Encopresis is a condition in which a child, over the age of 4, soils their pants or defecates in an inappropriate location. In “primary encopresis”, a child has never been fully potty trained. In “secondary encopresis” a child has lost potty training skills they once had. By the time I am working with a child and family, medical explanations for the soiling have usually been ruled out.
Contrary to common belief, only a small percentage of children with encopresis engage in this behavior willfully. Most children with encopresis become this way due to chronic constipation, which then leads to leakage of fecal material around a blockage in their colon. Dietary modifications, medication and/or scheduled potty breaks are common interventions for addressing this situation.
In order to treat encopresis, I focus families and children on establishing routine, calm times of the day to attempt going to the bathroom. I educate children on how their body works and address anxieties about painful toileting experiences. Frequently a child may start to withhold their stool due to a past painful experience while going to the bathroom. They develop the false belief that if, “if I don’t poop, it won’t hurt.” In reality, regular toileting habits prevent the painful passing of large stool.
If your child is having difficulty with their toileting habits, I am available for consultation to address this problem and your concerns.