DefinitionEncopresis is the passage of stool in places other than the toilet. It is most often an involuntary action. Encopresis is often called stool soiling because of the stains left on underwear.Accidents are normal in infants and toddlers until they learn bowel control. It is considered abnormal in children aged 4 years and older.
CausesEncopresis may be caused by a variety of conditions such as:
- Chronic constipation
- When a large amount of hard, dry stool is filling the rectum, over time the child becomes unable to recognize the sensation of fullness and the need to go to the bathroom.
- Liquid stool may leak around the hard mass of stool, causing staining of the underwear.
- May be associated with a diet low in fiber and fluids, and lack of exercise
- Poor toilet training or refusal to use the toilet for bowel movements
- Emotional problems
- Organic causes (rare)—result of problems or malformations in the intestines
Risk FactorsThis condition is more common in males. It is also more common in children with emotional problems such as:
- Passage of firm stool that causes a painful tear or "fissure" at the opening of the anus
- Children who have suffered sexual abuse (according to some researchers)
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SymptomsThe main symptom is the accidental passage of stool, usually into the underwear. Other symptoms may include:
- Low self-esteem
- Feelings of embarrassment, shame, or guilt
- Infrequent bowel movement
- Pain or bleeding with defecation
- Abdominal pain
- Bed wetting
When Should I Call the Doctor?Call the doctor if your child has stool staining in his underwear. The doctor can help find the underlying cause.
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