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