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Causes
By Mayo Clinic staffIn encopresis, stool collects in your child's colon and rectum and becomes impacted. When the colon is full of this impacted stool, some liquid stool may leak out of the anus, staining your child's underwear.
There may be two causes of encopresis:
- Constipation. Most cases of encopresis are the result of chronic constipation. In constipation, the child's stool is hard, dry and may be painful to pass. As a result, the child avoids going to the toilet — making the problem worse. The longer the stool remains in the colon, the more difficult it is for the child to push out. The colon stretches, ultimately affecting the nerves that signal when it's time to go to the toilet. When the colon becomes too full, soft or liquid stool may leak out.
- Emotional issues. Emotional stress also may trigger encopresis. A child may experience stress from premature toilet training or an important life change — for instance, the divorce of a parent or the birth of a sibling.
References
- Parenting Corner Q&A: My child is way past toilet training, but he still soils his underwear. What should I do? American Academy of Pediatrics. http://www.aap.org/publiced/BK5_Soiling.htm. Accessed Sept. 10, 2008.
- Stool soiling and constipation in children. American Academy of Family Physicians. http://familydoctor.org/online/famcoden/home/children/parents/toilet/166.printerview.html. Accessed Sept. 10, 2008.
- Berkowitz CD. Encopresis. In: Berkowitz CD. Berkowitz's Pediatrics: A Primary Care Approach. 3rd ed. Washington D.C.: American Academy of Pediatrics; 2008:223-236.
- Stafford B, et al. Child & Adolescent Psychiatric Disorders & Psychosocial Aspects of Pediatrics. In: Hay Jr. WW, et al. CURRENT Diagnosis & Treatment: Pediatrics. 19th edition. The McGraw-Hill Companies Inc.; 2009. http://www.accessmedicine.com/content.aspx?aID=3398994&searchStr=encopresis. Accessed Nov. 28, 2008.
- Nurcombe B. Developmental Disorders of Attachment, Feeding, Elimination, & Sleeping. In: Ebert MH, et al. CURRENT Diagnosis & Treatment: Psychiatry. 2nd edition. The McGraw-Hill Companies Inc.; 2008. http://www.accessmedicine.com/content.aspx?aID=3291880&searchStr=encopresis. Accessed Nov. 28, 2008.
- Vegetative Disorders: Elimination Disorders: Encopresis. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th edition. Philadelphia, Pa.: Saunders Elsevier; 2007.
- Ferry GD, et al. Definition, clinical manifestations, and evaluation of functional fecal incontinence in children. http://www.uptodate.com/online/content/topic.do?topicKey=pedigast/10533&selectedTitle=1~14&source=search_result. Accessed Nov. 28, 2008.
