Encopresis (or faecal incontinence) is a condition where children past the age of toilet training (from about four-years-old) continue to soil their underwear.
In the majority of cases this occurs after a child has not passed a bowel movement for a prolonged period of time (whether that is the child holding it in or being constipated for another reason), and so the poo gets impacted (backed up) inside the colon.
After it has been impacted for a while, the bowel muscles start to stretch and the nerves that tell the child when to go to the toilet are affected.
With muscles stretched and nerves not working properly, small amounts of softer poo can escape past the compacted poo without your child knowing until it is in their underwear – they usually can’t feel it at all and may not know until it is pointed out to them. This condition affects around 1-2% of kids under 10.
The main thing to remember is that this is not a decision on your child’s part or a behavioural issue of any kind – so punishment is not appropriate and won’t stop it happening. A doctor’s visit and positive encouragement from you is what they need.
Encopresis: causes, symptoms and treatment
Your child may show any or all of these symptoms:
- Leakage of poo (whether runny or hard) in your child’s underwear – sometimes if it is a large amount, you can mistake it for diarrhoea
- Fear of passing bowel movements
- Abdominal pain
- A long time between bowel movements (even as long as a week)
- Repeated urinary tract infections (UTIs)
Treatment for encopresis
The doctor will diagnose based on physical exams and/or x-rays. Once they have decided your child does have encopresis, the following treatment plan would be put in place.
Firstly, your child’s bowel needs to be emptied as soon as possible. There are a few methods your doctor can prescribe including:
- Stool softeners, such as lactulose
- Colon lubricants, such as mineral oil
- Rectal suppositories
- More oral fluids
Your child may need subsequent x-rays just to make sure there bowel is fully emptied. Once their bowel is all clear, you need to keep them passing bowel movements regularly. This can be done by ensuring your child’s diet is high in fibre, they are drinking lots of liquids, and possibly using stool softeners more long-term to make sure everything keeps moving healthily.
Occasionally, there could be a psychological problem as to why your child was holding in their poo in the first place, so this may be a port of call if the condition doesn’t resolve itself after the above treatment.
If you are worried that your child may have encopresis, do not hesitate to see your doctor, as earlier detection and treatment is always best for you child, and for your own stress levels. Remember not to get angry with your child – it is not their fault.