The main cause of encopresis or soiling is chronic constipation. If your child has been constipated for a long time, he’ll have very hard poo, which gets stuck and stretches his rectum. Your child might lose the urge to go the toilet because his rectum always feels stretched. Then liquid poo might overflow around the old hard, stuck poo, without him feeling it.
Emotional issues, such as stress from premature toilet training or the birth of a sibling, might also trigger encopresis.
Other causes for encopresis include rare neurological disorders and anus abnormalities.
Aside from pooing in places other than the toilet – usually in her pants – your child might also have symptoms of constipation. These include pain when doing a poo, which can mean she tries to avoid going to the toilet. She might have tummy pains that come and go, and long periods between poos.
It’s common for children with encopresis to have behaviour problems, but these usually go once the soiling improves. About 30% of children with encopresis also have bedwetting.
All children achieve bowel control at their own rate. Soiling isn’t generally considered a medical condition unless your child is at least four years of age.
When to see your doctor
You should see your doctor if your child is four years or older and has persistent soiling or constipation.
The treatment for encopresis depends on the cause of the problem. If chronic constipation is the main cause, your doctor will help you work out a treatment plan based on laxative medications and establishing good bowel habits.
If your child has behaviour problems associated with encopresis, he might need group or individual psychotherapy. Regardless of the treatment approach, evidence shows that encopresis eventually resolves in most children.