What Is Encopresis?
Encopresis is the repeated passage of feces in inappropriate places (such as in clothing or on the floor) by a child who is at least 4 years old. It's usually not intentional and is often related to chronic constipation.
Encopresis can be embarrassing and frustrating for both children and parents, but it's a treatable condition. Understanding the causes and getting appropriate treatment is important for helping your child.
Types of Encopresis
Retentive Encopresis
This is the most common type and is usually related to chronic constipation:
- • Child has chronic constipation
- • Stool becomes impacted in the colon
- • Liquid stool leaks around the blockage
- • Child may not be aware of the leakage
Non-Retentive Encopresis
Less common, this type is not related to constipation:
- • No evidence of constipation
- • May be related to emotional or behavioral issues
- • May be intentional or related to toilet training issues
- • Requires different treatment approach
What Causes Encopresis?
Chronic Constipation
The most common cause is chronic constipation, which can lead to:
- • Hard, dry stool that's difficult to pass
- • Painful bowel movements
- • Child avoiding going to the bathroom
- • Stool backing up in the colon
- • Stretching of the colon and loss of sensation
- • Liquid stool leaking around the blockage
Toilet Training Issues
Problems during toilet training, such as starting too early, pressure, or negative experiences, can contribute to encopresis.
Emotional or Behavioral Factors
- • Stress or anxiety
- • Oppositional behavior
- • Attention-seeking
- • Trauma or abuse
- • Family stress or changes
Dietary Factors
- • Low fiber intake
- • Inadequate fluid intake
- • Poor eating habits
Signs and Symptoms
Physical Signs
- • Soiling in underwear or clothing
- • Large, hard stools
- • Infrequent bowel movements
- • Abdominal pain or discomfort
- • Loss of appetite
Behavioral Signs
- • Hiding soiled underwear
- • Avoiding using the toilet
- • Withdrawal or embarrassment
- • Denial of the problem
- • Avoiding social situations
Treatment for Encopresis
Medical Treatment
Treatment typically involves:
- • Bowel cleanout: Removing impacted stool (may require enemas or laxatives under medical supervision)
- • Maintenance therapy: Keeping stool soft with medications
- • Regular toilet sitting: Establishing a routine
- • Dietary changes: Increasing fiber and fluids
Behavioral Strategies
- • Establish regular toilet sitting times
- • Use positive reinforcement for successful bowel movements
- • Avoid punishment or shaming
- • Create a calm, supportive environment
- • Use rewards and charts to track progress
Dietary Changes
- • Increase fiber intake (fruits, vegetables, whole grains)
- • Ensure adequate fluid intake
- • Limit constipating foods
- • Work with a dietitian if needed
Addressing Emotional Issues
If emotional or behavioral factors are involved, counseling or therapy may be helpful. Addressing underlying stress, anxiety, or trauma is important for successful treatment.
How Parents Can Help
Be Patient and Supportive
- • Remember that encopresis is usually not intentional
- • Avoid punishment, shaming, or anger
- • Be patient — treatment takes time
- • Stay positive and encouraging
Follow Treatment Plan
Work closely with your child's doctor to follow the treatment plan. Consistency is important for success. Don't stop medications or treatments without medical guidance.
Create a Positive Environment
- • Make bathroom time pleasant and stress-free
- • Use rewards and praise for successes
- • Keep a routine
- • Be understanding about accidents
Seek Support
Encopresis can be stressful for families. Don't hesitate to seek support from healthcare providers, support groups, or counselors. You don't have to handle this alone.
Frequently Asked Questions (FAQs)
Q: Is encopresis my child's fault?
A: No, encopresis is usually not intentional. In most cases, it's related to chronic constipation and the child may not even be aware of the leakage. It's important not to blame or shame your child. Encopresis is a medical condition that requires treatment, not punishment.
Q: How long does treatment take?
A: Treatment can take several months or longer. It requires patience and consistency. The first step is usually clearing the impacted stool, then maintaining regular bowel movements. Behavioral changes and establishing new habits take time. Work closely with your child's doctor and be patient with the process.
Q: Should I punish my child for soiling?
A: No, punishment is not helpful and can make the problem worse. Encopresis is usually not intentional, and punishment can increase stress and anxiety, which may worsen the condition. Instead, focus on positive reinforcement for successful bowel movements and following the treatment plan.
Q: When should I see a doctor?
A: If your child is 4 years or older and is soiling regularly, or if you notice signs of constipation or other concerns, consult with your pediatrician. Early treatment is important. Don't wait, as the condition can worsen over time and become more difficult to treat.
Key Takeaways
Seek Medical Help
Encopresis requires medical evaluation and treatment
Be Patient
Treatment takes time; avoid punishment
Stay Positive
Use positive reinforcement and support
⚠️ Important Note
This article provides general information and is not intended to replace professional medical advice. Encopresis is a medical condition that requires evaluation and treatment by a healthcare provider. If your child is experiencing encopresis, consult with your pediatrician or a gastroenterologist for proper diagnosis and treatment. Don't attempt to treat this condition on your own without medical guidance.