Encopresis (Faecal Soiling In Children): Symptoms, Causes, Diagnosis And Treatment

Symptoms Of Encopresis

If the child has not had proper bowel movements for three days and has painful and hard stools, it is most probably an indication of constipation [2].

The most common sign of encopresis is leakage of stool or liquid stool on underwear, which can get mistaken for diarrhoea. The other signs and symptoms of encopresis are as follows [3]:

• Lack of appetite
• Abdominal pain
• Constipation with dry, hard stool
• Urinary tract infections
• Passage of large stool
• Long periods of time between bowel movements
• Problems with daytime wetting or bedwetting (enuresis)
• Repeated bladder infections (in girls)

Note: The symptoms of encopresis are not under your child's control. Although it may start as behaviour in some kids, it becomes involuntary overtime.

Causes Of Encopresis

• Constipation: The primary cause for encopresis, constipation develops when the faecal matter becomes hard and difficult to pass due to the lack of a proper diet with fibre and water, and little to no exercise [4]. When the bowel movement becomes difficult, there are chances that the loose stool can leak around the hard stool in the rectum and into the underwear.In some cases, this can also occur as a result of the intestine becoming enlarged from a faecal blockage that the child loses the sensation of needing to poop [5]. Drinking too much cow's milk, withholding stool can also lead to constipation in a child.
• Emotional issues: In some cases, emotional stress may trigger encopresis. Some of the factors that can cause stress in a child are premature toilet training, dietary changes and other changes in the child's life such as starting in a new school, schedule shifts and factors such as the birth of a sibling or separation of parents [6].

Risk Factors For Encopresis

Certain factors increase your child's risk of developing encopresis and they are mentioned below [7]:

• A change in your child's toileting routine
• Poor toilet training
• Constant episodes of constipation
• Using medications that may cause constipation, such as cough suppressants
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder
• A tissue tear in the rectum
• Anxiety or depression
• Health conditions that may cause constipation, such as diabetes or hypothyroidism
• Sexual abuse [8]

Diagnosis Of Encopresis

To diagnose encopresis, the doctor will examine the reported symptoms, medical history, and then carry out a physical exam based on the aforementioned. The physical exam may involve an examination of the rectum [9].

An abdominal X-ray may be taken to confirm the presence of dried stool. In addition to that, a psychological evaluation may be used to look for an underlying emotional cause that may be acting as a contributing factor to the condition [10].

Treatment For Encopresis

The primary step in the treatment of encopresis is clearing out the blockage and relieving constipation. The doctor may recommend mineral oils or laxatives for that. In some cases, an enema may be prescribed [11].

The next step in treatment is to improve the lifestyle and food habits of your child. Adopting a diet high in fibre will encourage the flow of bowel movements. For children ages, 4 to 8, drinking five cups of water daily can help keep stools soft for easy passage [12]. In addition to food habits, daily exercise can also help move materials through the intestines.

If the issue is rooted in emotional distress, the doctor may recommend psychotherapy with a mental health professional. Because psychotherapy can be helpful for improving the self-esteem and confidence in your child.

Note: Restrict caffeine consumption.

On A Final Note…

Accidental soiling of underpants can be bothersome and your child may experience shame as a result, which may lead to them feeling depressed or have low self-esteem. Doctors point out that with proper treatment and care, encopresis can be managed.