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. This means that they regularly do poos in places other than the toilet, most often in their underwear.
Faecal incontinence is also called encopresis or soiling.
Faecal incontinence is 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.
Causes of faecal incontinence
The most common cause of faecal incontinence in children is chronic constipation.
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 neurological disorders and abnormalities of the anus.
Constipation and faecal incontinence are more common in children with attention deficit hyperactivity disorder (ADHD) and autistic children.
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 see symptoms of constipation in children with faecal incontinence. These include pain when doing a poo, large or hard poos, or less frequent poos. Children might try to avoid doing a poo or have 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 difficulties too.
All children learn to control their bowels at their own rate. If your child has developmental delays, toilet training might take longer for them.
Medical help: when to get it for children with faecal incontinence
You should see your GP for advice about treatment and management 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.
Treatment for faecal incontinence
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. A healthy diet and bowel habits will help to prevent faecal incontinence in the future.
Your GP will tell you which laxatives your child should take. Some children with faecal incontinence and chronic constipation will need to take laxatives for several months.