Debra—The birth of his baby sister could have been an initiating cause.  It does not take much to trigger the holding response.  It is just that once it gets started it may become firmly established and resistant to change. The holding response is our initial and predominate response to bowel urges.  This is normally followed by going to the bathroom and initiating the voiding response.  The response of the doctors is very disappointing, but very typical.  The medical profession’s initial response is to make sure that the stool is softened and moved along the colon.  An obstruction could result without such aids and result in a harsh clean out or even hospitalization.   After a time they can only encourage you to continue “maintenance therapy” and assure you that he will grow out of it.  They resist or don’t know about a more aggressive approach which should have been initiated by the time your child was 6 years of age.  I really can’t criticize them.  They are very busy, hardworking professionals and my writing is not well known. I basically developed that more aggressive approach and it has been published in a medical textbook and in a medical journal article of which many would not be aware.  I will attach the article for your information.  My basic protocol was first published as a manual in 1998 and was the first manual to ever have been published for any approach to encopresis.  It is resisted in general by the culture and the medical profession because it does rely on suppositories and enemas, at least initially, to prime the voiding response until it becomes more reliable and the child’s body and brain take it over.  This is a case of learning by actually doing successful voiding following an increase in awareness of his voiding urges.  Your grandson cannot help what he is doing and denial is a natural reaction. There is no other really reliable option available to you that can be done in the home.  If you order the Clean Kid Manual you will also have access to other parents who are using it and who will be happy to assure and guide you.  Do not try to guess my protocol on your own or from the medical journal article.  Timing, support from the parents, materials, procedures, and explanations are all important.