Moczenie kałowe
Charakterystyka, pielęgnacja i opieka

Moczenie kałowe (enkopreza) to medyczny problem dotyczący dzieci powyżej 4. roku życia, charakteryzujący się mimowolnym oddawaniem stolca w nieodpowiednich miejscach, najczęściej w bieliznę. Występuje u 1-3% dzieci, z przewagą chłopców (6:1). Najczęstszą przyczyną jest przewlekłe zaparcie, prowadzące do retencyjnego moczenia kałowego, gdzie twardy stolec blokuje odbytnicę, a płynny stolec przecieka wokół niego. Mechanizm patofizjologiczny obejmuje rozciągnięcie odbytnicy i osłabienie zwieracza odbytu, co skutkuje utratą kontroli nad wypróżnieniami. Objawy to m.in. plamienie bielizny, nagła potrzeba wypróżnienia, ból brzucha, zaparcia, a także objawy psychologiczne, takie jak lęk i niska samoocena. Diagnostyka opiera się na wywiadzie, badaniu fizykalnym i ewentualnie badaniach obrazowych.

Moczenie kałowe – wprowadzenie

Moczenie kałowe (enkopreza, soiling) to stan, w którym dziecko po ukończeniu 4. roku życia, a więc po wieku, w którym zwykle osiąga się kontrolę nad wydalaniem, oddaje stolec w nieodpowiednich miejscach, najczęściej w bieliznę12. Problem ten dotyka około 1-3% dzieci i występuje częściej u chłopców niż u dziewczynek, w stosunku 6:134. Moczenie kałowe i zaparcia są jednym z głównych powodów wizyt pediatrycznych u gastroenterologów dziecięcych5.

Istotne jest zrozumienie, że moczenie kałowe nie jest problemem behawioralnym ani brakiem samokontroli u dziecka, ale stanowi problem medyczny, który wymaga odpowiedniego leczenia i wsparcia67. Dzieci nie mogą kontrolować tych incydentów i czasami nawet nie są świadome, że do nich dochodzi, ponieważ nerwy nie wysyłają odpowiednich sygnałów regulujących wydalanie5.

Przyczyny moczenia kałowego

Najczęstszą przyczyną moczenia kałowego są przewlekłe zaparcia. Gdy dziecko cierpi na zaparcia, duży, twardy kawałek stolca może zablokować się w końcowej części jelita (odbytnicy)8. W konsekwencji, płynny stolec z górnej części jelita przecieka wokół zatrzymanego twardego stolca i wycieka, plamiąc bieliznę dziecka9. Ten typ moczenia kałowego nazywany jest retencyjnym2.

Do rozwoju zaparć może prowadzić wiele czynników10:

  • Niedobór błonnika w diecie i ogólna dieta
  • Choroba
  • Niewystarczające spożycie wody i płynów
  • Lęk przed korzystaniem z toalety
  • Ograniczony dostęp do toalety

Niektóre dzieci mogą również rozwinąć przewlekłe zaparcia w następstwie stresujących wydarzeń życiowych, takich jak znęcanie się, rozwód lub śmierć krewnego10. Zdarza się, że dzieci celowo wstrzymują wydalanie stolca, co prowadzi do zaparć, a następnie do moczenia kałowego11.

W rzadszych przypadkach moczenie kałowe może być związane z problemami emocjonalnymi lub psychologicznymi, takimi jak lęk lub stres1213. Może również wystąpić w kontekście innych zaburzeń psychicznych, zwłaszcza u dzieci z zespołem Aspergera, autyzmem lub ADHD1415.

Mechanizm moczenia kałowego

Gdy dziecko cierpi na przewlekłe zaparcia, dochodzi do następującego mechanizmu13:

  1. Stolec staje się twardy, suchy i może być bolesny podczas wydalania
  2. W rezultacie dziecko unika chodzenia do toalety, co pogarsza problem
  3. Im dłużej stolec pozostaje w jelicie, tym trudniej jest dziecku go wydalić
  4. Jelito rozciąga się, co ostatecznie wpływa na nerwy sygnalizujące, kiedy należy iść do toalety
  5. Gdy jelito staje się zbyt pełne, miękki lub płynny stolec może przeciekać wokół zatrzymanego stolca lub może nastąpić utrata kontroli nad wypróżnieniami

Z czasem odbytnica dziecka zostaje rozciągnięta, a mięśnie i nerwy stają się mniej wrażliwe na bodźce wskazujące, kiedy należy się wypróżnić14. Osłabiony „mięsień obwarzanka” (zwieracz odbytu) nie jest w stanie utrzymać stolca, co prowadzi do mimowolnego wycieku16.

Objawy moczenia kałowego

Głównym objawem moczenia kałowego jest oddawanie stolca w miejscach innych niż toaleta, najczęściej w bieliznę17. Zakres plamiącego zanieczyszczenia może wahać się od drobnych smug po większe ilości stolca. Często dzieci twierdzą, że nie mogą wyczuć ani poczuć zapachu wydzielonego stolca17.

Inne objawy, które mogą towarzyszyć moczeniu kałowemu, to18:

  • Nagła potrzeba wypróżnienia, z niewielkim ostrzeżeniem
  • Unikanie wypróżnień
  • Luźne, wodniste stolce przypominające biegunkę
  • Zaparcia
  • Ból brzucha
  • Wydalanie bardzo dużych, twardych, suchych stolców
  • Pocieranie okolicy odbytu z powodu bólu
  • Ukrywanie zabrudzonej bielizny
  • Utrata apetytu
  • Uczucie stresu, lęku lub poczucia winy

U dzieci z zaparciem mogą wystąpić następujące objawy19:

  • Luźny stolec (który można pomylić z biegunką) lub kawałki twardego stolca regularnie pojawiające się w bieliźnie
  • Ból podczas wypróżniania – dziecko może próbować wstrzymywać stolec z tego powodu
  • Niewielkie krwawienie podczas lub po wypróżnieniu, ponieważ stolec jest duży i twardy
  • Ból brzucha, który pojawia się i ustępuje
  • Słaby apetyt lub ból brzucha, który poprawia się po wypróżnieniu
  • Duże, twarde stolce lub małe stolce jak „królicze bobki”
  • Mniej niż 3 wypróżnienia tygodniowo

Wpływ na psychikę dziecka

Moczenie kałowe może mieć poważny wpływ psychologiczny na dziecko20. Dzieci z tym schorzeniem często czują się zaniepokojone wypadkami, które mają, gdy brudzą ubrania. W większości przypadków nie mogą kontrolować tego wycieku stolca, co może wpłynąć na ich samoocenę i relacje z innymi20.

Dzieci z moczeniem kałowym często są dręczone przez rodzeństwo i rówieśników, co może prowadzić do niskiej samooceny i depresji21. Mogą również odczuwać wstyd, zakłopotanie, frustrację i gniew13.

Diagnostyka moczenia kałowego

Diagnoza moczenia kałowego opiera się na objawach i wywiadzie medycznym dziecka22. Zgodnie z kryteriami diagnostycznymi, moczenie kałowe rozpoznaje się, gdy dziecko ma ponad 4 lata i często oddaje stolec w miejscach innych niż toaleta, jak np. w ubraniach lub na podłodze12.

Lekarz przeprowadzi dokładne badanie fizykalne, które może obejmować badanie brzucha i odbytu w celu wykluczenia innych przyczyn medycznych moczenia kałowego. W niektórych przypadkach mogą być zalecane dalsze badania, takie jak zdjęcie rentgenowskie jamy brzusznej, aby ocenić obecność zalegającego stolca w jelicie23.

Ważne jest, aby zgłosić się do lekarza, jeśli dziecko1724:

  • Ma 4 lata lub więcej i nie może jeszcze kontrolować, kiedy lub gdzie wypróżnia się
  • Regularnie brudzi bieliznę stolcem
  • Brudzący się ma opuchnięty brzuch i wymiotuje
  • Brudzący się ma drętwienie lub osłabienie obu nóg

Leczenie moczenia kałowego

Leczenie moczenia kałowego zależy od jego przyczyny i jest zwykle długoterminowe, a jego celem jest stworzenie regularnych wypróżnień u dziecka25. Ważne jest, aby nie próbować samodzielnie rozwiązywać problemu brudzenia, lecz skonsultować się z lekarzem9.

Leczenie zaparcia

Jeśli dziecko brudzi się z powodu zaparć, lekarz może przepisać środki przeczyszczające w celu usunięcia twardego stolca i przywrócenia regularnych, komfortowych wypróżnień824. Brudzenie może się pogorszyć, zanim się poprawi24.

Leczenie zwykle obejmuje kilka kroków21:

  1. Lekarz przepisze środek, taki jak środek przeczyszczający, aby pomóc usunąć nagromadzony stolec
  2. Następnie dziecko będzie przyjmować mniejszą, codzienną dawkę leku, aby utrzymać miękki stolec, tak aby wypróżnianie nie bolało
  3. Trzecim elementem leczenia jest nauczenie dziecka normalnego wypróżniania. Zwykle oznacza to, że dziecko siedzi na toalecie przez 10-15 minut w tym samym czasie każdego dnia (zwykle po posiłku), aby przyzwyczaić się do regularnego wypróżniania, które nie boli

Lekarz może również zalecić zmiany w diecie dziecka, takie jak zwiększenie ilości błonnika i płynów26.

Podejście behawioralne

Oprócz leczenia medycznego, ważne jest także podejście behawioralne25:

  • Ustalenie regularnej rutyny toaletowej dla dziecka, np. siadanie na toalecie na 5 minut codziennie po każdym posiłku i przed pójściem spać8
  • Pozytywne nastawienie i zachęta – można używać tablicy z gwiazdkami do nagradzania dziecka za siadanie na toalecie (niezależnie od tego, czy zrobi kupę, czy nie)24
  • Zachęcanie dziecka do korzystania z toalety, gdy tylko poczuje potrzebę w ciągu dnia24
  • Upewnienie się, że dziecko pije wystarczająco dużo płynów i ma w diecie odpowiednią ilość błonnika24
  • Zachęcanie dziecka do aktywności fizycznej24

Wielu rodziców uważa, że pozytywne wzmocnienie pomaga zachęcić dziecko podczas leczenia. Na przykład, można umieścić gwiazdkę lub naklejkę na kalendarzu za wypróżnienie (lub nawet za próbę), siedzenie na toalecie lub przyjmowanie leków6.

Wsparcie psychologiczne

Jeśli dziecko odczuwa wstyd lub poczucie winy z powodu moczenia kałowego, pomoc terapeuty może pomóc radzić sobie z tymi uczuciami i nauczyć sposobów normalnego wypróżniania21. W niektórych przypadkach może być konieczne wsparcie psychiatryczne, zwłaszcza jeśli moczenie kałowe jest związane z innymi problemami psychologicznymi27.

Wsparcie dla dziecka i rodziny

Rodzice odgrywają kluczową rolę w leczeniu moczenia kałowego. Ważne jest, aby podchodzić do problemu ze zrozumieniem i cierpliwością7.

Rola rodziców

Rodzice powinni62:

  • Pamiętać, że dzieci nie mogą powstrzymać wypadków i często czują się zawstydzone i zakłopotane z ich powodu
  • Wspierać dziecko i szukać przyczyny brudzenia
  • Nie karać ani nie zawstydzać dziecka – to tylko pogorszy sprawę
  • Zachować pozytywne nastawienie i zapewnić wsparcie
  • Zapewnić dziecko, że nie jest jedyną osobą na świecie z tym problemem

Leczenie enkoprezy zależy od wsparcia, jakie otrzymuje dziecko. Rodzice powinni zawsze zachęcać i chwalić swoje dziecko po skorzystaniu z toalety25.

Radzenie sobie z wypadkami

Gdy dochodzi do wypadku, ważne jest, aby2829:

  • Reagować spokojnie i bez krytykowania
  • Szybko posprzątać, unikając wstydu i zakłopotania
  • Dostarczyć dziecku informacji potrzebnych do lepszej kontroli wypróżnień i utrzymania czystości ubrań
  • Pamiętać, że dziecko może nadal mieć wypadki i brudzić bieliznę od czasu do czasu, dopóki jelito i odbytnica nie odzyskają napięcia mięśniowego

Warto również uświadomić sobie, że nawroty są normalne, więc nie należy się zniechęcać. Dziecko może ponownie mieć zaparcia lub brudzić spodnie podczas leczenia, zwłaszcza podczas odstawiania środków zmiękczających stolec6.

Zapobieganie moczeniu kałowemu

Aby zapobiec moczeniu kałowemu, należy2226:

  • Zapewnić dziecku zdrową, zbilansowaną dietę bogatą w błonnik
  • Zachęcać dziecko do picia wystarczającej ilości wody
  • Regularnie ćwiczyć z dzieckiem
  • Przyjąć zdrowe podejście do nauki korzystania z toalety
  • Nie rozpoczynać nauki korzystania z toalety, dopóki dziecko nie będzie gotowe

Wczesne leczenie, w tym wskazówki od lekarza dziecka lub specjalisty zdrowia psychicznego, może pomóc zapobiec społecznym i emocjonalnym skutkom moczenia kałowego26.

Rokowanie

Leczenie moczenia kałowego może potrwać kilka miesięcy lub nawet lat, ale z odpowiednim leczeniem i wsparciem większość dzieci ostatecznie przezwycięża ten problem1. Wyleczy się 65-70% dzieci kierowanych na leczenie, aczkolwiek mogą wystąpić nawroty podczas procesu leczenia7.

Choć możesz zauważyć pewne postępy już na początku leczenia, zwykle potrzeba kilku miesięcy, aby dziecko przezwyciężyło enkoporezę25. Ważne są regularne wizyty kontrolne u lekarza, które mogą pomóc zidentyfikować trwające lub nawracające problemy, dzięki czemu leczenie może być odpowiednio dostosowane w razie potrzeby26.

Kiedy szukać pomocy medycznej

Należy skonsultować się z lekarzem, jeśli1317:

  • Dziecko ma 4 lata lub więcej i regularnie brudzi się
  • Dziecko ma 4 lata i nie może jeszcze kontrolować, kiedy lub gdzie robi kupę
  • Dziecko jest już potrenowane w korzystaniu z toalety, a potem zaczyna się brudzić
  • Dziecko doświadcza jednego lub więcej objawów wymienionych powyżej

Wczesna interwencja jest kluczowa dla skutecznego leczenia moczenia kałowego i zapobiegania jego długoterminowym skutkom psychospołecznym30.

Pamiętaj, że moczenie kałowe jest problem medycznym, a nie behawioralnym, i nie powinno być powodem do karania lub zawstydzania dziecka31. Z odpowiednim leczeniem, cierpliwością i wsparciem, większość dzieci jest w stanie przezwyciężyć ten problem32.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Encopresis – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/encopresis/symptoms-causes/syc-20354494
    Encopresis (en-ko-PREE-sis), sometimes called fecal incontinence or soiling, is the repeated passing of stool (usually involuntarily) into clothing. Typically it happens when impacted stool collects in the colon and rectum: The colon becomes too full and liquid stool leaks around the retained stool, staining underwear. Eventually, stool retention can cause stretching (distention) of the bowels and loss of control over bowel movements. […] 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. Far less frequently it occurs without constipation and may be the result of emotional issues. […] Encopresis can be frustrating for parents and embarrassing for the child. However, with patience and positive reinforcement, treatment for encopresis is usually successful.
  • #2 Encopresis Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/17849-encopresis-soiling
    Encopresis is a condition where a toilet-trained child has bowel movements when they are not on the toilet. Constipation usually causes these accidents. […] 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. […] Children with encopresis often have the following symptoms: Passing stool in their clothes. […] The most common cause of encopresis is constipation. […] When children withhold or delay going to the bathroom, stool builds up in their colon. […] Encopresis with constipation is called retentive encopresis. […] Parents should encourage and offer support to their child by creating a potty routine to keep up with good bowel habits including: Not scolding or yelling at your child if accidents happen.
  • #3
    https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Fecal-Soiling.aspx
    Fecal soiling, referred to medically as encopresis in children over four years of age, affects about 1.5 percent of young school children, with boys outnumbering girls by a ratio of six to one. […] In most cases, however, fecal soiling is not voluntary, but occurs when emotional stress, resistance to toilet training, or physical pain during bowel movements causes a child to resist having bowel movements. […] If the problem continues beyond one or two accidents, however, be sure to make an appointment with your child’s pediatrician. […] Fecal soiling can occur when a child is anxious or emotionally distraught over some aspect of his life over which he has little control, such as family conflicts, academic difficulties, or problems with social relationships. […] No matter what the cause, your child needs to know and needs to know that you know that what has happened is not his fault. […] As with bedwetting, the situation is best corrected by quickly cleaning up, avoiding shame and embarrassment as much as possible, and providing him with the information he needs to better control his bowel movements and keep his clothes clean.
  • #4 Soiling in Children: A Guide to Understanding and Support
    https://readykids.com.au/soiling/
    Soiling, also called encopresis, can cause a great deal of stress for both the child and the parents. It occurs more often in boys than girls and usually starts around age 4. […] Soiling can happen because the child is not toilet trained yet. On the other hand, often parents find that their child has started soiling after a period of being toilet trained. […] Soiling accidents are likely to occur during the school day when the child is away from home and parents are not able to provide immediate assistance. Children with soiled underwear can face teasing and bullying from other kids in school. […] This can lead to low self-esteem and anxiety in kids. While soiling can make you feel frustrated, as a parent, have patience and offer encouragement to help your child overcome this issue. If your child is soiling, there are many ways to help them.
  • #5 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. Parents might assume that kids who soil their pants are misbehaving or too lazy to use the bathroom when they have the urge to go. […] 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. […] Soiling and constipation are a top reason that kids go to see pediatric gastroenterologists (doctors who diagnose and treat disorders of the stomach and intestines). […] Kids can’t prevent this soiling and sometimes dont know it’s happening because the nerves aren’t sending the signals that regulate pooping.
  • #6 Soiling (Encopresis) (for Parents) | Nemours KidsHealth
    https://kidshealth.org/en/parents/encopresis.html
    Parents can get upset when their child has poop accidents. But remember that kids cannot stop the accidents, and often feel ashamed and embarrassed by them. Some even try to hide their soiled underpants from their parents. Supporting kids and finding and treating the cause of the soiling will help it get better. […] 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. […] Keep in mind that relapses are normal, so don’t get discouraged. Your child might get constipated again or soil their pants during treatment, especially when being weaned off of the stool softeners. […] Successful treatment of encopresis depends on the support a child gets. Some parents find that positive reinforcement helps to encourage the child throughout treatment. For instance, put a star or sticker on the poop calendar for having a BM (or even for trying to), sitting on the toilet, or taking medicines. […] Don’t blame or yell it will only make your child feel bad and it won’t help manage the condition. With lots of love, support, and reassurance that they’re not the only one in the world with this problem, your child can overcome encopresis.
  • #7 Soiling (Encopresis) | Dayton Children’s Hospital
    https://www.childrensdayton.org/kidshealth/a/encopresis
    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). […] Soiling and constipation are a top reason that kids go to see pediatric gastroenterologists (doctors who diagnose and treat disorders of the stomach and intestines). […] Kids can’t prevent this soiling and sometimes dont know it’s happening because the nerves aren’t sending the signals that regulate pooping. […] Parents can get upset when their child has poop accidents. But remember that kids cannot stop the accidents, and often feel ashamed and embarrassed by them. […] 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. […] Keep in mind that relapses are normal, so don’t get discouraged. […] Patience is the key to treating encopresis. […] Successful treatment of encopresis depends on the support a child gets.
  • #8 Soiling (child pooing their pants)
    https://www.nhs.uk/conditions/soiling-child-pooing-their-pants/
    Soiling is when a child regularly poos their pants. If they’re already potty-trained, the soiling is usually because they are badly constipated. Treatment from a GP can help. […] Soiling usually happens when a child is so constipated that a large, hard piece of poo becomes stuck at the end of their gut (rectum). […] If your child is pooing their pants (soiling) because they’re constipated, a GP can prescribe laxatives to clear out the hard poo and get your child pooing regularly and comfortably again. […] If your child is regularly pooing their pants (soiling), it can help to set up a regular toilet routine for your child for example, they could sit on the toilet for 5 minutes every day after each meal and before going to bed.
  • #9 Soiling (child pooing their pants) | Health Information from Mediclinic Pharmacy
    https://mediclinicpharmacy.com/nhs_conditions_soiling-child-pooing-their-pants
    Soiling is when a child regularly poos their pants. If they’re already potty-trained, the soiling is usually because they are badly constipated. Treatment from a GP can help. […] Soiling usually happens when a child is so constipated that a large, hard piece of poo becomes stuck at the end of their gut (rectum). […] Fresh poo from higher up the gut then runs around the hard poo and leaks out, staining their pants. […] See a GP if: your child is regularly pooing their pants (soiling). […] It’s important not to try to sort out soiling by yourself. […] If your child is pooing their pants (soiling) because they’re constipated, a GP can prescribe laxatives to clear out the hard poo and get your child pooing regularly and comfortably again. […] If your child is regularly pooing their pants (soiling), it can help to: set up a regular toilet routine for your child for example, they could sit on the toilet for 5 minutes every day after each meal and before going to bed.
  • #10
    https://confidenceclub.com.au/blogs/news/soiling-in-children-why-it-occurs-what-to-do
    The causes of hard stools and constipation can include: Lack of fibre and overall diet, Illness, Not drinking enough water and fluids, Fear of going to the toilet, Limited access to a toilet. […] Some children may also develop chronic constipation following stressful life events, such as bullying, divorce or the death of a relative. […] As mentioned, the main symptom of soiling is doing a poo in places other than the toilet, which is most often in the childs underwear. […] If your child is constipated you may notice that they strain or feel pain when they poo, have stomach pains, or they having less frequent bowel movements. […] Your first port of call, if you notice your child is experiencing soiling, is to visit their GP. […] Ensuring your child receives a professional medical assessment means they’ll receive the appropriate treatment and avoid the condition worsening.
  • #11 Stool Soiling and Constipation in Children – familydoctor.org
    https://familydoctor.org/stool-soiling-and-constipation-in-children/
    Stool soiling (encopresis) happens in children who are toilet trained. It’s when they accidentally leak feces (poop) into their underwear. Constipation is one of many causes of stool soiling. Other causes include irritable bowel syndrome or when a child is fearful of the bathroom. In rare circumstances it is caused by disease or birth defects. Usually, the amount of soiling is small. It just stains the underwear. In most cases, it is involuntary. This means your child does not mean to soil his or her pants. If soiling happens often (daily or throughout the day), your child may need to see a doctor. […] It’s important to teach your child to know when it’s time to go to the toilet. Note that young children should tell a parent before they use the bathroom, in case they need help. […] Children who have constipation may have soft or liquid stools leak from the anus (the opening to the rectum). This is caused by a mass of stool stuck in the lower bowel. This happens because the amount of stool can become so large that it leaks out of the anus, causing soiling. These stools have a very bad smell.
  • #12 Encopresis in Children – A Quick Guide – Child Mind Institute
    https://childmind.org/guide/quick-guide-to-encopresis/
    Encopresis (or soiling) is a disorder in which a child over the age of four repeatedly poops in places other than the toilet, like their underwear or the floor. Some children with encopresis have problems with normal pooping, like constipation. Some children are afraid or anxious about pooping, so they try to hold it. In either case, not pooping for a long time makes it so the child can’t control it when they do finally poop. In some cases, when the encopresis is not because of constipation or holding it on purpose, it may be a sign of another psychiatric disorder. […] Encopresis is diagnosed when a child is over the age of four and often poops in places other than the toilet, like in their clothes or on the floor. […] Constipation is the most likely cause of encopresis. When a child becomes constipated then pooping can be painful and so the child tries not to poop at all. This causes the poop to get hard and then it’s even more painful for the child to defecate. This pattern causes the child to hold it to avoid the pain. After a while, the softer poop behind the hard poop leaks out at times and places the child can’t control.
  • #13 Encopresis – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/encopresis/symptoms-causes/syc-20354494
    Call your doctor if your child is already toilet trained and starts experiencing one or more of the symptoms listed above. […] 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 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: […] A child who has encopresis may experience a range of emotions, including embarrassment, frustration, shame and anger. If your child is teased by friends or criticized or punished by adults, he or she may feel depressed or have low self-esteem.
  • #14 Your ADHD Child Poops Pants? Here’s What To Do
    https://www.joonapp.io/post/adhd-child-poops-pants
    „My ADHD child poops pants regularly, but I don’t know why.” […] „ADHD children may experience delays in potty training for several reasons.” […] „Chronically large and hard bowel movements can stretch the rectum where stool is stored and cause the muscles and nerves there to be less sensitive to when it is time to go.” […] „Research shows that children with ADHD are significantly more likely to experience both constipation and fecal incontinence.” […] „Sometimes, retentive fecal soiling (a condition diagnosed in kids aged 4+ who have bowel movements in inappropriate places and times at least once monthly for two months or more) is connected to behavioral or emotional concerns.” […] „If retentive fecal soiling is to blame, it doesn’t mean that a child is doing it 'on purpose.'” […] „At times, medication treatment for other health problems can be the cause of problems with bowel movements.” […] „A wide variety of medical problems can cause issues with pooping.” […] „Children with ADHD are at an increased risk of various gastrointestinal and related problems.” […] „These can include but aren’t limited to constipation, fecal incontinence, and difficulty with potty training.”
  • #15 Autism and pooping in pants – Amazing K
    https://www.amazingk.co.za/autism-and-pooping-in-pants/
    Soiling or pooping in pants is a problem many families of autistic children face. It happens most often when the child does not reliable use the toilet for a bowel movement. But it can also happen when the child is fully toilet trained. It is a very common problem in children with autism, Aspergers syndrome and other development disorders. […] Children with an autism spectrum disorder struggle with bowel movements! They can struggle with leaky-gut, constipation, and/or diarrhea. Some struggle because of gastrointestinal issues which form part of their diagnosis, whilst others struggle because of their diet or lack of a proper diet. […] There are so many reasons why a child with autism poop in their pants rather than on a toilet. The best advice we can give is to keep a record of your childs toileting success and their mishaps. It will help you to understand the underlying problem your child has. Once we know what the reasons are we can start working on strategies to help your child overcome this behavior.
  • #16 Child Bowel Control: Prevent Soiled Pants | Ask Dr Sears
    https://www.askdrsears.com/topics/parenting/discipline-behavior/bothersome-behaviors/soiling-pants/
    Soiling pants, medically known as encopresis, is not that unusual or always abnormal. […] It occurs at some point after the child has been toilet trained. […] It occurs more in children with a strong sense of privacy or a strong tendency to concentrate on an activity to the point that they are unwilling to stop long enough to use the toilet. […] By understanding why this unpleasant problem occurs, you can help your child master his bowel habits. […] If you dont listen to your bowel signals the poop gets big and hard and wont come out. […] The longer this goes on, the harder the poop gets, the weaker the donut muscle gets, and the less bowel and brain talk to each other. […] Paradoxically, the most common medical cause of pant soiling that I see in my office is constipation. […] What soils the pants is the soft, watery stool that leaks past the hard feces.
  • #17 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. […] Faecal incontinence is also called encopresis or soiling. […] 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. […] You should see your GP for advice about treatment and management if you think your child is constipated or if your child: is 4 years old and cant yet control when or where they poo. […] The treatment for faecal incontinence depends on its cause.
  • #18 Encopresis: Definition, causes, symptoms, and treatments
    https://www.medicalnewstoday.com/articles/encopresis
    Emotional issues can trigger encopresis. […] The condition is more common among children from homes where abuse is happening. […] However, any incident that a child perceives as stressful may trigger stool soiling. […] Children with mental health conditions or a challenging family environment may be more at risk of encopresis. […] 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. […] Treatment usually involves one or more of the following: removing impacted stool, encouraging regular bowel movements, psychotherapy, caregiver support. […] It is essential not to shame, blame, or punish children for accidents. […] Most children with encopresis will overcome the condition with treatment and caregiver support. […] It is important not to shame or blame children when they have accidents.
  • #19 Soiling (child pooing their pants) | Health Information from Green Light Pharmacy
    https://greenlightpharmacy.com/nhs_conditions_soiling-child-pooing-their-pants
    Soiling is when a child regularly poos their pants. If they’re already potty-trained, the soiling is usually because they are badly constipated. Treatment from a GP can help. […] Soiling usually happens when a child is so constipated that a large, hard piece of poo becomes stuck at the end of their gut (rectum). […] Fresh poo from higher up the gut then runs around the hard poo and leaks out, staining their pants. […] If your child is constipated, they may have: runny poo (you may mistake this for diarrhoea) or bits of hard poo appearing regularly in their pants, pain when they poo they may try to hold in their poos because of this, some bleeding during or after pooing, because their poo is large and hard, stomach pain that comes and goes, a poor appetite or stomach pain that improves after they poo, big, hard poos, or small poos like „rabbit droppings”, fewer than 3 poos a week.
  • #20 Encopresis | Cedars-Sinai
    https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/e/encopresis.html
    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. […] Over time, liquid stool can start to leak around the hard, dry, impacted stool. This soils your child’s clothing. […] Encopresis can cause both physical and emotional problems. […] Children with encopresis often feel upset by the accidents they have when they soil their clothes. In most cases, they cant 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. Children are often ashamed or embarrassed by this problem.
  • #21 Encopresis in Children – A Quick Guide – Child Mind Institute
    https://childmind.org/guide/quick-guide-to-encopresis/
    There are a few steps to treating encopresis: First, a doctor will give the child something like a laxative to help get out built-up poop. Then, the child will take a smaller daily dose of a medicine to keep their poop soft so that it doesn’t hurt when they go. The third part of treatment is teaching the child to poop normally. This usually means having them sit on the toilet for 10–15 minutes at the same time every day (usually after eating), to get them used to pooping in a regular way that doesn’t hurt. The doctor might also recommend changes in the child’s diet. If the child has feelings of shame or guilt about their encopresis, a therapist can help them deal with those feelings and learn ways of pooping normally. […] Kids with encopresis are often teased by siblings and classmates. Parents should watch out for low self-esteem and depression in children with encopresis.
  • #22 Encopresis: Causes, Symptoms, and Diagnosis
    https://www.healthline.com/health/encopresis
    Certain common risk factors increase your child’s likelihood of developing encopresis. […] Encopresis is typically diagnosed based on the reported symptoms, a medical history, and a physical exam. […] Your child’s doctor might prescribe or recommend a product to remove the blockage and relieve constipation. […] Employ behavioral techniques to reward your child for sitting on the toilet, eating high-fiber foods, and cooperating with treatments as recommended. […] If emotional distress or an underlying behavioral problem is present, your child may need psychological counseling. […] Adopt a healthy approach to toilet training your child. Don’t start toilet training until your child is ready. […] Other ways to prevent encopresis include: making certain your child eats high-fiber foods, encouraging your child to drink plenty of water, regularly exercising with your child.
  • #23 Reddit – The heart of the internet
    https://www.reddit.com/r/Parenting/comments/15b1ati/i_am_at_my_wits_end_over_this_my_six_almost_7/
    I am at my wits end over this. My six, almost 7, year old son poops his pants daily. […] He would have small bits of poop in his underwear, brown stains every day. Then he started to have larger accidents. […] In June of 2022 I took him to a gastroenterologist. They performed blood work, which was normal. The x-ray showed that he was constipated. We proceeded with a bowel cleanse. There was no significant improvement. […] In June I took him to a different gastro and they thought it was behavioral and constipation. We proceeded with another bowel cleanse. There has been no improvement since. Both gastro’s basically dismissed his complaints of stomach pain. […] He rarely poops his pants while playing around the house. Normally it happens when he is outside, in our pool (in swim diapers), or playing video games. Activities that he doesn’t want to interrupt with a bathroom break.
  • #24 Soiling (child pooing their pants) | Health Information from Green Light Pharmacy
    https://greenlightpharmacy.com/nhs_conditions_soiling-child-pooing-their-pants
    See a GP if: your child is regularly pooing their pants (soiling). […] It’s important not to try to sort out soiling by yourself. […] Ask for an urgent GP appointment or get help from NHS 111 if: your child is pooing their pants (soiling), has a swollen tummy and is being sick, your child is soiling and has numbness or weakness in both legs. […] If your child is pooing their pants (soiling) because they’re constipated, a GP can prescribe laxatives to clear out the hard poo and get your child pooing regularly and comfortably again. […] The soiling may get worse before it gets better. […] If your child is regularly pooing their pants (soiling), it can help to: set up a regular toilet routine for your child for example, they could sit on the toilet for 5 minutes every day after each meal and before going to bed, be positive and encouraging you could use a star chart to reward your child for sitting on the toilet (whether or not they do a poo), or leave some toys or books next to the toilet, encourage your child to go to the toilet as soon as they get the urge to during the day, make sure your child is drinking plenty of fluids and has enough fibre in their diet, encourage your child to be physically active.
  • #25 Encopresis Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/17849-encopresis-soiling
    Treatment is long-term with the goal of creating regular bowel movements for your child. […] Always encourage and praise your child after they use the toilet. […] You can prevent encopresis by avoiding constipation and creating positive toileting experiences for your child. […] While you might see some progress early in treatment, it usually takes months for your child to overcome encopresis. […] Always provide positive encouragement for your child and have patience when you toilet train them.
  • #26 Encopresis – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/encopresis/symptoms-causes/syc-20354494
    Help your child avoid constipation by providing a balanced diet that’s high in fiber and encouraging your child to drink enough water. […] Early treatment, including guidance from your child’s doctor or mental health professional, can help prevent the social and emotional impact of encopresis. Regular follow-up visits with your doctor can help identify ongoing or recurring problems so that adjustments in treatment can be made as needed.
  • #27 How to Deal With Encopresis
    https://health.clevelandclinic.org/encopresis-what-to-do-when-your-potty-trained-kid-is-soiling-their-underwear
    Encopresis happens in kids who have already been potty trained. […] The answer might be encopresis, a condition that causes soiling as a result of chronic constipation. […] Soiling occurs when softer stool seeps out around that backup. […] Treating encopresis means treating chronic constipation. […] No child should be punished or penalized for soiling. Shaming is counterproductive, Dr. Kabbany says. […] Children with encopresis may benefit from seeing a psychologist, he says. […] Most children eventually become regular, without needing to take laxatives long-term.
  • #28 Child Bowel Control: Prevent Soiled Pants | Ask Dr Sears
    https://www.askdrsears.com/topics/parenting/discipline-behavior/bothersome-behaviors/soiling-pants/
    Explain to your child whats happening how the doughnut muscle that holds in the poop gets lazy and opens up and lets out poop. […] Encopresis is embarrassing. Children want help learning about their bodies. […] When older children (past age six) soil their pants by choice and not by accident, they are old enough to learn how to be responsible for cleaning their soiled pants. […] In most children pant-soiling, like bed-wetting, is a developmental nuisance, not a psychological problem. […] Seek professional help. […] Have a talk with your child about how you will work hard to change these factors as he works hard to control his bowel habits.
  • #29 Encopresis | Cedars-Sinai
    https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/e/encopresis.html
    Your child may still have accidents and soil underwear from time to time. This will happen until the intestine and rectum get their muscle tone back again. […] 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. If your child soils their underwear, dont get angry or punish your child. […] It can be very embarrassing for your child. […] Encopresis presents challenges for the family. Coordinating care among professionals in the school and medical community is important for recovery.
  • #30 Encopresis and Autism: Interventions, Coping Strategies, and Bowel HealthAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontReset
    https://www.specialstrong.com/encopresis-and-autism-interventions-coping-strategies-and-bowel-health/
    The key to managing encopresis and autism lies in early detection, openness about the symptomatic expressions, fostering a supportive environment, and seeking appropriate medical guidance the earliest. […] Encopresis could be triggered by numerous factors in children with autism, primarily constipation issues. […] Autistic children also often resist toilet training, which can further exacerbate the condition. […] Managing encopresis in individuals with autism requires a multifaceted approach that includes medical, behavioral, and holistic interventions. […] Behavioral therapy is critical for managing encopresis and autism. […] Emotional and psychological support is vital in managing encopresis in autistic children. […] A healthy diet and regular exercise can also promote smoother bowel movements.
  • #31 Encopresis in Children | Boston Children’s Hospital
    https://www.childrenshospital.org/conditions/encopresis
    Encopresis is the involuntary leaking of feces, most often caused by chronic constipation. An estimated 1 to 3 percent of children have this problem at one time or another in childhood. […] Encopresis happens when soft or liquid feces leak out of the rectum. […] Soft stool starts to leak around the impacted stool, soiling the child’s underwear and clothes. […] A child with encopresis can feel ashamed and embarrassed. […] Parents may also feel guilt, shame, and anger over their child’s accidents. It’s important to understand that encopresis is a medical issue, not a behavior that can be changed through punishment or discipline. […] After a child passes an impacted stool, it’s important to develop a good routine to ensure that stool does not get backed up again. The child may still have problems with leakage until the intestine and rectum return to their normal size.
  • #32 Soiling in Children: A Guide to Understanding and Support
    https://readykids.com.au/soiling/
    Soiling can be a difficult problem to deal with. It can be embarrassing for the child and frustrating for the parents. But with proper treatment, soiling can be resolved. […] Soiling can be difficult for children to deal with. Though it can be an embarrassing issue, soiling is not usually a sign of bad parenting or poor hygiene. […] If you find your little one with soiled underpants frequently, consult your doctor for sound advice to help your little one overcome it at the earliest.