Leslie—I see that you have ordered Clean Kid Manual (CKM-IV).  It is on the way to you.  Also, I have already entered you onto the exclusive Soiling Solutions Parents’ Forum where you will love the 300 or so parents who are or have been on the same treatment protocol. They are very supportive and insightful.  I am assuming that your encopresis specialist is a Pediatric Gastroenterologist (PedGI) which is the top medical specialty that addresses encopresis or functional fecal retention.  It is very unusual to see a young child on such a complex oral medical “cocktail.”  That could well be contributing to all of the gurgling and distension that you are observing.  Your note that the specialist is using “…the runny stool method to retrain the child that stooling doesn’t hurt.” may be narrowly accurate.  I am sure he is hoping that removing the pain will somehow magically allow the child to begin sitting on the toilet and start up his voiding reflex.  Not so, not a chance, I am the learning theorist here, actually he is training failure!  The voiding reflex arc requires a voiding urge signal going up to the brain which then messages back to the anal sphincter mechanism to “release” the prepotent more automatic holding reflex.  By assuring “runny stool” he is sabotaging a discrete, timely stimulus to the brain and an inability to hold until the voiding reflex is learned and established while sitting on the toilet stool.  The child won’t be able to control leaking and gassy expulsions because the urge stimuli are so intermittently confusing and mixed in the “top down” approach.  No wonder your child is “…always grumpy and always nervous about his poop.” The subcutaneous membrane at the end of the colon cannot distinguish between gas and liquid stool.  You need a normal solid stool at the end of the colon to send clear, discrete urge stimuli up to the continence center.  The Soiling Solutions (SS) protocol was the first and to this day the only available encopresis treatment manual available to the general public that can be done in the home using generally safe over the counter agents.  Yes, it features a more aggressive approach to encopresis using timely brief sits, suppositories, and enemas on a carefully worked out schedule as required for a daily treatment hour. Think of it, using a suppository or enema primer will almost immediately create powerful discrete voiding urge signals shortly followed by a very difficult to resist voiding response. That empties him out sufficiently in most cases so that he will be continent for the following 23 hour period when you redo the SS treatment hour.  Do this repeatedly and you will have successful toileting learning trials making the stimulus-reflex connection every day!  So simple!  Most children will stop having accidents within two weeks, though the protocol may have to be continued for a longer period for the conditioning to become truly reliable.  Relapses can occur, but they are much less likely with this protocol and you can always reapply the SS treatment and the children know this and will trust it and you.

I suggest that you should at least be monitored by a local physician as you proceed for any medical concerns that may come up.  Sadly, many parents have come to distrust and lose faith in their doctors on this issue and proceed without consulting them.   A physician should be at least be “open” to your trial of the SS protocol and be supportive of your efforts.  Many can learn from you parents.  I will attach a report of my recent medical journal article on SS and editorials concerning it in a separate email to you.  Frankly, it may take 20-30 years for my protocol to more effectively become adopted into general medical practice.  Most cultures are very inhibited in talking about this very private area of the body and dealing with a highly offensive body product.