If a child over the age of 4 has been toilet trained and then passes stool and soils clothes again, this is called encopresis. The child may or may not be doing this on purpose.
The child usually has 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 passes around the hard stool. It may leak out during the day or night.
Whatever the cause, the child may feel shame, guilt, or lose self-esteem, and may hide signs of encopresis.
The risk for encopresis may increase with:
The doctor may feel the stool stuck in the child’s rectum (fecal impaction). An x-ray of the child’s belly may show impacted stool in the colon.
It is best for parents to support rather than criticize or discourage the child
Treatments may include:
Most children respond to treatment.
Call for an appointment with your health care provider if a child is over 4 years old and has encopresis.
Toilet train in a positive way when the child is the right age.
If your child shows signs of constipation, such as dry, hard, or infrequent stools, ask your doctor how to treat it.
Soiling; Incontinence - stool
Feigelman S. Growth, development, and behavior. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 6.
Feldman MD. Encopresis. In: Ferri FF, ed. Ferri's Clinical Advisor 2009. 1st ed. Philadelphia, PA: Mosby Elsevier; 2009:section 1.
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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