What Is It?
Encopresis is when a child who is toilet trained passes stool (bowel movements) into his or her underwear. To have encopresis, the child must be at least four years old, the age by which most children can control bowel movements. Encopresis is also called fecal incontinence.
In most children, encopresis is related to chronic constipation. Constipation is when bowel movements don't occur often enough. Also, the stool is hard and dry.
When stool needs to be passed, it collects in the lower bowel (rectum). There, it stretches the bowel wall. This feeling of the bowel being stretched is what normally makes us realize we have to go to the bathroom.
However, if the bowel wall is stretched for long periods without passing a bowel movement, the rectum loses its normal muscle tone and feeling. This makes it harder and harder to pass the hard stool collecting in the rectum. Also it becomes more difficult for your child to know when stool is ready to be passed.
As newer stool continues to be made in the intestines, it leaks around the large chunk of hard stool. It passes out of the rectum, and soils the child's underpants. In almost all children with encopresis caused by constipation, this is not done on purpose. In fact, many children do not even realize that the stool has leaked out. The first clue that the child has a problem may come when someone notices that the child smells bad.
Chronic constipation that turns into encopresis can have many different causes. These include:
No matter what the initial cause of a child's chronic constipation, the end result is the same. A large chunk of stool builds up and stretches the rectum until it loses its normal tone and feeling. This makes it more difficult for the rectum to push out the stool. So, more and more stool builds up.
This unhealthy cycle can only be broken when the bowel is completely cleared of stool. At that point, the bowel can return to its normal size. Then a child can learn how to empty his or her bowel on a more regular schedule.
In rare cases, encopresis is related to:
Boys have encopresis more often than girls.
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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.
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