Soiling in Children and Adolescents - A Practical Guide for Parents, Teachers, and Caregivers

1 General Information on Soiling (p. 5-6)

1.1 Does this sound familiar to you?

My daughter soils. In the afternoon, when she returns from school I know exactly what is going to happen. It may be during lunchtime, while doing homework, or at the very latest when she’s playing. Sometimes the pants are just smeared, sometimes there are large amounts of stool in them. Sometimes my daughter seems to be distressed, but usually she seems not to care at all. She simply continues to play and does not go to the toilet until the underpants are completely full of poo. I feel completely helpless because I do not know what I ’ve done wrong. I would like to help my daughter, but I do not know how. All the advice I have received so far has not helped. On some days, I am really angry, especially if I find hidden underpants full of feces. The stinky laundry is really not very pleasant. I simply wish that this would stop. In contrast to other problems, many parents are often left alone with this plight. They often do not dare to even speak about it with other parents because other children seem to function so much better and are so successful – only their child seems to have these problems.

Many parents seek advice from their pediatrician, general practitioner, or therapist. When the soiling does not stop, parents sometimes seek psychotherapy or consult alternative medicine practitioners. This is a pity because effective treatments are available! The main requirement is that a good and careful assessment is performed, as different forms of soiling exist. Also, soiling may be – but does not need to be – combined with wetting as well as psychological problems and disorders. These two examples of Paul and Lisa illustrate the different types of soiling:

Paul is a seven-year-old boy who has good grades in school. He is in second grade. Unfortunately, he disrupts class very often, he teases other children and does not follow the rules. Soiling never happens during school time but in the afternoons and evenings. Sometimes Paul soils large amounts of stool, which are either very hard or very liquid. Paul seldom goes to the toilet to move his bowels. Sometimes 2 or 3 days will pass before he goes to the toilet again. Moving his bowels is often very painful for him, and Paul often complains about tummy aches. He is a very picky eater and does not drink very much. Although he has been dry before, he began to wet his bed again when entering school. During the day, he doesn’t go to the toilet very often to pee and his pants are nearly always wet. Paul is a very lively boy and often gets into long discussions and arguments when he is asked to do something.