caused by withholding or constipation. The constipation can be caused by a number of factors; diet, anatomy, stress, environment and a few others. Technically it isn't considered encopresis until your child is four, but I know in my son's case (and in many others) that he had encopresis from the beginning.

One of the biggest questions you may have about encopresis is whether or not it's treatable. For the vast majority of people, it is a treatable ailment. There are a small minority of people who live with this for years and do their best to "manage" encopresis. I don't know the percentages of each group but I'm hoping that you will fall into the treatable category.

I think there are two categories of children with encopresis. The first is the children who are potty trained and then at some point have an issue that causes constipation. The constipation makes them hold in painful bowel movements and they soil themselves (either by loose stool leaking around hard stool, or just not being able to hold it all in and the stuff at the bottom leaks out). The other category is children who have encopresis from the beginning (maybe from birth or when they went off formula/milk) and who never were potty trained to poop on the toilet. Anecdotally, the second category is much harder to treat.

Now that I have given a short overview of the definition of encopresis (and the links provided above are far more research-based and informative than my definition), I will move on to talking about what to do next.

Welcome to Encopresis Survival

Greetings and welcome to this blog about encopresis. If you are here it likely means that you are doing some research online and you are trying to find out more about living with encopresis. I am not a medical professional and I have no affiliation with any particular product or group, but I am a Mom who has tried to help her son treat this issue for a few years. One of the things I have realized through the course of our encopresis journey, is that there is a lack of information for parents with children who have more serious cases of encopresis. I started this blog in the hopes that I can help consolidate some of the information I have found over time and maybe, just maybe, could save a parent or two a little bit of time and heartache in their journey.

I hope to have links to good articles, research, videos, and maybe most importantly, testimonials and stories of other parents who have gone through this. The medical professionals in this field are helpful but as I found out through our own case and through others, not always as helpful as we would like. Gastrointestinal issues are tricky, just ask any adult who suffers from IBS or food intolerance. There is a lot of trial and error that goes on in treating intestinal issues. I joined an encopresis Yahoo board and that has been one of the most illuminating sources of support and information in this process. I hope to use those parents and vast knowledge base to fill this blog. New people come and go on that board and often the most experienced parents go on their way once they get what they need, leaving a gap of knowledge for the new parents who seek out help.

And last but not least, if you are a parent seeking out information, know that you are not alone in this journey and there are hundreds of other parents out there just like you who just want to help their children. You have people who understand what it's like to have a child who soils themselves at times and in places that are not socially acceptable. My hope is that this blog can be a place where we can share stories and help each other survive.

Thanks for listening.