"Hello Dr. Tom. I purchased your book "The Ins and Outs of Poop" and I have to say that the simple suggestion of teaching him to push resulted in his first "real" bowel movement in the toilet. Twenty one days later, he is not only pushing out his poop and pee, but he continues to do it in the toilet! After 2 years of struggling with withholding, I thought he would still be in diapers going into kindergarten in the fall. He still does not completely empty but at least he is going. Thank you for writing such a helpful book and for bringing information and attention to a struggle that you don't hear much about."
Parents assume that their child naturally "pushes" when they are sitting on the toilet to poop. However, children with encopresis often think that all they have to do is sit on the toilet long enough and the poop will come out on its own. Not surprisingly, these children frequently end up having either no bowel movement or an incomplete bowel movement both of which keep their rectum stretched and increases the likelihood of poop accidents.
Teaching your child how to push may at first feel unnecessary because it is not usually something we need to teach our children to do. For most children pushing happens naturally. But children with functional constipation often need to be taught or retrained how to push.