Encopresis is also known as fecal soiling. It occurs when a child
usually over the age of 4 has a bowel movement and soils their pants. This
behavior is often linked to constipation.
Constipation occurs when stool becomes backed up in the intestines.
Treating constipation is fairly easy and will typically eliminate soiling.
The most common symptom of encopresis is soiled underpants.
Constipation may happen before encopresis. If your child hasn’t had a bowel
movement in three days, they may be constipated.
Other symptoms may include:
- a lack of appetite
- abdominal pain
- urinary tract infections
Your child may also experience shame and guilt as a result of
soiling. They may even be teased at school if their classmates find out about
the problem. As a result, some children may show signs of secretive behavior
around the issue. For example, they may hide their soiled underwear.
Causes a Child to Develop Encopresis?
Fecal matter can become hard and difficult to pass if your child
doesn’t get enough fiber, water, or exercise, or if they hold in a bowel
movement. This can cause bowel movements to be painful. Then, liquid fecal
matter or a soft bowel movement can leak into a child’s underpants. This is
known as soiling. The child cannot consciously control soiling.
In some cases, the intestines may become so enlarged from fecal
blockage that your child loses the sensation of needing to poop.
Common causes of encopresis include:
- fewer than one bowel movement every three days
- a low-fiber diet
- little to no exercise
- a lack of water
- toilet training too early
Psychological causes may include:
- behavioral problems, such as conduct disorder
- familial, school, and other stressors
- anxiety over toileting
Just because encopresis is associated with psychological causes
doesn’t mean that the symptoms are under your child’s control. They’re most
likely not soiling themselves on purpose. The problem may begin because of
controllable situations, such as fear of using a public toilet or not wanting
to be toilet trained, but it becomes involuntary over time.
Increasing Your Child’s Risk
Certain common risk factors increase your child’s likelihood of developing
encopresis. These include:
- repeated bouts of constipation
- changing your child’s toileting routine
- poor toilet training
According to the Stanford
Children’s Health, boys are six times more likely to develop encopresis
than girls. The reason for this difference is unknown.
Other less common risk factors for encopresis include:
- health conditions causing constipation, such as
diabetes or hypothyroidism
- sexual abuse
- emotional and behavioral disturbances
- a tissue tear in the rectum, which is usually
the result of chronic constipation
Is Encopresis Diagnosed?
Encopresis is typically diagnosed based on the reported symptoms,
a medical history, and a physical exam. The physical exam may involve an
examination of the rectum. Your child’s doctor will be looking for a large
amount of dried and hard fecal matter.
An abdominal X-ray can help determine the amount of fecal
A psychological evaluation may be used to look for an underlying
emotional cause for this problem.
Is Encopresis Treated?
Removing the Blockage
Your child’s doctor might prescribe or recommend a product to
remove the blockage and relieve constipation. Such products may include:
- mineral oil
There are several lifestyle changes that can help your child
Adopting a diet high
in fiber will encourage the flow of bowel movements. Examples of
high-fiber foods include:
- bran cereal
For children ages 4 to 8, drinking five cups of water daily can help keep stools soft for easy
passage. Restricting caffeine consumption can also help prevent dehydration.
Daily exercise helps
move materials through the intestines. Encourage your child to exercise
regularly. Limiting media time may increase your child’s activity level.
Employ behavioral techniques to reward your child for using the
toilet, eating high-fiber foods, and not soiling their pants. Rewards can range
from positive praise to tangible objects, as long as there’s consistency. Avoid
scolding your child for soiling. This can increase their anxiety about going to
the bathroom. Instead, try to stay neutral after a soiling incident.
If emotional distress or an underlying behavioral problem is
present, your child may need psychological counseling. A counselor can help
address related issues. They can help children develop coping skills and build
self-esteem. They can also teach effective behavior modification techniques to
Can I Help My Child Avoid Encopresis?
Adopt a healthy approach to toilet training your child. Don’t
start toilet training until your child is ready. Typically, children aren’t
ready for training until after they turn 2 years old. Other ways to prevent
- making certain your child eats high-fiber foods
- encouraging your child to drink plenty of water
- regularly exercising with your child