What is Encopresis?
Encopresis is when a child who has been toilet trained holds his stools to such an extent that the fecal matter leaks out. The fecal matter hardens in the intestine and liquid poop leaks past the mass and out through the anus. The leakage is not controlled by the child. It is more common in boys than girls.
Children don't feel the urge to poop and so don't go to the bathroom to do it. They need to learn the sensation that comes just before they relieve themselves. Some children have occasional bouts of soiling while others can go a year or more without sitting to poop and only poop accidentally. This is very worrying if you are trying to get your child ready for Kindergarten or school when he will be away from you for most of the day.
What is the cause?
It's uncertain whether it is a control issue or a medical issue.
One theory is that the child wants control over his own body, but his body tells him when to go to the bathroom and he doesn't want to give in to that feeling, so he holds it until it leaks out. It can often start with constipation. When the child is constipated and finally has a bowel movement, it hurts, so they try not to poop again. The longer they hold it, the more constipated they become and the more it hurts and so the cycle begins.
Does it ever go away?
Remember this, encopresis doesn't last forever. The child does grow out of it, although when you are going through it, you will never think that it will ever end.
Is my child doing it on purpose?
Sometimes the parent thinks that the child does it on purpose because they know how much the parent hates the mess, or that the child is doing it just for attention. But encopresis is involuntary.
Lots of fiber and fresh fruit and vegetables in your child's diet will help your child not get constipated in the first place.
Enemas and Suppositories
An enema is when a liquid (usually water) is added to the rectum to soften the stool and this helps the stool to pass. This may need to be done daily until a regular bowel movement is achieved.
A suppository is inserted into the rectum to produce a bowel movement, this will also need to be done daily to achieve a regular bowel movement.
Laxitives encourage a bowel movement by irritating the bowel. While they may be useful for a short while, they are not good to use for the long term.
Frequent consumption of licorice helps with bowel movements, but it shouldn't be taken regularly.
In extreme cases when the bowel gets impacted then surgery may be necessary.
Will my child be unpopular at school?
One thing that children with encopresis deal with is that they frequently smell of poop. This can make them unpopular with their peers, which in turn makes the child embarrassed to ask for help. The child can keep a cleaning kit at school with wet wipes and clean underwear in case of accidents.
How can I help my child?
First you need to talk to your child about the problem and tell them it's not their fault. Show them how to clean their own mess. Encourage your child to sit on the pot at the same time every day. Make it a fun experience by letting them read books, play hand held video games or play with a favorite toy. One thing that works well is to get the child to blow up a balloon or cough as they both relax the ring of muscles around the anus and frequently a poop "accidentally" happens.
If your child is motivated by sticker charts, you could give him a sticker every time he poops in the toilet and a present for 10 stickers.
How do I deal with my own anger about the situation?
Anger in parents of children with encopresis is very common. Sometimes your house stinks and your child stinks and you think you'll be cleaning poop forever. Whatever you do, don't take your anger out on the child, he really can't help it.
You need to remove your emotions from the situation, which is very easy to say, but a lot harder in practice.
Will my child have any other problems?
Remember that poop is toxic and his body really should be getting rid of it. The longer the poop stays in him the more he is retaining those toxins. Some people say that along with the constipation they see behavior problems such as ADD. The more the child is constipated, the more ADD symptoms they see. Sometimes a parent can tell that a child needs to poop by the downward spiral of their behavior.
How to prevent it in the future
Make sure your child doesn't get too constipated and doesn't relate going to the bathroom with pain. Keep lots of fiber in his diet and gently encourage him to sit and try frequently and remember that it will go away in time.