Expert / 5 October, 2023 / Ellie Thompson

Encopresis In Kids: Causes, Diagnosis And How To Cope

Encopresis in kids is an often misunderstood condition, characterised by involuntary soiling beyond the age of toilet training, which can leave parents feeling lost and overwhelmed. We asked parenting expert Amanda Jenner to explain exactly what encopresis is, as well as shedding light on its causes, impact, and, most importantly, effective strategies to navigate this challenging journey.

Encopresis in kids

Begin by understanding encopresis in kids, including its causes and symptoms. This is a form of soiling involuntary and regular without any control. The symptoms are when they leak liquid without control or have stains in their pants but haven’t realised. The causes can be when a child is withholding and not letting go of their bowels, leading to severe constipation and poo becoming large and hard, which liquid can leak around.

Is my child at risk?

 Assess if your child is at a higher risk for encopresis due to family history or other factors. It can run in families if they have had trouble with constipation due to intolerances.

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When should I seek help?

Determine when it’s appropriate to seek medical advice for encopresis. 

You should seek help when the leakage becomes frequent. Your little one is complaining of stomach pains, loss of appetite, and not having regular bowel movements. Also, unusual bed wetting. 

What are the underlying causes?

Explore potential causes, such as constipation, emotional factors, or medical conditions. 

Constipation is a cause of a lack of good fibre in the diet. Also, the fear of opening their bowels can make them severely constipated as they withhold and then have no control over leaking poo when this happens. Lack of fluids can also contribute to this, so they must have regular liquids throughout the day.

How do we diagnose encopresis?

Understand the diagnostic process and what to expect during medical evaluations. 

Firstly, a doctor will ask about your child’s history and diet. They will examine the child, feel their tummy, and request a scan if necessary.

What treatments are available?

Discuss treatment options, including dietary changes, behavioral therapy, laxatives, or medication.

Treatments often work with your child to change their diet to naturally try and mend this. Increasing liquids, fibre and exercise can really help. Laxatives can also help soften the poo to make it more comfortable and help move things along less painfully. Also, try and use some encouragement methods to get your child to overcome the fear of passing poo. 

What lifestyle changes are needed?

Learn about lifestyle adjustments that can help manage encopresis, like establishing regular bathroom routines. 

Many lifestyle adjustments can be made. Increase their regular exercise, even a walk a day, as this helps keep the tummy moving. Regular visits to the bathroom help them get into a better routine and make it a daily routine. Limit sugary snacks and drinks caffeine as this will contribute to encopresis. Increase fruit into their diet daily and vegetables.

Are there emotional factors?

Investigate any emotional stressors or anxieties contributing to the condition. 

It can be linked to emotional anxiety and being around other children who find it fun to tease, and this can cause children to be worried about using the toilets at school or embarrassed about using the bathroom away from home.

How can I support my child?

Explore ways to provide emotional support and encourage open communication about the issue. 

It’s so important we talk about our bodily functions openly with our children from a young age. If they are having problems, we need to encourage them to feel okay to talk about it. Set out a reward system to make them feel good about succeeding in using the toilet. This will hugely encourage them and also turn it into a positive. But don’t over-talk about it and make it a bigger issue. Also, speak privately to their teacher so they can help, too.

Encopresis: what’s the prognosis?

Understand the long-term outlook and potential for recovery.

The long-term outlook is positive, but it can take months to overcome this, so it’s a very patient game. You have to be persistent and consistent with your approach.

What can I do at home? 

Ask about home strategies to manage encopresis effectively. 

Making daily smoothies with your child will help create a healthy gut and keep things moving. Look at your teatime meals. Make them fun and ensure you have a well-balanced diet. 

Encourage family meals whenever you can. When your child needs to use the toilet, it’s easy to feel rushed, especially with our busy schedules. However, it’s crucial to make these moments as stress-free as possible. Keep the atmosphere calm, offer encouragement, and avoid getting upset, as this can amplify their fear and anxiety.

Are there any complications?

Inquire about potential complications, such as social or self-esteem issues. 

This can have social impacts, as many children may fear attending parties or sleepovers due to the possibility of accidents, which can result in them becoming somewhat isolated from their friends. Therefore, holding playdates, even short ones at home where your child feels secure, is essential as part of this treatment plan. Additionally, having a secret code for them to communicate if they’ve had an accident can help maintain privacy and reduce embarrassment.

What should I tell my child’s school?

Discuss how to communicate with teachers and school staff about your child’s condition. 

It’s crucial to keep your childcare providers informed about the situation and the strategy you’re using to address it. Ensuring consistency among all caregivers is essential to avoid confusing the child or causing unnecessary fear.

How can we prevent relapses?

Understand strategies to prevent future episodes of encopresis. Keep a close eye on their toilet habits, and if you see this slipping, step on it ASAP. Ensure consistency in their diet and fluid intake while maintaining a positive attitude when discussing the toilet with your child to make them feel comfortable. Always offer praise and let them know how proud you are, as this goes a long way in building their confidence.

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