What is Encopresis?

Encopresis (stool holding, fecal retention) is a condition that mainly occurs in potty-trained kids (secondary encopresis), but it can happen while in still diapers (primary encopresis). Secondary encopresis is characterized by the soiling of underwear, and not because of control issues. Constipation occurs when the child avoids defecating, and it occurs in boys more often than in girls.

In both primary and secondary encopresis, the act of holding stool can begin after a experiencing a particularly painful bowel movement. The colon becomes more and more stretched as feces collects. The urge to defecate diminishes as it stretches. Watery feces from higher up in the colon trickles down past the impaction and leaks out onto undergarments. Upon inspection, it would seem that the child did not properly wipe after a bowel movement. However, when the feces finally builds to amounts that can no longer be physically held, entire bowel movements are inadvertently passed. In rare instances the problem could be caused by a disease that affects rectal nerves.

What are the Symptoms of Encopresis?

The signs of encopresis depend on the severity of the condition and how quickly the problem is realized. In many cases, the child is completely unaware of the event until after it happens.

Symptoms include

  • Tacky, dark and unusually foul smelling feces
  • Feces stains in undergarments
  • Constipation
  • Hard, dry and large bowel movements
  • Frequent toilet clogs
  • Seven or more days in between bowel movements
  • Decreased appetite
  • Stomach pain
  • Multiple urinary tract infections

Encopresis Causes

There are many causes of this condition in children. If a child holds in a bowel movement for too long, it can cause this condition. Holding it in can cause painful bowel movements, and this can leak to leakage of soft bowl movements. Dietary issues can also cause it to occur. When the child’s diet doesn’t include enough water or fiber, and the child doesn’t get exercise, the child can develop this condition. For some children with this condition, a fecal blockage causes the intestines to become enlarged. This leads to the loss of the sensation of needing to pass a bowel movement.

When a child is toilet trained at too young an age or has only one to two bowel movements per week, this condition can develop. There may also be psychological causes of the condition. Conduct disorder or other behavioral problems are related to this condition. If the child is under stress at home or at school, or has had anxiety about using the toilet, these problems can cause encopresis. Males are six times more likely to experience encopresis.

How is Encopresis Treated?

Once the problem is ascertained, treatment usually begins at home.

Treatment includes

  • Colon stimulation and evacuation with the help of laxative, enemas or suppositories
  • Behavior therapy including the establishment of regular bathroom breaks
  • Increasing daily fiber intake
  • Adding more fruits and vegetables to the diet
  • Drinking plenty of water each day
  • Physical activity

Surgery to correct encopresis is rarely necessary. In most cases, simply preventing constipation is enough to stop encopresis from recurring.

Encopresis Prevention

To help your child avoid this condition, take steps to avoid him getting constipation. He should eat a high-fiber diet, drink plenty of water and get regular exercise. Find out about the best ways to toilet train your child. Start when you feel your child is ready rather than an arbitrary time that may be too young. Use positive reinforcement during the training, and don’t be forceful to keep the experience stress-free.

Don’t get angry about the symptoms. Even if the cause is a psychological one, a child suffering from this condition has no control over the leakage. Anger about the problem can add to the child’s stress. If you do see leakage, get your child treatment right away. Early treatments can prevent this condition from getting worse.