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Thanks to all so much for the numerous helpful responses. Lots of folks
were empathetic and very kind. Thank you.
After reading all 34! of them, we have decided that this issue may be part
physical and part behavioral. Based on the advice of many, we are encouraging
her to sit on the potty for 5 minutes (one minute per year) twice a day. We
are also using a reward system for keeping her underwear clean. Finally, I
am adding more water, Benefiber and a probiotic to her daily diet to help keep
things moving. I am also going to limit her dairy intake and have her take a
Lactaid tablet when she does do dairy.
If we don't see marked improvement in the coming months I will consider some
of the more involved suggestions that others gave.
Here is a summary of experiences and suggestions I heard from our group:
1) Several adults wrote that they too have the very same problem and that
they really do not get any warning from their bodies that this is happening
2) Consider the possibility of her getting gluten in her diet somewhere as a
gluten ingestion was clearly linked to this result for several adults
3) Perhaps there is another food intolerance (like corn, soy, milk etc.)
3) Some folks suggested trying harder to get her to communicate what is going
on in her body when this happens
4) Many suggested that my daughter is likely constipated. Even if she was
having seemingly regular bowel movements that there was an impaction higher up
in her bowel causing her to "leak" waste without her knowledge. These folks
usually suggested seeking a doctor's aid in diagnosis of this issue and then
follow his/her advice to relieve it as well as adding fiber and water to her d
iet.
5) Along the same route as the constipation suggestion, several suggested
that she may be experiencing bloating and gas (possibly due to lactose
intolerance) - and that when she passes gas she excretes a little bowel along with it
6) Many strongly felt these accidents were CD and/or CD-recovery related.
That bowel spasms and irregularities do often occur
6) Someone suggested giving her veratrum alb 30 c after every bowel movement
to stop the accidents. Another response suggested giving her some B vitamins
7) One suggested reading an article at naturalfooworks.net called
"gluten/dairy free
diet
8) Several responses said this was fairly normal behavior for all kids to
just be too busy playing to stop what they are doing which causes leaks
9) A few folks suggested that this was a behavioral issue (called encopresis)
and to have her see a child/play therapist
10) The chart/rewards system I mentioned at the beginning of my email was
recommended by many. One specific idea I liked a lot was allowing her to have a
popsicle whenever she had a BM - to help entice her to not hold in any urges
11) Lots of people recommended having her clean up her own accidents (which
we already do) - not in a shaming way - just to make her responsible for her
own clothes/bathroom habits
12) One response said: she may have a neurogenic bowel that presents by
leaking.
13) That same response also said: She may have what the doctor's nickname
"toothpaste syndrome" where the bowel never completely empties but just keeps
pushing out small accidents when full. Like an open toothpaste tube. Or after
years of diarrhea, she might have a rather "sprung" bowel that doesn't work
right all of the time. This can be reversed with a "bowel program".
The bowel program was explained as follows: The goal of a bowel program is
for the bowel to fill, hold, and completely empty, every 24 hours. Every bowel
works optimally when it contains well formed, soft stool. To be sure this is
happening Metamucil is the magic thing. Given every day it produces well
formed, soft, easy to pass stool. It prevents both hard stools and leaking. The
second part of a bowel program is to train the bowel to really empty, not just
pass a little, once every 24 hours, preferably at the same time of day. This is
accomplished by sitting on the potty and if needed, a small stimulant enema,
and I mean 'small' just to stimulate the urge to 'go'. Fleets Bisacodyl enemas
are best for this purpose. These are not the saline fleets you usually see on
the shelves at the drug store. They are much smaller in size. Also, even the
very tiny Fleets Baby Lax bulbs of liquid glycine work wonders to get the bowel
moving. I do not recommend suppositories at all because they are slow,
invasive, and embarrassing. These other methods are very fast and minimally
invasive. The child should spend plenty of time on, preferably a small child's potty,
because sitting lower helps the ability to 'push' and empty the bowel
completely. The child should purposefully 'push' during the emptying time and stay on
the potty until the bowel is emptied. Very small 'accident' amounts of stool
in the potty indicate the child did not empty.
That is all for now. If I receive any new info I will be sure to pass it
along. I will also re-post in a few months to let you all know how the plan is
working.
Thanks again for all your help!
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