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4 year old potty trained now having accidents
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justfiveofus posted:
My son is 4, almost 5 and has been completely potty trained for about a year and a half (including at night) and he started having accidents almost a month ago. At first it was every now and then, he'd wet his pants. Then it became more frequent. We've talked about aiming to make sure he's getting everything in the toilet. It's gotten to where it's pretty much every day, several times per day. The other day he peed then said oh I peed but never said he had to go to the bathroom (we were in the car). The only UTI symptoms that he's had was really the frequency. He doesn't like it when we try to dry his private area and says that it hurts but there's no imflammation or anything. Then I found a pair of underware he hid that he had an accident with pooping it looked like and then tonight we went in his room and he was sound asleep and he had wet his bed and pooped his pants.

We have had a big move but that was only 2 weeks ago. We have talked about it and sometimes he doesn't seem to care and other times like tonight he's very very sorry and says it's an accident.

We have noticed that he seems to not have to pee then all of the sudden he has to go right then and if he doesn't he has an accident. As far as his BM's, they're normally very small and hard. He has to strain very hard to get them out and a couple of times they've gotten "stuck" and he can't get them out, but then two days ago he had explosive diarrhea. I've asked the pediatrician several times about this and they said as long as he was going that it was fine. But we're very concerned. At first we thought it was him rebelling against the changes but now we're not sure. We're in a new city and don't even have a pediatrician yet. I have researched and will call tomorrow for an appointment. In the meantime we're hoping to get some feed back here.

We're all very frustrated, including him so any thoughts would be helpful.
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Andrew Adesman, MD responded:
Although developmental regression (including toileting accidents) can result from a psychosocial stress like a major move, I am somewhat concerned that it is both urine & stool and both day & night.

Finding a new pediatrician quickly is a great plan, and you should make sure that the pediatrician takes your concern seriously. If your child has constipation or stool witholding, that can lead to bladder accidents. Your doctor's abdominal exam should give some indication of this; occasionally, an x-ray is done to assess this. You should try to use some behavioral rewards to try re-establish continence, including having your child sit on the toilet after big meals (typically after dinner) to try to pass a BM daily at that time. If this problem continues to get worse or if you have seen other signs of developmental regression (such as clumsiness or loss of other skills), then make sure your pediatrician is aware of this as well. Rare but serious neurological problems can sometimes present with new-onset wetting and soiling. The fact that there has been a major house move makes me think that it is most likely related to this; nonetheless, other possible causes need to at least be considered.


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