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What can be done to change toilet routine in a handicap child?

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Practicing since : 1997
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my handicap boy is 9yrs.he goes to a special school for multiple handicapped blind. Our concern is that he defecates in his pants in the afternoon, with no fixed routine. It can be anytime between noon till 1700h in the evening. this causes lot of stress for us. we want to set his potty time for morning ie before he leaves for school.His peadeatrician suggested use of neotonic enema in the morning for about 10 days, so that his potty routine changes to the morning instead of in the afternoon. The results have been negative with no sucess. Request suggest some method/medicine to change the potty routine. thanks
Posted Mon, 30 Dec 2013 in Child Health
Answered by Dr. Santosh Kondekar 1 hour later
Brief Answer: have patience Detailed Answer: Problem with most such cases is loss of control of gut from brain. So often such kids may be constipated or pass stools after feeds. At times it may be related to infection and may need drugs like metro.. discuss with your doctor. let me know if he has hard stools then I may advice enema like therapy for 100 days. other way is training the child to hold stools by teaching him some breathing exercises if he is able to understand any. Please get back with routine diet and daily stool pattern in quality and quantity.
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Follow-up: What can be done to change toilet routine in a handicap child? 47 hours later
i want to clarify that my son is not on any kind of medication. he is also not suffering from constipation. we want to change his biological /body clock vis-a-vis his potty time ie from afternoon to morning. request suggest...
Answered by Dr. Santosh Kondekar 37 hours later
Brief Answer: its not the biological clock alone Detailed Answer: As brain is partly nonfunctional; its likely that the part of brain controlling biological clock may be affected too.. though may not be possible to prove ; the tone of gut and the functioning of gut and center for its control in brain may be likely to be affected too. So its the training to hold breath and stool by one's own will may help delay the passage of stools or warn in advance so that he wont soil clothes. If it were an infection, which is commonest possibility, a course of specific antibiotics and antiamebic drug may help. suppositories help keep colon empty but it may get filled soon
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