5 Year Old Having Accidents in His Underwear and Not Telling Anyone.

The rash definitely sounds like yeast. Although Nystatin is for yeast and is not an antibiotic, as someone said, long-term use can cause a resistance. There are a couple of different OTC meds for yeast, so read labels and try a different one. Clortrimazole is a generic yeast cream, and can be found in feminine depts. and in foot care (athlete's foot is caused by yeast, as is "jock itch".) Wash his bottom with cool water, use a very small amount of cream, and then cover it with a water barrier, like Vaseline or Aquaphor. The other posts have dealt with the skidmark issue, so I won't bother.

My son has had chronic constipation since birth and I use miralax as needed. You didn't say if he is on daily miralax or only as needed. If he is on it daily, it may mean he is developing a rash from it. I may also mean now his stools are too loose, and you need to cut back or stop the miralax. if you use the miralax only as needed and have not used it much recently, he may be so impacted that the liquid poop is coming around the solid impacted poop(encopresis). If he is impacted once the big think blockage comes out, he should go back to normal, if not impacted, I would consider trying to stop the miralax for while. Miralax is not addicting like other things but it is still not great for long term usage. IT is mostly meant to get the bowels working normally. If a child is on it a year, continuously their bowel will shrink back to normal size and their poops should be regular enough to take them off. At that point it would only be needed if he got constipated again. And when used right away the bowel does not stretch back out so long term usage again is not needed. So it sounds like either he is in need of stopping the miralax if it still is used often, or if not, maybe he is in need of some along with an enema to get the blockage out. Good luck!

He has encopresis and needs to be seen by a Pediatric Gastroenterologist. I have a son with this, and he is now 13 and was considered finally "healed and cured" as of last summer. Be patient, you have a long road ahead of you.

This condition is treated with behavior modification and diet plus Mirilax. Long term Mirilax use is common and safe for kids with this condition. The nerves in his colon do not work properly, so the medication makes his stools soft, bulky, and easier to pass. These children cannot control their bowel movements, they often lie about having accidents and one of the symptoms is that they really truly cannot feel when they have an accident nor can they smell it. You should never ever punish a child for this condition, it is beyond their control, they must teach their own bodies to go properly, and the healing often takes years. My son has an IEP at school for a reading disability and we actually wrote the treatment for encopresis and certain accommodations for him (he was never ever to be told to wait to go to the bathroom, for instance) into his IEP.

If you want more info or someone to talk to, I have provided guidance to other moms here. Just send me a private message, I'm happy to help.

Have him take some flushable wipes with him. Make sure they alcohol free. As far as the rash on his rectum at home have him run around with out underware and make sure he gets some air to his bottom. Give him a bath with baking soda and let him sit in it while he plays. I would let him sit in there for a good twenty minutes. Take some liquid maalox and put it on with a cotton ball and let it dry. Then put on what ever cream you use. It will help adhere. Make sure he is getting enough probiotics. Give him yogurt like activia. I wish you luck. I feel bad that you are both going through this.

I have never known a child to be on Miralax for so long.... since birth.
I do not believe... that Miralax... is supposed to be used for that many years....

Look up "Encopresis." It is an INvoluntary leaking of poop.... and it then means this is a medical problem. Not "him." People with this medical problem... DO have 'skid marks' on their underwear. They cannot... help it.
You said... this JUST stared occurring in him... ...

Also, Per his RASH... he may have a Yeast infection. That is why, the creams you tried do NOT work. You need to use a Yeast cream... the kind women use. Per our Pediatrician... she said to use one that contains "Clortimazole" in it.

I feel so bad for your son.... it is obviously an involuntary... thing.

Maybe try explaining to his Teacher...that he has a medical issue... so that the Teacher does not wrongly.... "judge" your son. That would be so... negative for him.
AND have extra clothing/underwear for him, at school.
THIS is perfectly reasonable.
When my Daughter was in Kinder... she had pee accidents. The Teacher, NEVER brought attention to it, she told me in private, she never embarrassed by daughter... and she told me to bring in extra clothing/underwear for her. And that she as a Teacher would make sure/help her change her clothing.... if need be.

As far as using diapers at night... he is NORMAL. Day time pottying has NOTHING to do with night time. Nigh time dryness... is something that is not BIOLOGICALLY attained.. even up until 7 years old. And is normal... and per Pediatricians.
My daughter, was already 5 years old and still wearing diapers at night. Even at 7 years old, she still had, pee accidents at night. NO biggie.
I just used waterproof bed pads under her that I got from Amazon... and that's it.

I am surprised... your Pediatrician has not mentioned that his rashes... could be a yeast infection and prescribe the proper cream for it. And that the Nystatin... has been overly used... for 'years.' This is an antibiotic cream... which is not meant to be used for 'years.' It can then cause.... secondary problems. For example.. it becoming resistant... to the medication.

all the best,
Susan

Hi, DTMom:

1. Your son is so ashamed by what is happening to him. At this age, they are controlling their environment. He is not.
2. One of the side effects of Miralax is rash.
3. I would suggest you talk his ped about talking the son off this drug.
4. Hyland Vit. C 5 Mg tabs are effective to help children's bowels to move with increasing the amount of the tabs to the desired effect without the side effects.
5. Get your son some probiotics to take to replenish the friendly bacteria in his intestines. That also may help with the constiation problem
Thanks for asking
Good luck.
D.

It really sounds like encopresis to me, too.

My son (6years) started having these types of "accidents" out of the blue and so I immediately took him to the pediatrician. She could feel 12 to 14 inches of backed up fecal matter in his stomach...she had me press and feel it too.

The accidents are uncontrollable as the loose fecal matter leaks around the constipation and just shoots right out.

She gave me a plan to help get him cleaned out then to maintain good bowel health. He had started Kinder and was holding his poop all day until he got home...then would no longer have the urge to go...then get backed up. He now had a good scheduled time he goes after school, but also knows it is okay to go at school too if he needs to.

Get your son to the pediatrician ASAP and make sure he isn't super constipated.