B.—Say hi to the UNC folks for me!  The UNC Center for Functional GI and Motility Disorders is a highly reputable institution and I am assuming that the Constipation Clinic is contained in that center.  I coauthored a chapter in a medical text with one of their researchers and I do know the Co-director who recently received a $3.3 million dollar NIH research grant for Irritable Bowel Syndrome.  Now for the bad news.  Although the principals there know me and helped me to get a publication in “Digestive Health Matters”, they do not utilize my Soiling Solutions protocol to my knowledge.  So I will be very interested in their reactions to your request.  I have over 3000 parent “informants” out there who let me know what is going on in their community.  The SS protocol is typically dismissed.  There are other parents in your particular area who have finally adopted SS on their own.  When parents report back with highly successful results they typically report encountering indifference and dismissal as if the SS approach working was just a fluke.  However, I have a lot of “missionaries” out there and hope that eventually we will have more of an impact.

Although my approach is regarded as “aggressive,” I view it as heading off “…damage to his little body.”  Research shows that the colon does not necessarily return to “normal” and remains stretched out even in successfully treated children at a 4 years follow up.  The sooner you get “aggressive” the better off he will be!  Also, you wondered about the nature of his BMs, rawness, and rash with his current “maintenance therapy” in relationship to his diet.  Well, with the SS protocol parents get a much better and complete picture of the relationship between diet and stools because they get a clear look at his daily, complete BMs which occur only with my program.  Any variations in diet you will see the results of in the next day or two with his daily complete BMs.  The “back up” and over-holding reflex with poop and pee in his pull ups contribute to skin breakdown.  The bladder becomes involved with all of the additional pressure and confusion that goes with being backed up.  The SS protocol will clear this up fairly quickly within a week or two, though I think you would be well advised to check my website for “bidet inserts” which will clean that area with just water alone.  I am not popular now with diaper and paper manufacturers!  I have not heard of the leg pain associated with constipation, but it is possible that his muscles involved in the holding are responsible.  That is the external anal sphincter or EAS and the levator ani could be involved in some way, but I am speculating here.  Also, some children show a lot of strain in stiffening their lower body in resisting their BMs which would involve the leg muscles.  Do report back to me on your experience at the Continence Center, I will keep it confidential!