Soiling; Incontinence – stool
Definition of Encopresis
Encopresis is the voluntary or involuntary passage of stools in a child who has been toilet trained (typically over age 4), which causes the soiling of clothes.
Causes, incidence, and risk factors
Encopresis is frequently is associated with and fecal impaction. Often, hard fecal material remains in the colon and the child only passes a soft or semi-liquid stool around the impacted stool. Leakage of stool may occur during the day or night. There are rarely physical causes other than constipation (sometimes present since infancy).
Signs and tests
Digital examination of the rectal area may show a fecal impaction. An abdominal x-ray may confirm impacted stool in the colon.
The goal is to prevent constipation and encourage good bowel habits. Laxatives, and sometimes enemas, are used to remove fecal impaction. A stool softener is often prescribed.
Most children respond to treatment.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. – 9/13/2009