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What is Encopresis?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 26 September 2016
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Encopresis is a condition in which children hold in their bowel movements, eventually developing constipation and experiencing involuntary bowel movements. This condition is a common cause of fecal soiling, and it can be very frustrating for parents and other caregivers to deal with. The critical thing to be aware of is that fecal incontinence should be addressed quickly and without judgment or shame, to avoid turning it into a bigger problem.

In a child with encopresis, the child holds in bowel movements, which eventually leads to an impaction. This condition can be caused by mild constipation which makes bowel movements painful, causing the child to hold them in and thereby making the constipation worse. Children may also develop psychological distress which causes them to hold their bowel movements as long as possible.

The impaction of fecal material in the bowel weakens it, making it harder for the child to feel the urge to defecate because the muscles are not as strong. Eventually, the sphincter cannot hold the stools in, and the child experiences involuntary defecation, or some stool leaks out, smearing underwear, pajamas, or bedding. Children can develop this condition before or after toilet training.

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Boys are far more likely to experience encopresis than girls. This condition can be very shameful and humiliating, especially when it is not handled well. Treatment for encopresis revolves around first cleaning out the bowel to remove the impacted stool, and then supporting bowel health with a diet high in fiber and liquids. In addition, parents often find that scheduling set times to use the toilet for pooping can encourage children to defecate rather than holding in their stools, thereby reducing the risk of recurring encopresis.

Parents should keep a close eye on bathroom habits and the condition of stools, as they can provide early clues to emerging medical problems. If a child strains while on the toilet, for example, it can indicate that he or she is experiencing constipation, which can develop into encopresis if it is not addressed. Notable changes in color and consistency of stool can also be indicative of a problem.

Fecal soiling in general can be caused by a wide variety of medical and psychological conditions. Especially in cases where a child has been toilet trained, the development of fecal incontinence is usually a sign that the child is experiencing a medical problem. A pediatrician can provide treatment and advice to help parents manage and eventually cure the condition.

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anon927212
Post 4

What about a child who had this most of their lives and it continued into adulthood? Can it become a habit? I know a woman who had held back her bowels since childhood and even as a woman, when she feels the need to go, will hold it back initially for about a day before going. She said she hates having bowel movements. She doesn't remember a time in her life that she didn't do this. Is there help for her?

sunnySkys
Post 3

A good friend of mine works at a daycare, and she told me awhile ago about one of the kids there who had developed this condition. The child came from a large family that lived in a house with only one bathroom.

As you can imagine, the kids would fight over the bathroom. The youngest child became so distressed about using the bathroom while people were knocking on the door trying to get in that he simply started holding his bowel movements.

Eventually he developed encopresis and needed treatment. The parents also enlisted the help of a counselor to help the kid with the embarrassment that caused the problem in the first place.

JessicaLynn
Post 2

@Monika - This does sound quite distressing. And as the article said, encopresis soiling could be made even worse if the parents don't deal with it well.

Unfortunately, not every parent is a wonderful loving parent. I have a few friends who work with children in the medical field, and some parents are also not that great at dealing with their child's health issues.

I can easily imagine a parent getting angry at a child for soiling themselves in this way, and not thinking it's a medical issue. I imagine a negative reaction from a parent would just make this condition even worse!

Monika
Post 1

I've never heard of voluntary encopresis before. I can imagine how upsetting it would be for a kid to deal with though. Even as an adult, I have friends who get nervous about having bowel movements in public places, or while other people are at their homes, or when they're visiting someone else's home.

I can totally imagine children having these same kind of hangups, and more. It seems like a cruel joke that this behavior ends in the child soiling themselves, which is far more embarrassing than just having a bowel movement normally.

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