Pediatrics/Chronic constipation in 12 y.o boy.
My 12 year old son has had chronic constipation issues since I can remember. We have been under paediatric care in the past and after hospitalisation things seemed to be on track when he got to about 10 years old. Now he is 12 and BM are infrequent, and always large and solid. (they have to be broken up with a stick to flush them) Comparable to a 500ml soda can. I have been working around diet etc with no real success, and as of 6 weeks ago he has begun soiling himself again. I am waiting on a referral to the local paediatric department, in the mean time I am about to begin a cleanse for him, with movicol and microlax. Then continue with liquid paraffin until we get regular soft motions, I only have a two week time period to achieve this if we are to attempt to not miss any school. I have come to the conclusion that I need to attempt to toilet train him again, my question is, how do you toilet train a 12 year old? I don't even know where to start. Will it help? Or is the damage to his colon from the large BMs going to cause this to always be an issue?
Constipation w encopresis (stool incontinence) generally is treated by a consistent cleanout, softening and engaging the gastrocolic reflex. This is something that most experienced pediatricians know how to do. If this is a problem from birth, have an evaluation for Hirschsprungs disease.
Get a good experienced pediatrician to help you both out. I care for kids like this frequently and almost always help them.
Good luck, Dr. Olson