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Your Advice Requested: How to Help an Autistic Child with Bowel Movements?

By January 18, 2007

I know that there are parents and therapists who have dealt with this issue, and I'm hoping you can advise this reader:
I have a 4-year old girl with autism and severe sensory integration dysfunction. My daughter has had major issues with bowel movements. The gastroentologist calls it "withholding". My daughter is on a regimen of laxatives and refuses to poop still. It's a nightmare and cycle of laxatives, enemas, diet, etc. What else can I do?
January 18, 2007 at 1:38 pm
(1) Julie says:

I haven’t had experience with this problem with my son specifically, but there is a book titled “Constipation, Withholding, and Your Child” by Anthony Cohn that appears to be helpful.

January 18, 2007 at 6:20 pm
(2) Patti says:

Autism is a biomedical problem with your child’s digestive system no matter what most doctors are willing to admit to. Find a DAN doctor by searching online (Defeat Autism Now). After you heal your child’s gut you can then work on cleaning out their system to reduce and sometime completely remove the symptoms of autism. The sooner you learn and act the better for your child.

January 19, 2007 at 5:19 am
(3) Norway Mom says:

I had similar problems with my youngest son, who appears to be developing normally (although he’s under evaluation for social issues at pre-school). I know how exhausting and stressful it can be to deal with a child who withholds.

My son is a picky eater, and would hardly touch fruits and veggies, although this has gotten better with time. So he often had hard painful stools.

For a stool softener, we used daily doses of lactulose, which is over the counter here in Norway.

But the key issue was to get him to relax and let nature take its course. He was in diapers till he was 3-1/2, and I’d try to get him to play standing by a low table with a favorite toy — I’d interact as much as necessary to keep him concentrating on his play.

The toys ranged from wooden trains, puzzles, pop-up books, and a game called “Let’s Go Fishin’” (I just let him put the fish in and take the fish out while the “pond” turned in circles). As soon as I saw the urge come, I’d move him to the toilet (the close-fitting diaper made it harder to get his poops out).

After a couple years of this, he stopped withholding. Now, at age 5, he sits on the toilet, relaxing with toy catalogs, a magnetic drawing board or hand-held game. Sometimes I practically have to drag him off!

Another tactic that works well for us is kind of comical. When my kids fart, we say that a poop is “knocking on the door, wanting to come out”, and that it’s time to go to the toilet. The vast majority of the time, the kids do in fact have a bowel movement when that happens.

Some children might find it confusing to pretend that poops are capable of knocking, but you can still use farting as an indication that your child is probably ready to have a bowel movement.

Good luck, and hang in there.

Signed someone who has been there…

January 19, 2007 at 6:59 am
(4) Norway Mom says:

I forgot to mention that our oldest child (who has autism) was difficult to potty train, partially because of sensory problems. It helped when we let him sit backwards on the toilet, holding on to the tank. He feeled safer that way and could relax. Before long he was de-sensitized and could sit facing forwards.

January 19, 2007 at 10:46 am
(5) Marc says:

My daughter has had constipation problems from 1 yr of age. Her pediatrician had us load her with Miralax, a laxative of polyethylene glycol. It was the only way to avoid major BM problems, but we were unsatisfied with treating symptoms her entire life.

After talking with many professionals we started our daughter on a couple of new programs. One was the glutin-free/casin-free (GF/CF) diet. We also took her to a homeopathic pharmacist. the homeopath began giving by treating her digestive issues, as some have also suggested.

The results have been tremendous. After giving her the supplements suggested by the homeopath, our daughter is completely free of the polyethylene glycol and having BMs regularly. we have weened her off of the supplements as well and all things are operating normally. She remains on the GF/CF diet. (We believe this has a positive effect on her cognitive ability. The plan is to slowly add glutin and casin back into her diet over time — after her gut has healed.)

As a professional in the biological sciences, I was a major skeptic when it came to homeopathic treatments. While I cannot explain the mechanism for the homeopathic treatment, I cannot argue with the results.

I suggest contacting a homeopathic pharmacist in your area. FYI – Ethylene glycol, is used as a aircraft deicing product manufactured by Dow Chemical Company. This was the driving reasoning for getting my daughter independent of it. If it is used to deice airplanes, there is no way I was having my daughter drink it.

Good luck and please share what you learn.

January 19, 2007 at 11:52 am
(6) Jennifer says:

My son PDD-NOS has had more ‘typical’ and regular b/m since we started using a product called FrequenSea. If it helps you, then I’d be happy.
Thanks for your time.

January 19, 2007 at 1:01 pm
(7) CJ says:

They call it regularity for a reason. I have a split custody issue as well so dietary changes only help until my son is at his dad’s. He will come back completely blocked up.

I watch his diet and started sending him to the bathroom, with a favorite book, shortly after supper every night. He had to sit on the toilet for 30 minutes whether he had to go or not. With time he was going every night, once we broke the cycle of constipation (pain)and replaced it with regularity (no pain)we were on a schedule or regularity.

He is 15 now and every evening before bed he takes his book and announces that he’s going to the bathroom. Sometimes he still has problems, but he will at least “try” every night.

For the picky eater, prunes or prune juice mixed with apple juice work great too.

January 19, 2007 at 2:16 pm
(8) Mary Ann says:

My son suffered through many years with this. It helped when we discovered he was milk intolerant and gave him milk digestants (lactase) with any milk item. Since he had been on frequent antibiotics, we then added some Pro-biotics (acidophilus). The doctor added Benefiber for fiber and a powder to loosen the stools. Even though the powder was tasteless our son refused to take it. I found an enzyme product at a nutrition store and added that to his regimen of pills and vitamins. This combination seems to be the best solution. He back slides whenever either the Benefiber or enzyme is skipped, but bounces back fairly easily when on the correct doses. His irritable Bowel Syndrome is much improved now and bathroom times are down from 45 minutes to 10 minutes at max.

January 19, 2007 at 3:51 pm
(9) genevamom says:

Taking him to the toilet every evening after dinner and using glycerine suppositories as needed have helped to prevent constipation and impaction.

January 19, 2007 at 4:52 pm
(10) Celia says:

Hi, you’re not alone out there! Been there with my son with Autism and sensory integration dysfunction.

I do not know your daughter, but since you tell me she has severe sensory integration dysfunction you need to find out what is causing her to with hold. Is it fear of sensation of pooping or is it fear of pain or the toilet etc etc., or simply there is a co ordination problem between the brain and body and messages from her brain signalling her body to poop are not working appropriately. ( Hope you understand what I am trying to say!)Or is it something physical?

Try not to stress too much our kids often pick up on our stress and make problems worse.

My son was so constipated he had a prolapsed rectum from pushing at 2yo. A stay in hospital with Failure To Thrive soon rectified the problem with Nasal Gastric Feeds – don’t recommend!

Find a way for her to relax, i.e baths etc. Motivation helps – does she like chocolate, I used it to motivate and encourage my son to eat and it also helped alleviate his constipation by relaxing his stress, giving him energy to run about and also worked as laxative. My son has a very limited diet.

My son would not poop in the toilet only run and hide under a table or behind chairs etc when he did poop eventually.

He was not 6 year’s old before he pooped on his own in the toilet. When it happened the whole world new about it! I live in a different country to my family!

Is your daughter toilet trained for peeing? My son was three and a half when I finally managed to toilet train him by the regime of sitting him on the toilet every half an hour with a small amount of coke until he got the message. It is a bit severe, but he was toilet trained in 48 hours.
It does get easier – if I had a dollar for everyone who said that to me I would be very rich – but it does, the challenges never go but they change as the years go by. Good Luck! People do care!

January 19, 2007 at 10:18 pm
(11) Devin's Mom says:

Autism needs to be treated biomedically before other therapies can be the most beneficial. You wouldn’t want to train a racehorse to run if it has the flu! Most mainstream doctors are misinformed about medical treatments for autsitic children. You need to find a DAN doctor and ask him/her about Bethanechol, P.D.S. and Secretin. Also try Epsom Salt baths nightly (or the cream version). Your childs bowels have a motility problem. She is probably withholding because the intestines and bowels can’t physically move it along, the child becomes constipated, and then its probably painful (sensory) to pass – who would look forward to that process? I’ll bet she’s trying to put off the uncomfortable event. Fiber and laxatives don’t help due to Gluten/Casein problems – they make everything worse. Her sensory issues can also be treated biomedically by a DAN doctor. Don’t delay in finding a DAN doctor – inefficient exretion can lead to more toxicity issues, creating more sensory problems, among others. I stopped taking the advice of my pediatrician and finally found real help with a DAN doctor. There are specialized medical tests to prove these protocols work. Research!
If she is 4 years old you can still make a big difference in her health – but the younger these kids get started with treatment, the better off they are.

January 19, 2007 at 11:26 pm
(12) mother of Mark, Autistic, Severe Sensory Integration Disorder says:

I completely understand how a seemingly normal bodily function seems to take over your child’s, and the whole family’s, lives. We struggled with our son from the time he was 2 till he was over 5. We took him to GI specialists (who did find out a peanut allergy, not causing anaphylaxis but sores along the GI track), doctors and more specialists, hospitals did tests and NOTHING. They didn’t help at all, just gave him laxatives and more junk and ended up making him sicker than he started out.
We tried so many things at home and it was truly awful. We ended up having to give him enemas every week to 10 days and you can just imagine how that went. He would regularly go 10-12 days without having a bowel movement and once went 19 days and almost ended up in the hospital. We were so desperate.
Well, I tried a doctor that was treating my fibromyalsia with positive results and asked if he could help Mark. Figured we have tried everything else, (kind of like my fibro) what could it hurt? I wish we had done it years ago.
He put him on probiotics, tryptophan(the amino acid in turkey that makes you sleepy)and fish oil. The probiotics and tryptophan were in a capsule form, so I just sprinkled it over some applesauce or ice cream and down it went. Still working on getting the fish oil down, haha.
But within 1 week he had a bowl movement. No enema needed. After 2 weeks he was having bowl movements every 2 or 3 days. He wasn’t bloated and the gas went WAY down. He was calmer. He actually went on his own and put them in the potty. It was the first time in 3 years. We wanted to cry.
He has been on them for about 4 months and it has been such a HUGE improvement. It is amazing something sold in the whole foods store fixed what a slew of doctors, specialists and everyone else couldn’t. We are using something called PB-8 for the probiotics (which are digestive enzymes, like in yogurt)and 5-HTP for the tryptophan. It worked for us, maybe it will work for you.
This is the address for the doctor we see.
http://www.choosehealth.net and his name is Dr. Scott Monk. He is amazing! Good luck and God bless!

January 20, 2007 at 7:19 pm
(13) Christinna Guzman says:

Okay this is what worked for me and for many of you it may seem cruel. But my son did not learn to have a bowel movement in the toliet until he was almost in kindergarten. I was in panic mode because my school would not take my son until he was potty trained. Little did I know that this was going to be the least of my worries as his diagnosis was yet to come.
My son was able to get that he was to pee in the potty but I had him in pull ups which he would have his “number 2′s” in…usually behind a door crouched down with a red sweaty face. One day I heard the unmistakable sounds of nature calling and put him on the toliet and practically had the boy in a head lock until he gave way to the eneveitable. When he finally passed his stool he laughed and cried at the same time and I never had a problem with him again. I sat with him in the most loving, patient way (yes in a headlock) and explained that he needed to do this from now on. He may have been scared of the toliet eating him or the finality to the flush…whatever it was…was over. I would applaud and reward him after each time he did it on his own. He has suffered though bouts of constipation and to this day he has a ritual and cannot go in public restrooms comfortably. But that is another article all together.

January 20, 2007 at 9:26 pm
(14) diane hamilton says:

When my daugher was younger I asked this question and no one responded. Years later when GIRLS CAN have aspergers, everyone is talking about this subject that comes with the “package”. She struggled in all the ways mentioned above.Gastrologist gave her the cramping medicine to make her “feel” the urger better, (OUCH) with more problems, then lactulose syrup, then Miralax. Finally we cleaned out her “gut” with enzymes and put her on a GC diet. She is 16 now and has problems when she is afraid to go because she put it off. It is anxiety that causes it! Start with the gut cleaning AND healing. Their gut is underdeveloped and needs healing first, then the mind will follow! She never wet the bed! She was 10 though before she was bowel or bladder trained because both muscles were stretched out from waiting too long and she would “leak”. Good Luck! Some people say to keep them in the bathroom all day and give them a small cup of water every 15 minutes and read to them, play with them, etc.. with them stripped naked with only a t-shirt on. They can’t stand the dribbling down the leg. For poop though, you can’t make them go! Try to keep them off milk and bread products (including goats milk and whole wheat bread) It is like a plug for them!

January 20, 2007 at 9:39 pm
(15) gina says:

I had the same problems with my daughter until we went to see a gastroenterologist.At first we used Lactulose and then went on to Peg3350 which is a water specifically to soften the stool and let me tell you it works. She now goes on her own without the water. She nows eats veggies and certain berries,I’m still working on the fruits. Also in recipes where breadcrumbs are needed I use less and add ground up flax seeds or fibre cereal and grated vegetables. The trick is to hide what they won’t eat. Another thing that works in Benefibre that you add to any liquid and that also helps and it’s tasteless, be sure to mix well and wait a few minutes.
Good luck

January 23, 2007 at 11:21 pm
(16) Rosalyn Green says:

GI problems are no uncommon with children with autism. My son had a similar problem.For years he complained intermittently about his stomach hurting. When he was 12 he got so constipated he would eat then make himself throw up to keep from being nauseated. He would run around in circles saying, “It’s gonna hurt.” He would also jerk for extended periods of time to ward off the urge to make the bowel movement because it was painful to pass a hard stool. A gastroenterologist suggested Citrucell. It gives bulk to the stools and makes them softer. For a while we had to encourage him to go to the bathroom. Once he realized it wouldn’t hurt, he started going willingly. He’s 30 today, but still takes the Citrucell and we’ve had no more problems.

November 4, 2007 at 6:30 pm
(17) amy says:

I have a 7 year old autistic child & she has always had bowel issues. I buy organic yogurt that has 4 grams of fiber per serving, then stir the contents of a plant enzyme capsule. Plant enzymes are tasteless & white, so they’re hidden well in the yogurt. This has made her have a bowel movement once a day. I hope this helps!

March 20, 2008 at 11:46 pm
(18) Samara says:

I also have a problem with my eight year old daughter. She has been diagnosed as a “High functioning autistic, but refuses to poop. Now for the past week or so, she has been pooping in her pants, not so much actually trying to poop as it is the poop that she has been holding in just finds it’s way out and I have to use baby wipes to get whatever is still up there out. She has had it smeared all over her from using her hands to wipe it out of her. I am at a loss, and have no idea what to do. If anyon can help please do. She is eight years old, I’m wondering if this is older than the norm that have this problem.

May 9, 2008 at 3:21 pm
(19) Rick says:

For Samara #18-
Try putting her on the pot with her diaper on, if it works, cut a hole in the diaper, making it progressively larger.

June 25, 2008 at 5:32 pm
(20) Gail says:

Wow it just never ends. I feel sorry for us all. I for one can not afford a Dan doctor wish I could, but we just can’t. I put my son on Diflucan for yeast and found out he needed to get off all his pysch meds while being treated……what a nightmare! He was self abusive, aggressive, stopped talking. This just ended today!! I took him off and said forget this. I have him on probiotics. He has had an upper and lower G.I and tons of stool cultures. He has formed stool in his colon and just holds it back. I think I am going to try the prune juice thing it has worked for other people I know. My son is 7 going on 8. He will do the pee pee thing. The year I worked really hard on the potty thing he did go poop 9 times on his own, so I know he can do it.

July 3, 2008 at 10:49 am
(21) Mary Smith says:

Hey, My daughter did the same thing! It was truly an unbelieveable experience for our family. I won’t tell my story because I know that you living it,basically it was as simple as turning on a light switch. I found what interested my daughter…The magic school bus video on digestion…after watching it,she realized how important it was to get rid of the waste. If it could help her at least it’s worth a try. One thing that I found that works with my child and helps fight the effect of Autism,is to get down to her level,look her in the face,and never,never take silence as a answer. She is 7 years old and is going to the potty all by herself!

March 2, 2009 at 3:57 pm
(22) Connie says:

You could try Dr. Scotts Question and answers. Not sure of the web page address, but the address we use for question and answers is doctorscotts@yahoo.com
Could give that a try.

August 6, 2009 at 7:40 pm
(23) Tiffany Muniz says:

Hi, my 4 yo daughter had the same problem. We couldn’t afford a DAN! like many have suggested and we solved this problem on our own. You don’t need a DAN! to solve this problem. First I removed all diapers and pull-ups from the home. She would urinate but not have a bm in the toilet. She continued to withold her bm’s for whatever reason. I then found this detoxification product called Natural Cellular Defense. It removes heavy metals and toxins. It’s the safest natural form of chelation you can find. Once she got on the product, I no longer had any problem with her witholding her bm’s. My other daughter who is also autistic, started talking one day after using this product. I also recommend the Frequensea product, it helps us as well and diet… we started with Feingold as a basis then went gluten-free and low carb. Your child can recover without a DAN! mine are living proof! Contact me at tiffanymuniz@ymail.com I’d like to help in any way I can.

February 12, 2010 at 6:08 pm
(24) Jen says:

We are in the same boat. DD is almost 3, has autism, and refuses her bms. She will stay standing, cross her legs, and hold on to something and cry as if she is in pain. We originally thought she was constipated, but it is the opposite. She does this so much that it causes her pain and agony.She is non-verbal, and does not process language, so I can’t explain it to her. I end up having to give her a laxatives so she can’t fight her bm. Doctors WILL NOT HELP. They say they have no idea how to?!?

March 31, 2010 at 1:20 pm
(25) vanessa says:

after the day i had with Brendan, reading all the input to the question is a real eye opener. Brendan is 6, Autistic, and wears underpants full time for the last 3 months. When it comes to pooing in the toilet it becomes a +- 3 day stress for the whole household. He becomes clingy, tantrums, won’t eat. and eventualy goes in his underpants.

The peadiatrician has prescribed laxatives, but he withholds for so long, that when it eventualy kicks in, he actualy has a runny stomach.

Thanks for all the answers, parents have left. i’m defanately going to contact my closest homeopath tomorrow.

April 7, 2010 at 12:12 pm
(26) dawn says:

my daughter is 9years old and has autism, up until last year she never suffered from constipation. back in feburery last year my daughter had a massive change in her life, a month from then she suffered from constipation and urine infections. when my daughter is anxious about something this tends to happen as she knows how to hold onto her stools now and be in control if something is happning she is not sure about and her routine is not going to plan. the same thing happned again the end of last year and now attends a bowl clinic and is taking medication for this.

August 16, 2010 at 8:44 pm
(27) heather says:

I have the same problem with my six year old son who has autism. he passes urine into the toilet no problem but will scream and throw a temper tantrum if we try to put him on the toilet to make a bowel movement. those of you who suggest it is a GI issue have absolutely no idea what you are talking about and should refrain from posting.

October 11, 2010 at 8:26 am
(28) Katia Baptista Beukes says:


This is the comment session but I need an opinion. My 10 year old daugther has lost weight suddenly and has no apetite, she eats if I force her to eat. We have been to the doc for all blood tests but everything is normal. Now she is pooping on her panties and tell’s me she can’t hold. I am desperate, stressing as well because this was sudden and new for us and I have no idea what to do. I would like to ask Lisa Jo Rudy what should I do next because it’s a very embarrasing situation as she does it at school and everywhere. Please I am desperate.
Thank you

Thank you

December 7, 2010 at 8:58 pm
(29) Saralee says:

My son is 10 yrs old and autistic. He has learned to urinate in the potty on his own about a year ago but we are still having trouble with him knowing when he has a b/m. We feel there is a coordination problem between the brain and body and messages from her brain signalling her body to poop.(as stated by an earlier post) Doctors tell us this will come in time and take him in the restroom every 30 mins. This has failed to work or help him understand all together. Any suggestions or ideas on how to help him know when to go or anything like that?

January 28, 2011 at 4:17 pm
(30) Heather says:

Saralee: this is a prevalent problem with autists. It has been a struggle in our house we started training 5 years ago (at age 3). It took several months before my son would urinate, but he finally got the hang of it and goes consistenly. BMs are a completely different manner. He will comply with sitting on the toilet but will withhold – and the longer he withholds, the less likely he will be to go at all, causing him a lot of pain. The older the child, the less effective promptly them to go every 1/2 hour will be (what is called “trip training”). I don’t have an answer, but I can tell you that is generally ineffective for older children!

March 8, 2011 at 2:22 pm
(31) Wendy says:

I need help ASAP! My daughter is 10 and she has been potty trained (pee pee) for about 5 years now, she has never pooped on the potty always in a pull up, and she always goes and gets the pull up when she is ready to poop and puts it on by herself! Well 5 days ago she said she had to poop and I put her on the potty and she was very excited to go get her favorite toy at the toy store….. Well she still has not gone and in fear I put a pull up back on her thinking she would go and I was wrong she is very afraid of the word poop now when I bring it up she has missed school and she lays on the couch:( i have tried over the counter stool softners…… Please need some help hear! Thanks

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