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 four years and older.
Encopresis may be caused by a variety of conditions such as:
Risk factors include:
Bowel and Rectum
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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 haves the urge to move their bowels. Your child may also be unwilling to use the toilet in certain locations. These description of stool holding is important for the doctor to know about.
Call the doctor if your child has stool staining in his underwear. The doctor can help find the underlying cause.
The doctor will ask 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 studies, 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:
Mild constipation can be prevented through simple dietary changes. To help prevent constipation, encourage your child to:
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.
American Academy of Family Physicians
National Digestive Diseases Information Clearinghouse
Canadian Digestive Health Foundation
Encoporesis. Nemours kids health website. Available at: http://kidshealth.org/parent/general/sick/encopresis.html . Updated January 2012. Accessed August 9, 2012.
Fecal soiling. American Academy of Pediatrics Helath Children website. Available at: http://kidshealth.org/parent/general/sick/encopresis.html . Updated May 2011. Accessed August 9, 2012.
Fecal incontinence in children (encopresis). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . May 11, 2012. Accessed August 9, 2012.
Stool soiling and constipation in children. American Family Physician Family Doctor website. Available at: http://familydocto... . Updated November 2011. Accessed August 9, 2012.
Last reviewed December 2013 by Daus Mahnke, MD
Last Updated: 01/15/2014