Potty Training Etc, Help?

Question: “I have a 4 1/2 year old son who has trouble with potty training. He was first trained at 3 and did wonderfully-even at night. Well, about a year ago (about the time his older brother started school) he started having poop accidents. We chucked it up to anxiety, stress, or change. He tends to be more sensitive. We were patient and it went away. Over the past year it keeps coming back-often. Sometimes, there doesn’t seem to be any stress or change and it usually lasts for about two weeks (sometimes multiple daily accidents). We have gotten frustrated with him, which I am sure has made it worse. We have also tried tons of positive reinforcement. I talked to his Doctor and he brushes it off as a kid-thing. When I talk to him about it he tells me “he didn’t feel it coming out.” I have read on the internet and most of the issues I have read about stems from fear, pain, or constipation. He has never complained about fear or pain and the kid is really regular. I am not sure if there is something we can do as far as mental or if this is a medical problem. Thank You.”

Answer: Thanks for the question. I’d recommend that you see a medical specialist that specializes in gastrointestinal issues, not your primary care physician that is more of a generalist. This may be stress related but it is difficult to tell as it may be in fact a medical condition that is coupled with his stress. I have seen both enuresis and encopresis following trauma but as this is more intermittent and does not appear to follow a set pattern per your post below.

My counsel to you would be to ensure you don’t exhibit your stress with it in front of him. I know this is a huge pain and difficult but as it may be psychosomatic “mind-body” you want to ensure that you don’t complicate the equation. I’d do some research of local specialists in your area, that may be dual-specialized gastro as well as pediatric.