When Your Child Has Encopresis

Outline of child showing lower digestive tract.

Your child has uncontrolled leakage of stool from the anus (opening where stool leaves the body). This is called encopresis. The leakage is caused by the backup of dry, hard stool (called constipation). Hard stool piles up at the end of the rectum (where stool is stored before leaving through the anus). The lower colon and rectum may become stretched out. Your child may not even feel the need to have a bowel movement. In time, liquid stool leaks around the blockage and out through the anus. This leakage often happens without your child’s knowledge. The good news is that encopresis can be treated. 

What are the Symptoms of Encopresis?  

  • Leakage of liquid stool onto the underwear

  • Stool leakage with the passing of gas

  • Pain around the belly button or below

  • No sensation of having to pass stool before leakage happens

  • Swelling or bloating of the abdomen (belly)

What Causes Encopresis?

Encopresis is caused by constipation. Some causes of constipation that may lead to encopresis include:

  • Child holding back stool (due to prior painful bowel movement or other reason)

  • Hirschsprung’s disease, a birth defect in which nerves in the large intestine (colon) are missing

  • An anus that is closer to your child’s vagina or penis than normal (anteriorally placed anus)

How is Encopresis Diagnosed?

Close up cross section of rectum and anus showing liquid stool leaking around hard stool.

The health care provider will examine your child and ask questions. Lab tests may be needed to rule out other problems.

How is Encopresis Treated?

  • The health care provider may prescribe a stool softener to help your child have normal bowel movements.

  • The health care provider may suggest changes in diet, such as adding more fiber (which helps stool retain water).

  • The health care provider may suggest increasing water intake and exercise. 

  • Your child may have bowel retraining. This process can help your child have normal bowel movements. Your child sits on the toilet for a short time after meals. This helps the body reconnect eating with having bowel movements. Your health care provider will talk to you about the best way to start bowel retraining. Be patient. It can take 4 to 6 months or longer before encopresis goes away.