Learn About Encopresis

What is the definition of Encopresis?

If a child over 4 years of age has been toilet trained, and still passes stool and soils clothes, it is called encopresis. The child may or may not be doing this on purpose.

What are the alternative names for Encopresis?

Soiling; Incontinence - stool; Constipation - encopresis; Impaction - encopresis

What are the causes of Encopresis?

The child may have constipation. The stool is hard, dry, and stuck in the colon (called fecal impaction). The child then passes only wet or almost liquid stool that flows around the hard stool. It may leak out during the day or night.

Other causes may include:

  • Not toilet training the child
  • Starting toilet training when the child was too young
  • Emotional problems, such as oppositional defiant disorder or conduct disorder

Whatever the cause, the child may feel shame, guilt, or low self-esteem, and may hide signs of encopresis.

Factors that may increase the risk of encopresis include:

  • Chronic constipation
  • Low socioeconomic status

Encopresis is much more common in boys than in girls. It tends to go away as the child gets older.

What are the symptoms of Encopresis?

Symptoms can include any of the following:

  • Being unable to hold stool before getting to a toilet (bowel incontinence)
  • Passing stool in inappropriate places (as in the child's clothes)
  • Keeping bowel movements a secret
  • Having constipation and hard stools
  • Passing a very large stool sometimes that almost blocks the toilet
  • Loss of appetite
  • Urine retention
  • Refusal to sit on toilet
  • Refusal to take medicines
  • Bloating sensation or pain in the abdomen
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What are the current treatments for Encopresis?

The goal of treatment is to:

  • Prevent constipation
  • Keep good bowel habits

It is best for parents to support, rather than criticize or discourage the child.

Treatments may include any of the following:

  • Giving the child laxatives or enemas to remove dry, hard stool.
  • Giving the child stool softeners, such as magnesium hydroxide, lactulose, or polyethylene glycol powder, as recommended by the provider.
  • Having the child eat a diet high in fiber (fruits, vegetables, whole grains) and drink plenty of fluids to keep the stools soft and comfortable.
  • Taking flavored mineral oil for a short period of time. This is only a short-term treatment because mineral oil interferes with the absorption of calcium and vitamin D.
  • Seeing a pediatric gastroenterologist when these treatments are not enough. The doctor may use biofeedback, or teach the parents and child how to manage encopresis.
  • Seeing a psychotherapist to help the child deal with associated shame, guilt, or loss of self-esteem.

For encopresis without constipation, the child may need a psychiatric evaluation to find the cause.

Who are the top Encopresis Local Doctors?
General Surgery | Undersea and Hyperbaric Medicine | Urology
General Surgery | Undersea and Hyperbaric Medicine | Urology
140 Lincoln Ave, Fl 3, 
Haverhill, MA 
 8.9 mi

Andrey Layer is a General Surgeon and an Undersea and Hyperbaric Medicine provider in Haverhill, Massachusetts. Dr. Layer and is rated as an Advanced provider by MediFind in the treatment of Encopresis. His top areas of expertise are Peptic Ulcer, Necrosis, Cellulitis, Encopresis, and Tissue Biopsy.

Gastroenterology
Gastroenterology

Mass General Brigham Community Physicians Inc

260 Merrimac St, 
Newburyport, MA 
 6.8 mi

Ahmer Ibrahim is a Gastroenterologist in Newburyport, Massachusetts. Dr. Ibrahim and is rated as an Experienced provider by MediFind in the treatment of Encopresis. His top areas of expertise are Trichohepatoenteric Syndrome, Chronic Erosive Gastritis, Gastritis, Gastrectomy, and Colonoscopy.

 
 
 
 
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Gastroenterology
Gastroenterology

Seacoast Affiliated Group Practice Inc

255 Low St, Suite 2, 
Newburyport, MA 
 7.0 mi

Thomas Liu is a Gastroenterologist in Newburyport, Massachusetts. Dr. Liu and is rated as an Experienced provider by MediFind in the treatment of Encopresis. His top areas of expertise are Gastrointestinal Bleeding, Anemia, Barrett Esophagus, Gastrectomy, and Endoscopy.

What is the outlook (prognosis) for Encopresis?

Most children respond well to treatment. Encopresis often recurs, so some children need ongoing treatment.

What are the possible complications of Encopresis?

If not treated, the child may have low self-esteem and problems making and keeping friends. Other complications may include:

  • Chronic constipation
  • Urinary Incontinence
When should I contact a medical professional for Encopresis?

Contact your provider for an appointment if a child is over 4 years old and has encopresis.

How do I prevent Encopresis?

Encopresis can be prevented by:

  • Toilet training your child at the right age and in a positive way.
  • Talking to your provider about things you can do to help your child if your child shows signs of constipation, such as dry, hard, or infrequent stools.
What are the latest Encopresis Clinical Trials?
Sacral Neuromodulation for Constipation and Fecal Incontinence in Children and Adolescents - Randomized Controlled Trial on the Application of Invasive vs. Non-invasive Technique

Summary: The purpose of this study is to assess the efficacy of neuromodulation for treatment of chronic constipation and fecal incontinence in pediatric patients and to evaluate the differences between the invasive vs. non-invasive approach.

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Who are the sources who wrote this article ?

Published Date: July 28, 2022
Published By: Charles I. Schwartz MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Marcdante KJ, Kliegman RM, Schuh AM. Digestive system assessment. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 126.

Noe J. Constipation. In: Kliegman RM, Toth H, Bordini BJ, Basel D, eds. Nelson Pediatric Symptom-Based Diagnosis. 2nd ed. Philadelphia, PA: Elsevier; 2023:chap 19.

Roy D, Akriche F, Amlani B, Shakir S. Utilisation and safety of polyethylene glycol 3350 with electrolytes in children under 2 years: A Retrospective Cohort. J Pediatr Gastroenterol Nutr. 2021;72(5):683-689. PMID: 33587408 pubmed.ncbi.nlm.nih.gov/33587408/.