Constipation & soiling are not uncommon problems in young people but it is important that a health professional is consulted to ensure successful treatment.
Why am I soiling when I thought I was constipated?
Although it might not seem logical, constipation is often a major factor in soiling. Constipation is where there is a build-up of hard stools (poos) in the bowel, which become hard to pass. What happens is that new poo starts to ‘leak' round the hard lumps. Often you get no warning this is happening and it is out of your control. This leaking is called ‘soiling'; sometimes doctors call it ‘retention with overflow'.
I am teased at school and people call me "smelly". Everyone seems to think I can stop soiling my pants but I can't. I have a problem of constipation and am on medication but nothing really helps me.
This is really a very difficult problem for you to resolve. When you have had a constipation problem over many years, your bowel may become distended, or longer, as the muscles have been constantly stretched by the large stools you have been passing. Very often, the poo will sit in your rectum and, each time you move, a little escapes without you knowing. Hence there is always poo on your pants, causing the odour. It is very important to get the medication right to prevent constipation reccurring. If it is not working for you, you will need to go back to your doctor. Try to get into the habit of sitting on the toilet 15 - 30 minutes after your breakfast or evening meal and allow yourself time to empty your bowel. Drink plenty of fluids, at least 6-8 cups of water-based fluid each day. Even young people with very severe problems often get better in their teens.
I do not soil a lot, but it always seems to happen when I am upset, why?
It is well understood that soiling accidents can occur when we are stressed or feel under pressure. Sometimes this is related to very loose stools that can be brought on by anxiety. If you feel that this may be a factor, do try to work out the source of stress and talk it through with a trusted family member or friend; you may find that this helps.
What should I eat and drink?
If you are constipated, it is important to have a high fibre diet. The best foods are wholemeal or multigrain bread, cereals (especially those which are made from wheat, oat or bran), fruit & vegetables. It is important to drink well; about 6-8 glasses a day is the recommendation. Water or well-diluted squashes and fruit drinks are good. It is worth noting that, for some people, milk can make constipation worse.
What medications can I take to help?
The majority of people with soiling problems have underlying constipation. Laxative medications can be a great help with controlling this and may have to be used for a long period of time (over a year) if your constipation has been a problem for a few years. There is no evidence that this causes any long term side effects. The most important factor is to make sure that the laxatives that you use are effective in helping to keep the lower part of your bowel cleared out properly on a regular basis. This means making sure your bowels are emptied, preferably every day, or at the most on alternate days.
Stimulant laxatives (these will help make your bowel empty) such as Sodium Picosulphate, Senna and Bisacodyl can be used at the same time as softeners such as Lactulose to get the best effect. Sometimes it can take some time experimenting with different medicines to get the best result. There are some newer laxatives available now that come in sachets and can be mixed with juice drinks. These can be successful when used as the only medication.
When your constipation has been controlled for many months with laxatives, it is often best to reduce the dose very gradually as relapses are common if they are stopped suddenly. Relapses in this condition are generally common, but usually respond quickly to treatment again. A few people will always have a tendency to constipation and may require courses of treatment from time to time as well as being careful with diet and drinks for many years.
It is important before starting medication that you get advice from a health professional to get the medication that is right for you!
I have had a lot of urinary infections but I'm being treated for constipation - why?
It has been shown that these two conditions often go together, especially in girls - even if the constipation is not very obvious at first. It is likely that bacteria can creep round the corner from a mostly permanently full rectum (lower bowel) to the urethra (front passage) and cause recurrent urine infections.
A full rectum also presses on the bladder and can stop it emptying properly. This allows any bacteria in the bladder to multiply and the infection can then take hold. Normally the rectum should be empty until just before you need to do a poo, but some people do not completely empty their bowel when they poo and the rectum stays full, which causes the problem. If this type of constipation is treated, it reduces the risk of further infection reaching your bladder and allows your bladder to empty properly when you do a wee.
