My daughter is now 13
After 12+ years...we are accident experts.
She has been to Doctor after Doctor for what they diagnose as Ecopresis....It started with a few cases of constipation, starting when she was just a few months old. Every Laxative in the world was tried and she would still only go to the bathroom 1-2 times a week. when she finally went? she passed things when she was 5 that were too big to flush. Then she stared having accidents 3-5 times a day. Who poops that much??? She was potty trained by 20 months...why is she having accidents. But x-rays showed she had an obstruction. The doctor kept giving her laxatives, Huge Fiber doses and drinking 1/4 cup of mineral oil 3x a day. I finally switched doctors.
We went to Dr. Baker at the Women and Childrens Hospital GI Clinic and a neurologist (on recommendation from Dr. Baker). Her problem was initially caused by a genetic back deformity (very mild scoliosis and bulging discs only detected by MRI) that caused her to have neurostenosis....a reduced nerve size and branching from her lower back. This is what caused the constipation. Because her colon didn't have the nerve supply needed, it did not know how to draw enough fluid to move her bowels, she was always constipated. The thought of going to the bathroom stressed her out becasue it was so painful and it made it worse. At times she was so obstructed that the stool did not pass, but the liquified waste would seep around the obstruction and make it seem as though she was having a zillion accidents.
As her problem went on and on, we found out from other family members that they had similar problems. Nobody wants to admit, yes, I pooped my pants....but after seeing her suffer for so long, I found out a sibling and 2 nephews had the same problem. I had an aunt that also had back problems causing reprodutive disorders.
Talk to your family and see if there is something someone can offer as faras a history of a disorder to help find the caue.
Some things they suggested...Drink lots of water. we gave her big kid cups instead of sippy cups with water and she refilled it from the dispenser herself. She loved it, and water doesn't stain when spilled anyway. Make the child sit on the toilet for a period of time right after meals, this is when the stimuli to move the bowels is greatest. Get a small stool for in the bathroom, so the childs feet are NOT dangling and they can relax and 'GO'. Lots of physical activity. It moved the intestines around and does prevent impaction. In my daughters case, the more flexible her back is she tends to 'feel' more when she has to go. So it motivates her in her gymnastic abilities.
She eventually grew into her colon and she is able to go wihout laatives....but there is so much damage done already. Her sphincter muscle does not "hold-it" now. If she says she has to go....she has to go NOW, not when we get home. She also has a limited ability to 'feel' the urge to go. So when she feels it, it's almost to late. So now? she has to time herself and go every 2 hours to keep herself 'empty' and prevent being in a situation where it is that urgent to find a bathroom. Being a teenager she learned that pantyliners are her best friend in school but we still buy lots and lots of underwear. she is resposible for keeping herself clean and being socially acceptable in public, although accidents happen...if the child is not punished, they won't hide it and help to work towards living with it comfortably. Nothing worse than dirty underwear hidden under the bed. eeewww. Her Doctor wrote a prescription for her school for unlimited bathroom breaks....during tests, exams, anytime, she has to go. she also has scheduled breaks to keep her 'empty'. When she was younger, we explained it like a water balloon....if you keep it empty and you never have to worry about it leaking in public.
If there is a liquid runny accident often....it may mean there is an obstruction. It is often accompanied by extremely foul smelling gas and an odor left in the soiled underwear that does not come out in the wash...like a 4 day old poop.
Please feel free to ask me questions about it if you think it is a similar problem.....
JUST ADDED
Stress is a big factor...new siblings, starting new daycare or kindergarten....its more common than people know becasue of course, people don't sit and talk about how their kids poops....they all brag about how quick they potty trained though...LOL
Check out these web sites
www.medicinenet.com/encopresis/article.htm
www.aafp.org/afp/990415ap/2171.html
www.keepkidshealthy.com/welcome/conditions/encopresis.html
kidshealth.org/parent/emotions/behavior/encopresis.html