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.