My child is nervous about going to the toilet

Bereaved child

How can I control my seven-year-old?

Question

My child is nervous about going to the toilet to pass stools.

Is this a psychological problem or is there a medical condition? Stools are hard when passed.

Answer

Children rarely develop psychological problems about going to the toilet.

If they are very emotionally disturbed or desperately trying to seek attention by soiling in inappropriate places, it may be a different story, but I doubt this is the situation here.

You say your son's motions are hard, and this is very likely to be the cause of the problem. When a child becomes constipated they find straining to pass a hard stool uncomfortable or even very painful.

Small children are not patient at the best of times and there are much more interesting things to do than sitting on a potty waiting for things to happen, particularly if they are uncomfortable.

Hard stools in turn can become impacted, barring the passage of further waste material so that over-flow incontinence with apparent diarrhoea may occur.

To prevent this happening, try to make his stools softer by giving him plenty of freshly squeezed orange juice which acts as a natural laxative, and make sure he eats plenty of fibre in the form of fruit and vegetables as a large part of his diet. Plenty of fluids to drink will also help.

If the problem still cannot be overcome, temporary use of glycerine (soap) suppositories can soften the motions for long enough to break the cycle of potty-avoidance because of discomfort.

Talk to your health visitor or GP for further advice, but I expect this one will resolve itself fairly quickly.

Yours sincerely

The Medical Team

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