What is faecal incontinence?
Faecal incontinence is when children who are past the age of toilet training 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 soiling or encopresis.
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
A 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 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.
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.
If your child has faecal incontinence, they might also have symptoms of constipation. Symptoms include pain when doing a poo, which can mean your child tries to avoid going to the toilet. Your child might also have tummy pains that come and go, and might go for long periods between poos.
About 30-50% of children with faecal incontinence have emotional or behaviour problems too.
All children achieve bowel control at their own rate. Faecal incontinence isn’t generally considered a medical condition unless your child is at least four years old.
Should you see a doctor about faecal incontinence in children?
You should see your GP for advice about treatment and management if your child:
- has ongoing constipation after being toilet trained
- starts having regular problems with controlling when and where they poo after being toilet trained
- is four years old and can’t yet control when or where they poo.
Treatment for faecal incontinence
The treatment for faecal incontinence 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 using laxative medications and establishing good bowel habits.
Your doctor will tell you which laxatives your child should take.
You can help your child get into good bowel habits by encouraging your child to sit on the toilet regularly and push. For example, try encouraging your child to sit on the toilet for five minutes about 20-30 minutes after eating breakfast, lunch and dinner. Rewards and praise can help your child cooperate.
If faecal incontinence is associated with behaviour problems, your child might need counselling, and group or individual therapy.
Regardless of how it’s treated, faecal incontinence usually goes away by itself.