• Suitable for 4-8Years

Soiling (encopresis)

 

Encopresis is when children who are past the age of toilet training regularly do poos somewhere other than the toilet. They can’t control when and where the poo comes. This can be very upsetting for children and parents.

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Encopresis is also known as ‘soiling’ or ‘faecal incontinence’.

 

Causes

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.

Symptoms

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.

Treatment

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.

 
 
 
  • Last updated29-06-2011
  • Last reviewed20-04-2011
References

  • Gibb, S., & Harari, M. (2009). Constipation and continence. In K. Thomson, D. Tey & M. Marks (Eds), Paediatric handbook (8th edn, pp. 326-335). Melbourne: Wiley-Blackwell.

    Sundaram, S., Hoffenberg, E., Kramer, R., Sondheimer, J.M., & Furuta, G.T. (2009). Gastrointestinal tract. In W. Hay, M. Levin, J. Sondheimer & R. Deterding (Eds), Current diagnosis and treatment: Pediatrics (19th edn, pp. 595-630). New York: McGraw-Hill.

    Stafford, B.S. (2009).Child and adolescent psychiatric disorders and psychosocial aspects of pediatrics. In W. Hay, M. Levin, J. Sondheimer & R. Deterding (Eds), Current diagnosis and treatment: Pediatrics (19th edn, pp. 171-211). New York: McGraw-Hill.

    Boris, N.W., & Dalton, R. (2007). Encopresis. In R. Kliegman, R. Behrman, H. Jenson & B. Stanton (Eds), Nelson textbook of pediatrics (18th edn, pp. 114). Philadelphia: Saunders Elsevier.

    Royal Children’s Hospital (2010). Constipation. Retrieved January 14, 2011, from http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=3718

    Mayo Foundation for Medical Education and Research (2010). Encopresis. Retrieved January 14, 2011, from http://www.mayoclinic.com/health/encopresis/DS00885Articles

    Levitt, M. & Pena, A. (2010). Update on pediatric faecal incontinence. European Journal of Pediatric Surgery, 19(1), 1-9.

    Nijman, R. (2008). Diagnosis and management of urinary incontinence and functional fecal incontinence (encopresis) in children. Gastroenterology Clinics of North America, 37(3), 731-48.

    Culbert, T. & Banez, G. (2007). Integrative approaches to childhood constipation and encopresis. Pediatric Clinics of North America, 54(6), 927-47.