What is Encopresis? Encopresis is fecal incontinence or the deposition of feces in inappropriate places. This includes voluntary or involuntary passage of feces in a child 4 years or older at least 1 time a month for 6 months. Organic fecal incontinence is due to a structural, neurological, or other organic cause. Functional fecal incontinence can be due to fears associated with toileting, refusal to use toilet, fecal mass accumulation, and passage of larger stools paired with retention posture.

Signs and Symptoms? Signs of encopresis include frequent leakage of liquid stool on underwear, despite child not being ill, constipation with hard or bloody stool, passage of stool that frequently clog toilet, avoidance of bowel movements, delaying bowel movements, loss of appetite, abdominal pain, enuresis, and repeated bladder infections.

What causes Encopresis? Encopresis can have many causes such as toilet phobia, toilet refusal, past traumatic event during toileting, fear of painful stools, not wanting to interrupt fun activity to have BM, not drinking enough fluid, eating too little fiber, certain medications, and stressful life events.

Typically, encopresis is caused by fecal matter backing up into the rectum and then colon. The longer this fecal matter stays in the colon, the more water is removed from it causing large and hard stool. This large stool will stretch out the colon, making muscles weak and affecting the nerve that alerts a child of the time to use the restroom. Over time, the stretched out rectum will weaken sphincter control which leads to liquid stool leaking around the hard stool (bypass diarrhea). The child will be unaware of leakage because the nerve impulse to use the restroom is no longer functioning properly.

How is Encopresis diagnosed? Encopresis is diagnosed by your doctor. The doctor may perform a physical exam, complete a rectal exam, or may suggest an abdominal X-ray.

How is Encopresis treated? Encopresis is usually treated through the use of medications such as laxatives, suppositories and enemas followed by dietary changes, fluid intake monitoring, posturing and breathing, desensitization of toilet avoidance, bulking agents and dietary fiber intake, massage, and decreasing the resting tone of pelvic floor muscles.