Encopresis

What is encopresis?
Encopresis, also known as fecal soiling is the soiling of underwear with stool by children who are pass the age of toilet training and are at least 4 years old or older. Encopresis in most cases is involuntary which means they have no control over soiling their underwear. They are often embarrassed by the fact that the soiling has occurred and since fecal soiling is involuntary, children should not be punished or disciplined for soiling episodes. Encopresis is treatable and is curable.
It is important to remember that your child:

• Has no control over soiling their underwear
• is often embarrassed
• should not be punished or disciplined for soiling episodes

What causes encopresis?
In the vast majority of cases, encopresis is the result of chronic (long-standing) constipation. It is rarely caused by an anatomic abnormality or disease that the child is born with.

What are they symptoms of encopresis?
Symptoms of encopresis are different for every child and may include:

• loose, watery poops
• No urge to pass a poop before soiling of underwear
• involuntary soiling of underwear with poop that happens during the day
• Large poops that plug the toilet
• Hiding of underwear

When children hold in their poop in, their lower bowel begins to fill up. As they continue to do this, their lower bowel stretches out of its normal shape and the poop gets larger and harder. This makes pooping even more painful. When children hold their poop in repeatedly the muscles they used to push the poop out become stretched and as a result do not work well. Hard poop can get stuck and only liquid can pass around the hard poop. The stretched nerves become less sensitive and the child does not feel the leaking poop

Symptoms of encopresis may look like other conditions or medical problems. Please consult your child’s doctor for a diagnosis.

How is encopresis diagnosed?
Encopresis is diagnosed by:
• A history and physical assessment by your doctor
• Imaging tests may also be done to evaluate the intestine and rule out other health problems

How is encopresis treated?
Treatment for encopresis may include:

1. Initial cleanout – involves clearing the bowel of the impacted stool with medications such as pico-salax or PEG 3350
2. Maintenance therapy involves:
• Using laxatives daily to prevent stool impaction
• Scheduling toileting times
• Dietary changes – such as increasing fiber and water intake
• Increasing physical activity
3. Counseling – can help with the social and emotional impact of encopresis

Links
GI Kids – Fecal Soiling
Mayo Clinic – Encopresis
Healthy Children – Soiling Encopresis
Kids Health – Encopresis

REMINDER: This information is intended to provide general information and should not be used to base a diagnosis or treatment. Please consult the doctors about your specific condition and the approach for treatment.