What is Encopresis?

If you are reading this, you most likely have or know a child that has recently been diagnosed with, or you suspect they have encopresis. Encopresis is the term given to the soiling of stool in clothing of a child who is above the potty-training age. Soiling, also known as fecal incontinence, is usually involuntary and happens when a child cannot hold their stool in time to make it to the bathroom.

Why does Encopresis happen?

The biggest culprit of encopresis is constipation. When stool sits in the rectum for several days at a time, more water is absorbed from it, making it larger in size and harder to pass. As the new stool forms in the colon, it ends up leaking around the old, dried-up stool and into the underwear. Encopresis is sometimes mistaken for diarrhea as the consistency of the leaked stool is usually watery and runny. If constipation has been ruled out in the child suffering from encopresis, then it could be due to psychological or emotional stress.

What are the signs & symptoms of constipation?

Leakage of stool usually occurs after stool has been sitting in the rectum for a long time. To identify constipation early, look for the following signs:

• Bowel movements are large (baseball size) and sometimes clog the toilet

• Long periods between bowel movements

• Child strains or feels pain when having a bowel movement

• Child avoids having a bowel movement

• Lack of appetite

• Abdominal pain

• Urinary incontinence or bed-wetting at night (enuresis)

How does a child initially become constipated?

There are several factors that affect a child’s bowel regularity and habits:

1 - Diet: allergies or sensitivities to food, fibre intake and hydration all affect bowel movement

2 - Habits/Lifestyle: fear of releasing bowels due to a previous, painful BM or not wanting to take a break from playing 

3- Emotional stress: a big change in a child’s life, conflict with previous potty-training, anxiety/depression 

4- Medication: that may cause constipation 

How can I help my child with Encopresis?

If you haven’t already, it’s important to visit your primary healthcare provider to rule out any other conditions and identify the severity of the constipation and whether the child requires medication.

Paediatric Pelvic Floor physiotherapy is crucial in identifying the cause of the constipation and working with you and your child to treat the issue at hand through a combination of lifestyle changes and pelvic floor exercises.