BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuEncopresisSoiling; Incontinence - stool; Constipation - encopresis; Impaction - encopresisIf a child over 4 years of age has been toilet trained, and still passes stool and soils clothes, it is called encopresis. The child may or may not be doing this on purpose. Causes The child may have constipation. The stool is hard, dry, and stuck in the colon (called fecal impaction). The child then passes only wet or almost liquid stool that flows around the hard stool. It may leak out during the day or night. ConstipationConstipation in infants and children occurs when they have hard stools or have problems passing stools. A child may have pain while passing stools o...Read Article Now Book Mark Article Fecal impactionA fecal impaction is a large lump of dry, hard stool that stays stuck in the rectum. It is most often seen in people who are constipated for a long ...Read Article Now Book Mark Article Other causes may include:Not toilet training the child Starting toilet training when the child was too young Emotional problems, such as oppositional defiant disorder or conduct disorderOppositional defiant disorderOppositional defiant disorder is a pattern of disobedient, hostile, and defiant behavior toward authority figures.Read Article Now Book Mark Article Conduct disorderConduct disorder is a set of ongoing emotional and behavioral problems that occurs in children and teens. Problems may involve defiant or impulsive ...Read Article Now Book Mark Article Whatever the cause, the child may feel shame, guilt, or low self-esteem, and may hide signs of encopresis.Factors that may increase the risk of encopresis include:Chronic constipation Low socioeconomic statusEncopresis is much more common in boys than in girls. It tends to go away as the child gets older. Symptoms Symptoms can include any of the following:Being unable to hold stool before getting to a toilet (bowel incontinence) Passing stool in inappropriate places (as in the child's clothes) Keeping bowel movements a secret Having constipation and hard stools Passing a very large stool sometimes that almost blocks the toilet Loss of appetite Urine retention Refusal to sit on toilet Refusal to take medicines Bloating sensation or pain in the abdomen Exams and Tests The health care provider may feel the stool stuck in the child's rectum (fecal impaction). An x-ray of the child's belly may show impacted stool in the colon.x-ray of the child's bellyAn abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the spleen, stomach, and intestines. When the ...Read Article Now Book Mark Article The provider may perform an examination of the nervous system to rule out a spinal cord problem.Other tests may include:Urinalysis UrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...Read Article Now Book Mark Article Urine culture Urine cultureA urine culture is a lab test to check for bacteria or other germs in a urine sample. It can be used to check for a urinary tract infection in adults...Read Article Now Book Mark Article Thyroid function tests Thyroid function testsThyroid function tests are used to check whether your thyroid is working normally. The most common thyroid function tests are:Free T4 (the main thyro...Read Article Now Book Mark Article Celiac screening tests Celiac screening testsCeliac disease is an autoimmune condition that damages the lining of the small intestine. This damage comes from a reaction to eating gluten. This ...Read Article Now Book Mark Article Serum calcium test Serum calcium testThe calcium blood test measures the level of calcium in the blood. This article discusses the test to measure the total amount of calcium in your blo...Read Article Now Book Mark Article Serum electrolytes testSerum electrolytes testThe basic metabolic panel is a group of blood tests that provides information about your body's metabolism.Read Article Now Book Mark Article Treatment The goal of treatment is to:Prevent constipation Keep good bowel habits It is best for parents to support, rather than criticize or discourage the child.Treatments may include any of the following:Giving the child laxatives or enemas to remove dry, hard stool. Giving the child stool softeners. Having the child eat a diet high in fiber (fruits, vegetables, whole grains) and drink plenty of fluids to keep the stools soft and comfortable. Taking flavored mineral oil for a short period of time. This is only a short-term treatment because mineral oil interferes with the absorption of calcium and vitamin D. Seeing a pediatric gastroenterologist when these treatments are not enough. The doctor may use biofeedback, or teach the parents and child how to manage encopresis. Seeing a psychotherapist to help the child deal with associated shame, guilt, or loss of self-esteem.For encopresis without constipation, the child may need a psychiatric evaluation to find the cause. Outlook (Prognosis) Most children respond well to treatment. Encopresis often recurs, so some children need ongoing treatment. Possible Complications If not treated, the child may have low self-esteem and problems making and keeping friends. Other complications may include:Chronic constipation Urinary Incontinence When to Contact a Medical Professional Call for an appointment with your provider if a child is over 4 years old and has encopresis. Prevention Encopresis can be prevented by:Toilet training your child at the right age and in a positive way. Talking to your provider about things you can do to help your child if your child shows signs of constipation, such as dry, hard, or infrequent stools.Open ReferencesReferencesMarcdante KJ, Kliegman RM. Digestive system assessment. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 126.Noe J. Constipation. In: Kliegman RM, Lye PS, Bordini BJ, Toth H, Basel D, eds. Nelson Pediatric Symptom-Based Diagnosis. Philadelphia, PA: Elsevier; 2018:chap 16.AllVideoImagesTogRelated Information Bowel incontinence(Symptoms)Constipation in infants and children(Symptoms) Review Date: 8/29/2020 Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. 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