Case study – 11 year old boy J

 

Presented to the clinic with regular daily soiling that has been going on for years:

  • Reports that he can’t feel when a poo is coming

  • Seen by Paediatrician for many years

  • Has tried Movicol and Dulcolax inconsistently

  • Very motivated to fix the problem

  • Both J and his mother are highly anxious about the constant soiling

  • Apparently J can take self to toilet occasionally and passes a hard and lumpy stool

  • Mother regularly makes him sit on the toilet prior to school and J is sometimes able to pass a stool at these times

  • Soils daily multiple times in varying amounts

  • Parents separated. Limited time spent with father.

  • J is extremely worried about using school toilets or at other toilets away from home

Treatment/Outcome

  • Seen 3 times in clinic

  • Great results immediately (no soiling at all!) after reviewing medications

  • Education about digestive system helped J to pay better attention to his body signals and sensations

  • Appropriate rewards negotiated with mum which motivated J to do better

  • Confidence improved significantly and immediately

  • Anxiety became almost non-existent (both J and his mother!)

  • J now independent and able to pass a daily bowel motion in the toilet without prompts from his mother

  • Will require regular medication for the long term and advice given re appropriate management