What is encopresis?
Encopresis is characterized by involuntary and regular evacuation of feces by a child older than 4. These little accidents are often the result of chronic constipation, which causes an accumulation of feces in the rectum leading to an involuntary discharge by the child. To diagnose encopresis, the following criteria must be met:
- The child is older than 4
- They eliminate involuntarily and in inappropriate places
- The problem has been present at least once a month for more than three months.
- 3 % to 5 % of pediatric visits are because of constipation
- Encopresis affects 1.5 % to 7 % of children aged 6 to 12 and affects boys significantly more than girls.
- 85 % of children with a diagnosis of encopresis also have a diagnosis of constipation.
As encopresis is often present in children who suffer from constipation, symptoms are generally similar:
- Stomach ache
- Cramps or bloating
- Loss of appetite
- Weight loss
- Anal fissures
You may also notice that your child will have a tendency not to have a bowel movement for several days, and when they do, their stool will be large and hard. Some children will continue to use the bathroom every day, while still having some accidents in their underwear, which will look like diarrhea. In more severe cases, the child will completely refuse to go to the toilet.
Psychological aspects for the child
While encopresis is very frustrating to live with as a parent, try not to forget the impact on your child and how they may be feeling about the situation, which might lead them to withdraw, to feel shame or even to try to hide their underwear to avoid reprimands. As a parent, it’s important that you offer your child proper support in their daily problems in an empathetic and non-aggressive way so you can help them feel more confident as they progress.
The moms on our discussion forums share their experience with encopresis!
- My mom had this experience with her children. She started using a system of small stickers on the calendar for every time we would use the bathroom for our bowel movements. If all the days in a month had a sticker on them, we would get a treat. She stopped after 6 months because everything was in order, and we had established the routine. – Dauph50
- My two children have had this problem, and we are beginning to solve it (they’re twins). Everything was fixed for my son when he started using the toilet because it hurt him less than the diaper. However, my daughter still refused to use the toilet; she would hold it for 5 to 6 days and the more she waited, the more it hurt. I tried everything: drinking more water, prune juice, suppositories, probiotics and so on. Finally, the doctor prescribed Lax-a-day and since then, her stools haven’t been as painful, and she no longer refuses to use the bathroom. I’m trying to reduce the medication to eventually stop it completely. She just needed to see that it wasn’t that big of a deal! – Twin
- My oldest complains that it hurts and his anus often becomes red and irritated so in the evening before bed, I put some cream on his bottom, and I tell him that tomorrow everything will be better. The next day he wakes up confident. Up to this day, this has worked every time. - Sapphire
If you suspect your child has encopresis, the first thing you should do is to consult your family doctor who can perform a clinical examination of their rectum to identify physical causes as well as a psychological examination to determine whether the problem may have a more serious underlying cause. The reasons for encopresis will determine the proposed treatment and it’s possible that a multidisciplinary team, including psycho-pediatricians, psychologists or kinesitherapists, may offer the treatment.