Encopresis, sometimes known as fecal soiling or overflow incontinence, is a complication from longstanding constipation.
Encopresis occurs when potty-trained children have bowel movements in places other than the toilet.
When constipation is severe or longstanding, stool will impact against the walls of the rectum and colon, which can disrupt the nerve signals to the brain that give your child the healthy urge to poop when it’s time. Without these signals, constipation worsens in a vicious cycle that only adds to the growing stool burden. Over time, the nerves in the colon become desensitized to the presence of stool and soiling can occur. Newer poop is liquid and, when it reaches the impaction, can leak around the fecal mass, causing encopresis. Sometimes these accidents come out as smears or liquids, which can make them easily confused for diarrhea, when the real culprit is actually constipation. It is important to note that most children are completely unaware when these accidents occur, and it is outside of their control.
Encopresis rarely causes long term complications, but can cause significant burden on both the child and their caretakers in ways that can affect the physical and the social well-being of your child.
If your child is experiencing signs of encopresis, it is important to have them evaluated by their pediatrician or a pediatric gastroenterologist. Treatment usually requires a combination of bowel clean-out techniques followed by a medication regimen (typically stool softeners and/or stimulant laxatives) uniquely tailored to your child’s needs in order to prevent reaccumulating of the stool burden. Importantly, these medications are used in addition to behavioral techniques to help address the underlying causes of constipation.
Encopresis can be diagnosed without invasive imaging or bloodwork. Depending on severity, however, additional tests may be necessary to rule out other disease processes.
For better understanding, you and your child can watch the following video from Children’s Hospital in Colorado, which can help prepare you for what we will discuss at your visit to Southeastern Gastroenterology.