by Rosalyn Carson-DeWitt, MD
Encopresis is the passage of stool in places other than the toilet. It is most often an involuntary action. Encopresis is often called stool soiling because of the stains left on underwear.
Accidents are normal in infants and toddlers until they learn bowel control. It is considered abnormal in children aged 4 years and older.
Encopresis may be caused by a variety of conditions such as:
Risk Factors TOP
This condition is more common in males. It is also more common in children with emotional problems such as:
Risk factors include:
The main symptom is the accidental passage of stool, usually into the underwear. Other symptoms may include:
If associated with constipation your child may have:
Parents are often unaware that their child is constipated. However, they may see their child forcibly holding stool when they have the urge to move their bowels. Your child may also be unwilling to use the toilet in certain locations. These descriptions of stool holding are important for the doctor to know about.
When Should I Call the Doctor?
Call the doctor if your child has stool staining in his underwear. The doctor can help find the underlying cause.
You will be asked about your child's symptoms and medical history. A physical exam will also be done. The diagnosis can usually be made this way. A rectal exam may reveal the presence of a large quantity of hard, dry stool in the rectum
To make help a diagnosis, the doctor may order imaging tests such as:
Treatments will depend on the cause of soiling. As a parent, it is important that you do not shame your child. Treatment will include some or all of these:
Enemas and laxatives may be recommended if constipation is a problem. It will help to clean out your child's bowel. These treatments are only used short term.
Your doctor may recommend:
Dietary Changes TOP
Mild constipation can be prevented through simple dietary changes. To help prevent constipation, encourage your child to:
Bowel Training TOP
Help your child learn when to use the toilet. For example, encourage your child to go to the bathroom at regular times during the day.
Keep positive. Consider rewards for your child for keeping their clothes clean and using the toilet.
Counseling may be needed if your child:
Following guidelines for toilet training may help prevent encopresis. A healthy, high-fiber diet and adequate liquid intake may also help prevent this condition.
Family Doctor—American Academy of Family Physicians
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Digestive Health Foundation
Encopresis (soiling). Kids Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Updated September 2015. Accessed January 9, 2018.
Fecal soiling. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Fecal-Soiling.aspx. Updated November 21, 2015. Accessed January 9, 2018.
Fecal incontinence in children (encopresis). EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated September 28, 2017. Accessed September 28, 2016.
Stool soiling and constipation in children. Family Doctor—American Family Physician website. Available at: https://familydoctor.org/stool-soiling-and-constipation-in-children. Accessed January 9, 2018.
Last reviewed November 2018 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 12/20/2014
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