What is faecal incontinence (encopresis or soiling)?

Faecal incontinence is when children who are 4 years old or older can’t control when and where they do a poo. They might poo in their pants or places other than the toilet.

Faecal incontinence is also called encopresis or soiling.

If your child soils their pants, it’s accidental – your child doesn’t do it on purpose. But it can be difficult to live with, and it’s natural to find it challenging or upsetting. If this sounds like your situation, talk to your GP about getting support.

What causes faecal incontinence?

Chronic constipation is the most common cause of faecal incontinence in children.

If children have been constipated for a long time, poo builds up in their rectum. This can cause the rectum to stretch. Children might lose the urge to go to the toilet because their rectums always feel stretched. Then soft or liquid poo might overflow around the old, stuck poo, without children feeling it or meaning to let it go.

Other causes of faecal incontinence include rare nervous system disorders and abnormalities of the anus.

Constipation and faecal incontinence are more common in children with ADHD and autistic children.

What are the symptoms of faecal incontinence?

The main symptom of faecal incontinence is pooing in places other than the toilet, usually in underwear. This can range from ‘skid marks’ to larger bits of poo. It’s quite common for children to say that they can’t feel or smell that they’ve done a poo.

Because the most common cause of faecal incontinence is constipation, you might also see symptoms of constipation in children with faecal incontinence. These symptoms include trying to avoid doing a poo or:

• pain when doing a poo
• large or hard poos
• less frequent poos
• tummy pains.

Some children with faecal incontinence also have daytime wetting or night-time wetting.

And some children with faecal incontinence have emotional or behaviour concerns too.

All children learn to control their bowels at their own rate. If your child has developmental delay, toilet training might take longer for them.

Does your child need to see a doctor about faecal incontinence?

You should see your GP for advice about treatment if you think your child is constipated or if your child:

• is 4 years old and can’t yet control when or where they poo
• starts having poo accidents again after a long time without accidents.

How is faecal incontinence treated?

The treatment for faecal incontinence depends on its cause.

If chronic constipation is the main cause, your GP will help you work out a treatment plan. This will probably involve using laxatives to treat the constipation. Your GP will tell you which laxatives your child should take. Most children with faecal incontinence and chronic constipation will need to take laxatives for several months.

Healthy eating and bowel habits will help to prevent constipation and faecal incontinence in the future.