Encopresis is passing or leaking stool (poop) in places other than the toilet. It is often done without control. It can happen in children older than 4 years of age.
The most common cause is chronic constipation. Large amounts of hard, dry stool can make it hard to know when to go to the bathroom. This can cause liquid stool to leak around the hard mass of stool.
Other causes may be:
This problem is more common in boys and in children who are 5 to 10 years of age. Other things that may raise the risk are:
- Poor toilet training—or refusal to use the toilet to pass stool (poop)
- Having other family members who had encopresis
- Being overweight
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The main symptom is accidentally passing stool, usually into the underwear. Other problems may be:
- Infrequent passing of stools
- Trying to avoid passing stools
- Passing small amounts of liquid stool
- Pain or bleeding when stool passes
- Belly pain
- Passing urine without control
The doctor will ask about the child's symptoms and past health. A physical exam will be done. The doctor may do a digital rectal exam. This involves inserting a gloved finger into the child's rectum to check for hard, dry stool.
Images may be taken of the abdomen to check for stool in the rectum. This can be done with an x-ray .
Blood and urine tests may also be done to rule out underlying conditions.
The goal of treatment is to help stool pass on a regular basis. Options are:
- An enema to inject fluid in the colon—to empty stool from the body
- Medicines, such as:
- Laxatives to help stool pass
- Stool softeners to make it easier to pass stool on a regular basis
- Retraining the bowels to pass stool at the same time each day
- Dietary changes, such as drinking plenty of water and eating foods that are high in fiber
- Mental health counseling to address emotional or behavioral issues
The risk of this problem may be lowered by:
- Offering a high fiber diet and plenty of fluids
- Encouraging regular exercise
- Fecal incontinence in children (encopresis). EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/fecal-incontinence-in-children-encopresis.
- 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.
- Nurko S, Scott SM. Coexistence of constipation and incontinence in children and adults. Best Pract Res Clin Gastroenterol. 2011;25(1):29-41.
- Soiling (encopresis). Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/encopresis.html.
- Stool soiling and constipation in children. Family Doctor—American Family Physician website. Available at: https://familydoctor.org/stool-soiling-and-constipation-in-children.
- Daniel A. Ostrovsky, MD
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