Materiały źródłowe

• #1

• #1 Encopresis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/encopresis/symptoms-causes/syc-20354494

  Encopresis usually occurs after age 4, when a child has already learned to use a toilet. […] In most cases, soiling is a symptom of long-standing constipation. […] The longer the stool remains in the colon, the more difficult it is for the child to push stool out. […] When the colon becomes too full, soft or liquid stool may leak out around the retained stool or loss of control over bowel movements may occur. […] Signs and symptoms of encopresis may include: Leakage of stool or liquid stool on underwear, which can be mistaken for diarrhea. […] Constipation with dry, hard stool. […] Passage of large stool that clogs or almost clogs the toilet. […] Avoidance of bowel movements. […] Long periods of time between bowel movements. […] Lack of appetite. […] Abdominal pain. […] Problems with daytime wetting or bedwetting (enuresis). […] Repeated bladder infections, typically in girls.

• #2 Encopresis Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17849-encopresis-soiling

  Encopresis, also known as functional fecal incontinence or soiling, is when children pass stool (poop) into their underwear, in most cases accidentally. It occurs in children 4 years of age and older who have been toilet trained. The condition is more common in boys than girls. It affects 1% to 4% of children who are 4 years old, and the frequency of this condition decreases with older age. […] Children with encopresis often have the following symptoms: Not being able to hold their stool until they get to a toilet. Passing stool in their clothes. Hiding bowel movements (poop) or keeping them a secret. Hiding soiled clothes. Not having regular bowel movements. Feeling bloated or experiencing pain in their abdomen or stomach. Loss of appetite. […] The most common cause of encopresis is constipation. When a child experiences constipation, its difficult to have a bowel movement because their stool is dry and hard inside their colon and it can be painful to pass.

• #2 Encopresis Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17849-encopresis-soiling

  Encopresis with constipation is called retentive encopresis. […] While you might see some progress early in treatment, it usually takes months for your child to overcome encopresis. There will be accidents along the way. Parents must keep their reactions to accidents low-key and continue to support the child. Most children who receive treatment for encopresis eventually are free from constipation and become accident-free as they grow older. […] Treatment is long-term with the goal of creating regular bowel movements for your child. It could take several months to achieve this goal. Have patience with your child as they become more comfortable using the toilet. […] Sometimes children with encopresis lose the feeling in their body that tells them it is time to use the toilet. If they have constipation, the buildup of stool could stretch their colon, and they won’t feel the need to go until there is a large amount of stool. Once your child begins treatment to loosen their stool, they will need to re-learn when their body tells them it is time to use the toilet. This process could take several months, but be patient with your child as they better understand their body.

• #3 Soiling (Encopresis) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/encopresis.html

  If your child has bowel movements (BMs) in places other than the toilet, you know how frustrating it can be. […] But many kids beyond the age of toilet teaching (generally older than 4 years) who soil their underwear have a condition known as encopresis (en-kah-PREE-sis). They have a problem with their bowels that dulls the normal urge to go to the bathroom. So they can’t control the accidents that usually follow. […] Encopresis isn’t a disease. It’s a symptom that may have different causes. […] When a child holds in BMs, the poop starts building up in the rectum and may back up into the colon and a frustrating cycle begins. […] The colon’s job is to remove water from the poop before it’s passed. The longer the poop is stuck there, the more water is removed and the harder it is to push the large, dry poop out.

• #3 Soiling (Encopresis) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/encopresis.html

  In time, the rectum and lower part of the colon get so full that it’s hard for the sphincter (the muscular valve that controls the passage of feces out of the anus) to hold the poop in. Partial BMs may pass through, causing the child to soil their pants. […] Kids can’t prevent this soiling and sometimes dont know it’s happening because the nerves aren’t sending the signals that regulate pooping. […] Encopresis is not a behavioral issue or a simple lack of self-control. […] Treatment happens in three phases: Emptying the rectum and colon of the hard poop. […] Helping your child begin having regular BMs. […] Reducing use of the stool medicines. […] Patience is the key to treating encopresis. It can take several months to a year for the stretched-out colon to return to its normal size and for the nerves in the colon to become effective again.

• #4 Encopresis in Children and Adolescents – Society of Pediatric Psychology

  https://pedpsych.org/fact_sheets/encopresis/

  Encopresis is the voluntary or involuntary passage of stool in places other than toilets. To receive a diagnosis of encopresis, the child must pass feces into inappropriate places (such as clothing or on the floor) at least once per month for three months or more. Passage of stool into inappropriate places is also known as soiling or fecal incontinence. The child must be at least 4 years old (or the developmental equivalent). The behavior must not be due exclusively to the direct physiological effect of a substance (e.g., laxatives or stool softeners) with the exception of constipation. There are two specifiers for encopresis: with constipation and overflow incontinence and without constipation and overflow incontinence (also sometimes referred to as nonretentive fecal incontinence). Assessment and treatment of encopresis is based on a biobehavioral model.

• #4 Encopresis in Children and Adolescents – Society of Pediatric Psychology

  https://pedpsych.org/fact_sheets/encopresis/

  Encopresis has been estimated to occur in approximately 4 percent of 4-year-olds and 1.6 percent of 10-year-old children, affecting boys three to six times more often than girls. As many as 95 percent of children referred for the treatment of encopresis present with functional constipation or constipation without identifiable cause (e.g., medical conditions or side effects of medication). Experiences such as painful defecation, psychosocial stressors (e.g., entering school or the birth of a sibling), and challenges during toilet training may predispose some children to functional constipation. Encopresis and enuresis (urinating in inappropriate locations) commonly co-occur. […] Two types of trajectories have been described for children with encopresis: primary and secondary. In primary encopresis, the child has never been successfully toilet trained whereas, a child with secondary encopresis had a period of six months or more in which they were continent of stool.

• #5 Encopresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560560/

  The prevalence of encopresis worldwide is estimated between 0.8% and 7.8%. In the United States, a prevalence rate of 4% for functional encopresis was found in a retrospective review in four hundred and eighty-two children, 4 to 17 years of age, attending a primary care clinic. Encopresis was related to constipation in 95% of the children in this study. Fecal incontinence is more common in boys, having a male-to-female ratio of 3:1 to 6:1. Functional encopresis is more common in younger children (prevalence 4.1% in children ranging from 5 to 6 years of age and 1.6% in 11- to 12-year-olds), and the majority of children seek medical care at the age of 7 to 8 years. Encopresis can also be seen during the young adulthood period. Encopresis usually happens during the day time, and organic causes should be considered if the provider encounters the patient who presents with only nocturnal encopresis.

• #5 Encopresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560560/

  Encopresis or fecal incontinence is defined as the involuntary passing of stool into inappropriate places such as the underwear in children older than four years of age. It represents severe psychological distress on children and their families. In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), encopresis criteria consisted of the repeated passage of stool into inappropriate places, and it can be either voluntarily or involuntarily. These encopretic events should occur for at least three months. The diagnosis cannot be made below the age of four. The encopresis of fecal incontinence also called soiling or fecal overflow incontinence. […] Encopresis can be divided into constipation-associated encopresis or overflow encopresis, and non-retentive encopresis. More than 80% of the children with encopresis have retentive fecal incontinence. Other organic non-functional causes for encopresis include repaired anorectal malformation, postsurgical Hirschsprung disease, spinal dysraphism, spinal cord trauma, spinal cord tumor, cerebral palsy, and myopathies affecting the pelvic floor and external anal sphincter. Encopresis in children can also be subclassified into primary, in those children who have never been toilet trained, and secondary, where incontinence returns after successful toilet training.

• #5 Encopresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560560/

  Most children treated for retentive encopresis are eventually cured, although the time required for treatment varies, and relapses are frequent. A systematic review found that only half of all children with constipation followed for 6 to 12 months after therapy did well without laxatives. Treatment needs to resume if constipation or fecal incontinence recurs. Early age of onset of constipation and family history were predictive of the persistence of symptoms. On the other hand, there is little evidence about the long-term outcome in children with non-retentive encopresis. In one study where children with non-retentive encopresis were followed for ten years, only 29% of children were having less than one episode of fecal incontinence in two weeks after two years of medical and behavioral therapy. At the age of 18 years, 15% of children progressed to adulthood with fecal incontinence. No prognostic factors for success were found in this study.

• #5 Encopresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560560/

  In the absence of organic causes, encopresis is secondary to overflow, and therefore results from the presence of constipation. Withholding of stool creates a vicious circle of accumulation of feces and hardening of the fecal mass in the rectosigmoid colon. Finally, feces leak between the solid fecal mass and rectal wall and come out through the anal canal when the sphincter muscles are relaxed. The volume of fecal matter that leaks out is usually small and, most of the time, just stain the underwear. […] Risk factors for functional encopresis are low socioeconomic background, unhygienic toilets, living in an urban area or war-affected zone, hospitalization of the child for another illness, and bullying at school. Psychological and behavioral problems such as aggressive behavior, depression, social withdrawal, anxiety, disruptive and oppositional behavior, and poor school and social performances were noted in one-third of children with functional encopresis.

• #6

  https://www.shrinerschildrens.org/en/pediatric-care/encopresis

  Encopresis is constipation caused when impacted stool collects in the colon and rectum. Encopresis typically occurs in children with the ability to toilet train, but who have developed severe, chronic constipation, which leads to stools that are infrequent or hard to pass. […] It can also occur in children with anatomical abnormalities that lead to developing constipation. While most of these children have the ability to control their bowel movements, they become so constipated that stool impacts and then overflows. […] What Are the Symptoms of Encopresis? […] Leakage of stool or liquid stool on underwear, which can be mistaken for diarrhea […] Constipation with dry, hard stool […] Passage of large stool that clogs or almost clogs the toilet […] Avoidance of bowel movements […] Long periods of time between bowel movements […] Lack of appetite […] Stomach pain […] Problems with daytime wetting or bedwetting (enuresis) […] Repeated bladder infections, typically in girls.

• #6

  https://www.shrinerschildrens.org/en/pediatric-care/encopresis

  Treatment is focused on preventing constipation and can be done through diet and medications. In some cases a bowel management program can be used to identify the correct medication dosage, and rarely, in very severe cases, surgery may be needed to help normalize bowel function and help prevent soiling. […] The good news is that with patience, encouragement and the right treatment, most children can develop good bowel control and live normal lives. […] Our goal is for your child to empty their bowel daily with no accidents and to live with as few limitations as possible. Success depends on your child’s condition and following your plan closely.

• #7 Encopresis Symptoms, Causes, Treatments, & More

  https://www.webmd.com/digestive-disorders/encopresis

  More than 80% of children with encopresis have experienced constipation or painful defecation in the past. […] Most children with encopresis say they have no urge to pass a bowel movement before they soil their underwear. […] In many children with encopresis, their colon has become stretched out of shape, so they may intermittently pass extremely large bowel movements.

• #8 Encopresis in Children | Causes, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/e/encopresis

  Children with encopresis, also called soiling, have bowel movements or leak a small amount of stool in their underclothes or on themselves. Soiling is very common, occurring in at least two out of 100 children. […] Soiling is often the result of constipation. Constipation often begins when children hold back, or with-hold, their bowel movements. […] When children hold in their poop, the lower colon fills up. Over time this can stretch the lower colon out of its normal shape. The more a child holds in poop, the more the colon stretches, and the poop gets larger and harder. This makes pooping even more painful. When this happens over and over again, the colon becomes so stretched and floppy that the muscles children use to help push out poop do not work well. Hard poop can get stuck and only liquid can pass around the hard poop. The stretched nerves become less sensitive and the child does not feel the leaking poop.

• #8 Encopresis in Children | Causes, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/e/encopresis

  Some children will hold their poop in for many days then pass a very large, hard stool. This poop can be so large that it clogs the toilet, but children will also leak liquid poop at the same time. […] Other things you may see in children who soil: They often cannot feel or even smell that they have soiled. […] Until the lower colon regains muscle tone, children may still soil.

• #9 Encopresis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/encopresis

  In some cases, the intestines may become so enlarged from fecal blockage that your child loses the sensation of needing to poop. […] Just because encopresis is associated with psychological causes doesnt mean that the symptoms are under your childs control. Theyre most likely not soiling themselves on purpose. The problem may begin because of controllable situations, such as fear of using a public toilet or not wanting to be toilet trained, but it becomes involuntary over time.

• #9 Encopresis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/encopresis

  The most common symptom of encopresis is soiled underpants. Constipation happens before encopresis, but may not be recognized. If your child hasnt had a bowel movement in three days or passes hard, painful stools, they may be constipated. […] Other symptoms may include: a lack of appetite, abdominal pain, urinary tract infections. […] Your child may also experience shame and guilt as a result of soiling. They may even be teased at school if their classmates find out about the problem. As a result, some children may show signs of secretive behavior around the issue. For example, they may hide their soiled underwear. […] Fecal matter can become hard and difficult to pass if your child doesnt get enough fiber, water, or exercise, or if they hold in a bowel movement. This can cause bowel movements to be painful. Liquid fecal matter or a soft bowel movement can then leak around the hard stool in the rectum and into a childs underpants. The child cant consciously control this soiling.

• #10 Encopresis (Fecal Soiling) in Children | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/encopresis/

  The following are the most common symptoms of encopresis. However, each child may experience symptoms differently. Symptoms may include: Loose, watery stools […] Involuntary stooling, or needing to have a bowel movement with little or no warning, which may soil underwear when a child cannot get to the bathroom in time […] Scratching or rubbing of the anal area due to irritation by watery stools […] Withdrawal from friends, school, and/or family. […] Until the intestine and rectum regain their muscle tone, children may still have „accidents” and soil their underwear on occasion.

• #10 Encopresis (Fecal Soiling) in Children | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/encopresis/

  Encopresis is a problem that children can develop due to chronic constipation. With constipation, children have fewer bowel movements than normal, and the bowel movements they do have can be hard, dry and difficult to pass. […] The child may avoid using the bathroom to avoid discomfort. Stool can become impacted and unable to move forward. The rectum and intestine become enlarged due to the hard, impacted (backed up) stool. Eventually, the rectum and intestine have problems sensing the presence of stool, and the anal sphincter (the muscle at the end of the digestive tract that helps hold stool in) loses its strength. Liquid stool can start to leak around the hard, dry, impacted stool, soiling a child’s clothing. […] Encopresis can cause both physical and emotional problems. Impacted stool in the intestine can cause abdominal pain, as well as loss of appetite. Some children develop bladder infections. Other health problems may cause chronic constipation, including diabetes, hypothyroidism, Hirschsprung disease and inflammatory bowel disease.

• #11 Encopresis

  https://healthlibrary.somc.org/Library/DiseasesConditions/Pediatric/AdolescentMed/90,P01992

  Symptoms of encopresis may look like other health conditions. Always see your child’s healthcare provider for a diagnosis. […] Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. […] Encopresis can cause both physical and emotional problems. […] It can also cause a loss of appetite. Some children may get bladder infections. […] Children with encopresis often feel upset by the accidents they have when they soil their clothes. […] It can also affect how they deal with other people. Children are often ashamed or embarrassed by this problem. […] If your child’s encopresis is caused by another health problem, treating that condition may help. […] Making changes in your child’s diet and activity level may help prevent constipation and stool soiling. […] If your child soils their underwear, dont get angry or punish your child. […] Encopresis presents challenges for the family. Coordinating care among professionals in the school and medical community is important for recovery.

• #12 About encopresis | Children’s Wisconsin

  https://childrenswi.org/medical-care/gastroenterology-liver-and-nutrition-program/conditions/encopresis

  Encopresis can cause both physical and emotional problems for the child and the family. […] Impacted (backed up) stool in the intestine can cause abdominal pain, as well as loss of appetite. Some children develop bladder infections. […] The following are the most common symptoms of encopresis. However, each child may experience symptoms differently. Symptoms may include: Loose, watery stool accidents or smears or streaks in the undergarments. […] Involuntary stooling, or needing to have a bowel movement with little or no warning, which may soil underwear when a child cannot get to the bathroom in time. […] Symptoms of encopresis may resemble other conditions or medical problems. Please consult your child’s physician for a diagnosis. […] Specific treatment for encopresis will be determined by your child’s health care provider based on the following: The extent of the problem […] Until the intestine and rectum regain their muscle tone, children may still have „accidents” and soil their underwear on occasion.

• #13 Encopresis (Fecal Soiling) in Children Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/encopresis-fecal-soiling-in-children.html

  In most children with encopresis, the most obvious signs are: Soiled underpants […] A foul body odor (the smell of stool) […] Other signs and symptoms may include: Periods of constipation (no bowel movements) alternating with very large bowel movements […] Pain in the lower abdomen or rectum […] In rarer cases, when encopresis is caused by serious psychological problems, a child may drop or smear stool on floors, walls or furniture. […] Most children with encopresis either outgrow the problem or respond to treatment. Treatment may involve changes in diet, medication and motivational therapy. […] When encopresis is related to psychological or emotional problems, treatment may take longer.

• #14 Soiling (Encopresis) | Rady Children’s Hospital

  https://www.rchsd.org/health-article/soiling-encopresis/

  When a child holds in BMs, the poop starts building up in the rectum and may back up into the colon and a frustrating cycle begins. […] The colons job is to remove water from the poop before its passed. The longer the poop is stuck there, the more water is removed and the harder it is to push the large, dry poop out. […] Then, the colon cant easily push the hard poop out, and its painful to pass. So the child continues to avoid having a BM, often by dancing, crossing the legs, making faces, or walking on tiptoes. […] In time, the rectum and lower part of the colon get so full that its hard for the sphincter (the muscular valve that controls the passage of feces out of the anus) to hold the poop in. Partial BMs may pass through, causing the child to soil his or her pants. […] Kids cant prevent this soiling nor do they have any idea its happening because the nerves arent sending the signals that regulate pooping.

• #14 Soiling (Encopresis) | Rady Children’s Hospital

  https://www.rchsd.org/health-article/soiling-encopresis/

  Call the doctor if your child has any of these symptoms of encopresis: poop or liquid stool in the underwear when your child isnt ill, hard poop or pain when having a BM, toilet-clogging BM, belly pain, loss of appetite, blood on the toilet paper when wiping or dripping into the toilet bowl. […] Encopresis is not a behavioral issue or a simple lack of self-control. Punishing or humiliating a child with encopresis will only make matters worse. […] Treatment happens in three phases: Emptying the rectum and colon of the hard poop. […] Helping your child begin having regular BMs. […] Reducing use of the stool medicines. […] Keep in mind that relapses are normal, so dont get discouraged. […] Patience is the key to treating encopresis. It can take several months to a year for the stretched-out colon to return to its normal size and for the nerves in the colon to become effective again.

• #14 Soiling (Encopresis) | Rady Children’s Hospital

  https://www.rchsd.org/health-article/soiling-encopresis/

  Successful treatment of encopresis depends on the support a child gets. Some parents find that positive reinforcement helps to encourage the child throughout treatment. […] With lots of love, support, and reassurance that theyre not the only one in the world with this problem, your child can overcome encopresis.

• #14 Soiling (Encopresis) | Rady Children’s Hospital

  https://www.rchsd.org/health-article/soiling-encopresis/

  A large, hard poop may also cause a tear in the skin around the anus that will leave blood on the stools, the toilet paper, or in the toilet. […] Parents can get frustrated if their child seems unfazed by the poop accidents, which happen mostly during waking hours. […] Denial may be one reason for a child seeming calm kids cant face the shame and guilt they feel about the condition. Some even try to hide their soiled underpants from their parents. […] Another reason may be more scientific: Because the brain gets used to the smell of poop, the child may no longer notice the odor. […] Most encopresis cases are due to constipation. Stool (poop) is hard, dry, and difficult to pass when a person is constipated. Many kids hold their BMs to avoid the pain they feel when they go to the bathroom, which sets the stage for having a poop accident.

• #15

  https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Soiling-Encopresis.aspx

  With time, these retained stools become harder, larger and much more difficult to pass. Bowel movements then can be painful, which further discourages these children from passing the stools. […] Eventually, the sphincters (the muscular valves that normally keep stools inside the rectum) are no longer able to hold back all the stool. Large, hard feces may be retained in the colon (large intestine) and rectum, but liquid stool can begin to seep around this impacted mass, passing through the anus and staining the underwear. At other times, semiformed or partial bowel movements may pass into the underwear, and because of the decreased sensation, the child may not be aware of it. […] Encopresis is a chronic, complex but solvable problem. However, the longer it exists, the more difficult it is to treat. The child should be taught how the bowel works, and that he can strengthen the muscles and nerves that control bowel function.

• #15

  https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Soiling-Encopresis.aspx

  Encopresis is one of the more frustrating disorders of middle childhood. It is the passing of stools into the underwear or pajamas, far past the time of normal toilet training. Encopresis affects about 1.5 percent of young school children and can create tremendous anxiety and embarrassment for children and their families. […] Doctors divide cases of encopresis into two categories: primary and secondary. Children with the primary disorder have had continuous soiling throughout their lives, without any period in which they were successfully toilet trained. By contrast, children with the secondary form may develop this condition after they have been toilet trained, such as upon entering school or encountering other experiences that might be stressful. […] When encopresis occurs, it begins with stool retention in the colon. Many of these youngsters simply may not respond to the urge to defecate and thus withhold their stools. As the intestinal walls and the nerves within them stretch, nerve sensations in the area diminish. Also, the intestines progressively lose their ability to contract and squeeze the stools out of the body. Therefore, these children find it increasingly difficult to have a normal bowel movement. Most of these children are chronically constipated.

• #16 Encopresis | Psychology Today

  https://www.psychologytoday.com/us/conditions/encopresis

  For a diagnosis of encopresis, according to the DSM-5: A child passes feces involuntarily or on purpose into clothing, on the floor, or in other inappropriate places. This occurs at least once a month for more than three months. The child is at least 4 years old (or at an equivalent level of development). This behavior must not be attributable to a substance’s physiological effects or another medical condition. […] Encopresis can be further classified according to two subtypes: with constipation and overflow incontinence and without them. […] With constipation and overflow incontinence: There is evidence of constipation. Leakage may or may not occur frequently. Episodes happen mostly during the day. […] Without constipation and overflow incontinence: There is no evidence of constipation. Soiling is intermittent. Feces may be left in a prominent place. The behavior may coincide with the presence of oppositional defiant disorder or conduct disorder.

• #17 Encopresis | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/encopresis

  Encopresis can cause both physical and emotional problems. Stool that is backed up (impacted) in the intestine can cause belly (abdominal) pain. It can also cause a loss of appetite. Some children may get bladder infections. […] Children with encopresis often feel upset by the accidents they have when they soil their clothes. In most cases, they can’t control this stool leakage. This can affect how they feel about themselves, or their self-esteem. It can also affect how they deal with other people. […] If your child’s encopresis is caused by another health problem, treating that condition may help. […] Making changes in your child’s diet and activity level may help prevent constipation and stool soiling. But solving encopresis may be harder for some children.

• #18 Faecal incontinence, soiling or encopresis | Raising Children Network

  https://raisingchildren.net.au/school-age/health-daily-care/toileting/faecal-incontinence

  Faecal incontinence is when children who are 4 years old or older cant control when and where they do a poo. This means that they regularly do poos in places other than the toilet, most often in their underwear. […] The main symptom of faecal incontinence is pooing in places other than the toilet, usually in underwear. This can range from skid marks to larger bits of poo. Its quite common for children to say that they cant feel or smell that theyve done a poo. […] Because the most common cause of faecal incontinence is constipation, you might see symptoms of constipation in children with faecal incontinence. These include pain when doing a poo, large or hard poos, or less frequent poos. Children might try to avoid doing a poo or have tummy pains. […] Some children with faecal incontinence also have daytime wetting or night-time wetting. […] All children learn to control their bowels at their own rate. If your child has developmental delays, toilet training might take longer for them.

• #19 Encopresis

  https://healthlibrary.uwmedicine.org/wellness/bloodpressure/tools/quizzes/90,P01992

  Encopresis is when your child leaks stool into their underwear. It’s also called stool soiling. It’s most often because of long-term (chronic) constipation. Encopresis happens to children ages 4 and older who have already been toilet trained. […] In most cases, stool soiling happens by accident. Encopresis can be very embarrassing for your child. […] Each child’s symptoms may vary. Symptoms may include: Having loose, watery stools. Needing to have a bowel movement with little or no warning, called involuntary stooling. Your child may soil underwear if they can’t get to the bathroom in time. […] Symptoms of encopresis may look like other health conditions. Always see your child’s healthcare provider for a diagnosis. […] Encopresis can cause both physical and emotional problems. Stool that is backed up (impacted) in the intestine can cause belly (abdominal) pain. It can also cause a loss of appetite. Some children may get bladder infections.

• #20 Encopresis | ABC Medical Center

  https://centromedicoabc.com/en/padecimientos/encopresis/

  It is a condition that occurs in children over five years old who have learned to use the bathroom, but who defecate involuntarily due to the effect of accumulated fecal matter in the colon and rectum. […] The most common cause of encopresis is chronic constipation, in which the feces dry and harden, making it painful to defecate, which is why the child avoids going to the bathroom, aggravating the situation, since the longer the stool remains, the colon stretches and fills, passing soft or liquid stools around the hard ones or causing loss of control of bowel movements, which can be embarrassing for the child and parents. […] The characteristic symptoms consist of: Abdominal pain. Constipation. Incontinence problems. Avoid defecation. Recurrent bladder infections, especially in girls. Lack of appetite. Large stool that clogs the toilet. Involuntary escape of liquid stool. Scratching or rubbing the anal area due to irritation. Prolonged time between one evacuation and another. […] Treatment will be based on the symptoms, severity, and general condition of the child, but generally includes: Elimination of retained feces through: Enemas, Laxatives, Suppositories, Medications that help keep stools soft for several months.

• #21 Encopresis DSM-5 307.7 (F98.1)

  https://www.theravive.com/therapedia/encopresis-dsm–5-307.7-(f98.1)

  In some cases, encopresis can be volitional in nature. Children presenting with oppositional defiant disorder and/or conduct disorder may use inappropriate soiling as a form of retaliation or as a way to demonstrate the anger that they feel towards their parents and other authority figures. Further, while not common in older children, younger children or infants may find it interesting to play with or smear their feces, if given the opportunity. Children who do engage in this practice may have further psychiatric issues that should be explored. In other cases, fecal smearing may result when an embarrassed child attempts to hide or clean up feces that were involuntarily passed. Due to the variability of causes leading to this activity, a full investigation and psychological work up may be warranted (Klyko Kay 2012).

• #22 Encopresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/928795-overview

  Encopresis is the involuntary discharge of feces (ie, fecal incontinence). In most cases, it is the consequence of chronic constipation and resulting overflow incontinence, but a minority of patients have no apparent history of constipation or painful defecation. […] Symptoms of encopresis may include the following: History of constipation (sometimes very remote) or painful defecation (~80-95% of children with encopresis). […] In most patients, the diagnosis of encopresis is established on the basis of the history and complete physical examination, including a rectal examination. […] In most cases, encopresis is thought to develop as a consequence of chronic constipation with resulting overflow incontinence. Approximately 80-95% of children with encopresis have a history of constipation or painful bowel movements. […] Even with aggressive medical and behavioral interventions, as many as 30% of children remain symptomatic. […] Nonretentive encopresis may be associated with oppositional defiant disorder and conduct disorder.

• #23 When Your Child Has Encopresis | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/when-your-child-has-encopresis

  Belly swelling or bloating […] Your child may have bowel retraining. This process can help your child have normal poop (bowel movements). Your child sits on the toilet for a short time after meals. This helps the body reconnect eating with having bowel movements. Your child’s provider will talk with you about the best way to start bowel retraining. Be patient. It can take 4 to 6 months or longer before encopresis goes away.

• #24 Managing Encopresis in Schools | Show Me School Health

  https://showmeschoolhealth.org/resources/managing-encopresis-in-schools/

  The management of encopresis depends on the type of fecal incontinence. For students with constipation-associated (retentive) functional fecal incontinence, management focuses on treating the underlying constipation using both behavioral modification and laxatives. For children with non-retentive fecal incontinence, management involves similar behavioral interventions, with particular attention to identifying the trigger for the episodes of incontinence but without laxative therapy. […] The process of bowel retraining, with readjustment of the nerves and muscles in the rectum, can take as long as six months to several years. Relapse is not uncommon.

• #25 Encopresis (Fecal Incontinence) – MD Searchlight

  https://mdsearchlight.com/gut-health/encopresis-fecal-incontinence/

  For non-retentive encopresis (not related to constipation), the long-term outcomes are less clear. One study found that after ten years of follow-up, only 29% of children with non-retentive encopresis experienced less than one episode of fecal incontinence in a two-week period, even after two years of medication and behavioral therapy. By the time these children turned 18, 15% of them still had difficulties controlling their bowel movements. No factors were found to predict successful outcomes in this study.

• #26 Encopresis: Definition, causes, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/encopresis

  Encopresis is repeated episodes of stool soiling in children who are more than 4 years old. […] For a diagnosis of encopresis, stool soiling must occur at least once a month for a minimum of 3 months. […] Signs and symptoms of encopresis include: needing to pass stool suddenly, with little warning; avoiding bowel movements; loose, watery stools resembling diarrhea; constipation; stomach pain; passing very large, hard, dry stools; rubbing the anal area, due to pain; hiding soiled underwear; loss of appetite; feelings of stress, anxiety, or guilt. […] Most children with encopresis will overcome the condition with treatment and caregiver support. It may take several months for children to regain normal bowel function. During this time, relapses can be frequent. […] According to some studies, up to 30% of children with encopresis will continue to experience chronic constipation into adulthood.

• #27

• #28 Encopresis: Symptoms, Mental Health, and Treatment

  https://psychcentral.com/disorders/encopresis-symptoms

  It’s important for parents and caregivers not to punish children for soiling themselves. This can backfire and make the problem worse. […] If your child is experiencing encopresis, the first step is to get them evaluated by a qualified medical professional, like a pediatrician. […] While many children can outgrow encopresis, it’s something that may continue into adulthood if it’s not addressed during childhood.

• #28 Encopresis: Symptoms, Mental Health, and Treatment

  https://psychcentral.com/disorders/encopresis-symptoms

  The root cause of encopresis is chronic constipation. Chronic constipation can happen for several reasons, including because a child holds their bowel movements in. […] Your child may begin to hold their stool, creating a cycle of constipation and overflow incontinence because they have an unusually painful bowel movement, have an anal fissure, have an infection, don’t want to use the toilet in a specific environment, like at school, or don’t want to stop doing what they’re doing to use the bathroom. […] A combination of medication and behavioral therapy is often the most successful treatment for encopresis. […] Treatment for constipation may include oral or rectal medications, such as stool softeners to flush out the bowels. […] Behavioral treatment helps encourage healthy bowel movements.

• #28 Encopresis: Symptoms, Mental Health, and Treatment

  https://psychcentral.com/disorders/encopresis-symptoms

  Encopresis refers to when a child empties their bowels anywhere but the toilet. It can be voluntary or involuntary. Your child may do this in their clothes, on the floor, or elsewhere. […] Understanding the symptoms of encopresis and why it happens can help you quickly address the situation and help your child. […] A medical professional will diagnose your child with encopresis if they: have bowel movements in inappropriate places, have inappropriate bowel movements at least once a month for at least 3 months, are at least 4 years old, aren’t on any medication that causes the soiling. […] Sometimes, children with encopresis experience enuresis, also known as urinating in inappropriate places. […] Children with encopresis may also complain that their stomach hurts. This happens because constipation can cause abdominal pain, bloating, and cramping.

• #29 Pediatric encopresis (bowel impaction) – Children’s Health Gastroenterology (GI)

  https://www.childrens.com/specialties-services/conditions/pediatric-encopresis

  Pediatric encopresis (encopresis) occurs when the colon becomes too full and liquid stool (bowel impaction) involuntarily leaks into the underwear. Encopresis is sometimes mistaken for diarrhea. […] Also known as soiling or fecal incontinence, encopresis is the repeated, involuntary leaking of stool into a childs underwear. In most cases, encopresis occurs due to chronic (long-term) constipation. When the colon and rectum become too full of impacted stool (as in constipation), liquid stool leaks around the impact, out of the rectum and into the underwear. […] Encopresis is typically diagnosed in children age 4 or older, after theyve been toilet trained. […] What are the signs and symptoms of pediatric encopresis? Bedwetting, Chronic bladder infections (in girls), Chronic constipation, Daytime wetting (incontinence), Going long periods of times (usually several days) between stooling, Large stools that clog the toilet, Leakage of solid or liquid stool into the underwear, Little interest in eating, Pain in the abdomen. […] Chronic constipation is the typical cause of encopresis. Much less frequently, emotional issues can cause encopresis.

• #30 Patient Basics: Encopresis (Fecal Soiling) | 2 Minute Medicine

  https://www.2minutemedicine.com/patient-basics-encopresis-fecal-soiling/

  In rare cases, encopresis is related to medical problems involving the nerves in the spine or the bowel wall. […] Boys have encopresis more often than girls. […] In most children with encopresis, the most obvious signs are soiled underpants and a foul body odor. […] Other signs and symptoms may include periods of constipation alternating with very large bowel movements, streaks of blood on the outside of stool, pain in the lower abdomen or rectum, stool-stained clothes hidden in closets, and bedwetting. […] In rarer cases, when encopresis is caused by serious psychological problems, a child may drop or smear stool on floors, walls or furniture. […] With treatment, most children will recover from encopresis. […] The length of treatment varies greatly depending on the child and the circumstances.

• #31 Encopresis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/encopresis/

  The longer the stool remains in the colon, the more difficult it is for the child to push stool 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 around the retained stool or loss of control over bowel movements may occur. […] Emotional stress may trigger encopresis. A child may experience stress from: Premature, difficult or conflict-filled toilet training; Changes in the child’s life, such as dietary changes, toilet training, starting school or schedule changes; Emotional stressors, for example, the divorce of a parent or the birth of a sibling. […] Generally, the earlier that treatment begins for encopresis, the better. The first step involves clearing the colon of retained, impacted stool. After that, treatment focuses on encouraging healthy bowel movements.

• #32

  https://www.nuhs.edu.sg/patient-care/find-a-condition/enuresis-and-encopresis

  Functional Encopresis refers to the passage of faeces into inappropriate places involuntarily or intentionally, during the day or at night. […] The symptoms are: […] Encopresis: Repeated passage of faeces into inappropriate places (e.g., clothing or floor), involuntarily or intentionally. […] The behaviour has occurred at least once a month for at least three consecutive months. […] The child must be at least four years old. […] The behaviour is not substance-induced (e.g., laxatives) or due to a general medical condition (except constipation).

• #33 Encopresis – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/constipation/encopresis/

  Encopresis is a problem that children age four or older can develop due to long-term constipation. Children have fewer bowel movements than normal when they are constipated, and the bowel movements they do have can be hard, dry and difficult to pass. […] The following are the most common symptoms of encopresis. However, each child may experience symptoms differently. Symptoms may include: Loose, watery stools […] Involuntary stooling, or needing to have a bowel movement with little or no warning, which may soil underwear when a child cannot get to the bathroom in time […] Scratching or rubbing of the anal area due to irritation by watery stools […] Withdrawal from friends, school and/or family […] Hiding their underwear. […] Symptoms of encopresis may look like other conditions or medical problems. Please consult your child’s doctor for a diagnosis.

• #34 Encopresis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/encopresis

  Encopresis is a problem that children age 4 or older can develop due to chronic (long-term) constipation. With constipation, children have fewer bowel movements than normal, and the bowel movements they do have can be hard, dry and difficult to pass. […] The child may avoid using the bathroom to avoid discomfort. Stool can become impacted (packed into the rectum and large intestine) and unable to move forward. The rectum and intestine become enlarged due to the hard, impacted stool. Eventually, the rectum and intestine have problems sensing the presence of stool, and the anal sphincter (the muscle at the end of the digestive tract that helps hold stool in) loses its strength. Liquid stool can start to leak around the hard, dry, impacted stool, soiling a child’s clothing. […] The following are the most common symptoms of encopresis. However, each child may experience symptoms differently. Symptoms may include: Loose, watery stools, Involuntary stooling, or needing to have a bowel movement with little or no warning, which may soil underwear when a child cannot get to the bathroom in time, Scratching or rubbing of the anal area due to irritation by watery stools, Withdrawal from friends, school, and/or family, Hiding their soiled underwear. […] Symptoms of encopresis in children may look like other gastrointestinal (GI) conditions or medical problems. Please consult your child’s doctor for a diagnosis.

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