Encopresis in Children


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Created at17 September 2021
Update22 March 2023

Soiling stool or encopresis is not much discussed even with doctors. If it happens to children aged 3-4 and older, parents tend to wait for the problem to disappear on its own. Soiling stool can be not only frustrating for parents, but also may be embarrassing for a child. What should be highlighted is that anal sphincters are expected to function properly in children aged 5 and older.

Encopresis in Children

NPISTABUL Brain Hospital psychiatrist Neriman Kilit, Associate Professor at Uskudar University, shared her medical opinion on encopresis in children.

Chronic constipation

Two anal sphincters (inner and external) should function properly starting from age 4. Encopresis is a disorder, when a child leaks his or her stool in places other than toilet even if he or she has been toilet trained. About 1% of children aged 5 suffer from this disorder, more frequently boys. Encopresis can be of two types: the one is caused by chronic constipation and the other happens when a child has got some emotional issues or conflict-filled toilet training. Irregular dry and solid stool stretches the colon of a child, therefore, ultimately affects the nerves that signal when it is time to go to the toilet. At this moment watery part of stool can leak into a child’s underwear causing embarrassment and discomfort. The treatment is obvious – chronic constipation or irregular bowel movements should be treated. Otherwise, it may lead to withholding stool due to fear or painful defecation.  

Emotional issues

If there is no complains about irregular bowel movements or constipation, encopresis or soiling stool might be caused by emotional issues such as the divorce of the parents, starting school or schedule changes, etc. Sometimes it can be caused by a child’s desire to unconsciously control his or her parents, to take control over their actions towards him or her. In this case, parents are recommended to receive guidance from their child’s doctor or a mental health professional. This proactive action can prevent social and emotional negative impact of encopresis on a child’s psychological condition. If your child grows up but the problem keeps happening, medical examination and regular follow-up visits with your doctor can help to identify certain problems, so that adjustments in treatment can be made as needed. We, as grown-ups, should be aware of the fact that mentally and physically healthy children will not do it on purpose. 

Neuropsychological development 

If you are a parent and you face such a problem as encopresis in your child, the first thing to do is to consult your doctor, undergo physical examination and make all required diagnostic tests. Your doctor will sort out possible causes and come up with an efficient and proper treatment plan. Children are usually diagnosed with encopresis if they are older than 4 and have been toilet trained, in spite of this fact they still are not able to control bowel movements and can pass stool in places other than WC. Apart from that, it should be mentioned that several psychiatric disorders can also cause encopresis in children. Those disorders are ADHD (attention deficit and hyperactivity disorder), anxiety, autism and other neuropsychiatric disorders. Taking into consideration a possible negative impact on a child’s future life and self-esteem, parents, whose children experience encopresis or stool soiling, need to see a doctor as quick as possible.