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Last Updated: September 07, 2017

Encopresis - Stool Holding or Soiling

Overview

Encopresis is characterized by hardened stool and unintended soiling. It typically affects children over the age of 4 who have infrequent bowel movements. When children with chronic constipation or other types of stress resist the natural urge to pass stool, the stool accumulates in the rectum and large intestine and becomes hardened (impacted). This can eventually cause the colon to swell and lose its ability to sense or control bowels, allowing loose/liquid stool to leak out and soil clothes.

There are two types of encopresis; primary encopresis is associated with children who are not fully toilet trained, while secondary encopresis is associated with children who develop the condition after toilet training. Children suffering from encopresis may feel guilty or embarrassed and lose interest in socializing. Without proper treatment, encopresis can lead to chronic constipation, abdominal pain, poor appetite and bladder infections. The majority of patients develop healthy bowel habits with a combination of treatment and positive encouragement. Encopresis is six times more common in boys than girls.

Causes and Risk Factors

The main causes of encopresis are constipation and emotional stress. Accumulated stool in the colon can affect the nerves that control the bowel, leading to accidental soiling.

Symptoms

Most encopresis symptoms are associated with abnormal bowel habits. These include:

Diagnosis and Treatment

Diagnosing encopresis begins with a physical exam followed by tests that look for evidence of fecal compaction in the rectum and intestine.

The goal of treatment is to clear out the colon and help the child adopt a healthy bowel routine. Most treatment regimens include a shift in diet and establishing a bowel schedule. Treatment depends on the child’s age, toilet training status and other factors.

Prevention

The best way to prevent encopresis is through regular exercise (or outside play) and a healthy diet rich in fruits, vegetables, whole grains and fiber. Fast foods and processed foods should be avoided. Drinking plenty of fluids, especially water, helps keep stool soft. Recognizing and addressing emotional stress in children also reduces the risk of developing encopresis. This includes toilet training children at the right age (usually after 2 years old) and avoiding negative reinforcement tactics.

Sources

  1. “Encopresis “. Medline Plus. Retrieved Mar 27, 2015. http://www.nlm.nih.gov/medlineplus/ency/article/001570.htm.
  2. “Encopresis”. Mayo Clinic Foundation. Retrieved Mar 27, 2015. http://www.mayoclinic.org/diseases-conditions/encopresis/basics/definition/con-20029758.
  3. “Encopresis”. Stanford Children’s Health. Retrieved Mar 27, 2015. http://www.stanfordchildrens.org/en/topic/default?id=encopresis-90-P01992.

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Authored by: Tina Shahian, PhD