Materiały źródłowe

• #1 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. […] To diagnose encopresis, your healthcare provider will examine your child. Their exam could include: Questions about the child’s medical history, symptoms, emotional wellbeing (stress), toilet training and diet. Physical examination of your child. Rectal examination where your provider will insert a gloved, lubricated finger into their rectum to check for blockages and muscle tone. X-ray of your child’s abdomen. Psychological evaluation to determine the cause if it relates to emotional stress, fear or behavioral challenges.

• #2 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. […] When children hold in their poop, the lower colon fills up. Over time this can stretch the lower colon out of its normal shape. […] Children who have emotional or behavioral issues can have trouble with soiling. […] A doctor or nurse practitioner will examine your child and get a medical history. Testing is usually not required but might include: […] Treatment for soiling will be guided by your child’s healthcare team with your and your child’s input. […] Your child’s doctor or nurse practitioner will often order medications to help keep your child’s bowel movements soft.

• #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). […] Encopresis isn’t a disease. It’s a symptom that may have different causes. […] 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. […] 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.

• #4 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). […] Encopresis isn’t a disease. It’s a symptom that may have different causes. […] 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.

• #5 Soiling (Encopresis) | Dayton Children’s Hospital

  https://www.childrensdayton.org/kidshealth/a/encopresis

  Encopresis is not a behavioral issue or a simple lack of self-control. […] Treatment happens in three phases: […] Keep in mind that relapses are normal, so don’t 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.

• #6 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.

• #7 Encopresis |Understanding & Managing Encopresis In Children

  https://www.childpsychologist.com.au/resources/encopresis-soiling-in-school-aged-children

  Encopresis (or faecal soiling) is one of the most frustrating difficulties of middle childhood, affecting approximately 1.5% of young school children (von Gontard, 2013). […] According to the Diagnostic Statistical Manual (DSM-V) (American Psychiatric Association, 2013) encopresis (or otherwise known as Elimination Disorder) is essentially the repeated passing of stools into inappropriate places, after the age at which toilet training is expected to be accomplished. In order to receive this diagnosis, 4 features should be present: Patients chronological age must be at least 4 years, A repeated passage of feces into inappropriate places, which is either intentional or involuntary, At least one such event must occur every month for at least 3 months, The behaviour is not attributed to the effects of substances (e.g., laxative) or any other medical condition.

• #8 Encopresis DSM-5 307.7 (F98.1)

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

  Encopresis is essentially a repeated passage of feces into inappropriate places, such as on clothing or the floor. […] If the passage is involuntary, it is often related to constipation, impaction and retention with a resultant overflow. […] Included in this list are the following: The passage of stool in inappropriate places (for example in the child’s clothing). […] According to DSM-5, there are 4 features that must be present to support a diagnosis of encopresis: A repeated passage of feces into inappropriate places, e.g., clothing or floor. This can be either intentional or involuntary. […] In making the diagnosis, it is critical that the clinician specify which of the following is present: With constipation and overflow incontinence: through physical examination or medical history, there is evidence of constipation.

• #9 Encopresis |Understanding & Managing Encopresis In Children

  https://www.childpsychologist.com.au/resources/encopresis-soiling-in-school-aged-children

  There are two basic categories of encopresis i) primary encopresis-which refers to children who have never attained bowel control, ii) secondary encopresis-which refers to soiling after successfully attaining toilet control usually brought upon by entering a stressful environment (such as family conflict). […] Parents of children with encopresis often feel frustrated as they often believe that their children play an active role in controlling their bowel movements. While in some cases, soiling may be intentional, in other cases it may be involuntary and beyond the child’s control. […] Biological factors: Functional constipation (persistent constipation with incomplete defecation without evidence of a structural or biochemical explanation) is one of the main causes of encopresis, accounting for 90% of cases amongst children (Har Croffle, 2010).

• #10 Encopresis DSM-5 307.7 (F98.1)

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

  Encopresis is essentially a repeated passage of feces into inappropriate places, such as on clothing or the floor. […] If the passage is involuntary, it is often related to constipation, impaction and retention with a resultant overflow. […] Included in this list are the following: The passage of stool in inappropriate places (for example in the child’s clothing). […] According to DSM-5, there are 4 features that must be present to support a diagnosis of encopresis: A repeated passage of feces into inappropriate places, e.g., clothing or floor. This can be either intentional or involuntary. […] In making the diagnosis, it is critical that the clinician specify which of the following is present: With constipation and overflow incontinence: through physical examination or medical history, there is evidence of constipation.

• #11 Encopresis – Wikipedia

  https://en.wikipedia.org/wiki/Encopresis

  Encopresis (from Ancient Greek, enkprsis) is voluntary or involuntary passage of feces outside of toilet-trained contexts (fecal soiling) in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into their undergarments. […] The psychiatric (DSM-5) diagnostic criteria for encopresis are: Repeated passage of feces into inappropriate places (e.g., underwear or floor) whether voluntary or unintentional; At least one such event a month for at least 3 months; Chronological age of at least 4 years (or equivalent developmental level); The behavior is not exclusively due to a physiological effect of a substance (e.g., laxatives) or a general medical condition, except through a mechanism involving constipation. […] The DSM-5 recognizes two subtypes: with constipation and overflow incontinence, and without constipation and overflow incontinence. In the subtype with constipation, the feces are usually poorly formed and leakage is continuous, and this occurs both during sleep and waking hours. In the type without constipation, the feces are usually well-formed, soiling is intermittent, and feces are usually deposited in a prominent location.

• #12 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. […] To diagnose encopresis, your healthcare provider will examine your child. Their exam could include: Questions about the child’s medical history, symptoms, emotional wellbeing (stress), toilet training and diet. Physical examination of your child. Rectal examination where your provider will insert a gloved, lubricated finger into their rectum to check for blockages and muscle tone. X-ray of your child’s abdomen. Psychological evaluation to determine the cause if it relates to emotional stress, fear or behavioral challenges.

• #13 Encopresis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/encopresis/diagnosis-treatment/drc-20354500

  To diagnose encopresis, your child’s doctor may: […] Conduct a physical exam and discuss symptoms, bowel movements and eating habits to rule out physical causes for constipation or soiling […] Do a digital rectal exam to check for impacted stool by inserting a lubricated, gloved finger into your child’s rectum while pressing on his or her abdomen with the other hand […] Recommend an abdominal X-ray to confirm the presence of impacted stool […] Suggest that a psychological evaluation be done if emotional issues are contributing to your child’s symptoms. […] Your child’s doctor may recommend psychotherapy with a mental health professional if the encopresis may be related to emotional issues. Psychotherapy may also be helpful if your child feels shame, guilt, depression or low self-esteem related to encopresis.

• #14 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. […] A child must be at least the age of four and poop in places like their underwear or the floor. It must happen at least once a month for at least three months. Before making a diagnosis of encopresis, a doctor will rule out things like food allergies or medicines that act as laxatives.

• #15 Encopresis (Fecal Soiling) – Harvard Health

  https://www.health.harvard.edu/a_to_z/encopresis-fecal-soiling-a-to-z

  Encopresis is when a child who is toilet trained passes stool (bowel movements) into his or her underwear. To have encopresis, the child must be at least four years old, the age by which most children can control bowel movements. Encopresis is also called fecal incontinence. […] In most cases, your doctor can diagnose encopresis based on your child’s: Age, History and symptoms of chronic constipation, Physical examination. […] The doctor will begin by asking about your child’s bowel habits, including: How often he or she has bowel movements, The size of your child’s bowel movements, Whether the outside of the stools have been streaked with blood. […] Call your doctor if your child is older than age four and consistently soils his pants with stool. Also call if your child has started soiling after being clean for many months or years. Call your doctor if your child frequently has constipation, even if he or she is not having a problem with encopresis. […] Most children with encopresis either outgrow the problem or respond to treatment. Treatment may involve changes in diet, medication and motivational therapy.

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

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

  Encopresis is when a child who is toilet trained passes stool (bowel movements) into his or her underwear. […] Encopresis is also called fecal incontinence. […] In most cases, your doctor can diagnose encopresis based on your child’s: Age, History and symptoms of chronic constipation, Physical examination. […] Usually no further tests are necessary. […] Sometimes an x-ray is done of the abdomen to see how much stool is present. […] If the doctor thinks the problem may be related to abnormalities in your child’s lower digestive tract, he or she may order additional tests. […] In a biopsy, a small piece of tissue from the rectum is removed to be examined in a laboratory. […] If your child has signs of hypothyroidism, your doctor may order blood tests to measure thyroid hormone levels. […] Call your doctor if your child is older than age four and consistently soils his pants with stool. […] Call your doctor immediately if your child begins to intentionally drop or smear stool anywhere, including around the home or school.

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

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

  Soiling in a child who is at least 4 years old. […] To diagnose encopresis, your child’s health care provider will ask many questions about their medical history, toilet training history, diet, lifestyle, habits, medications, and behavior. […] The examiner may insert a gloved finger into your child’s rectum to feel for stool and make sure their anal opening and rectum are normal sized and that their anal muscles are of normal strength. […] In some cases, an exam called an anorectal manometry test may be performed. […] Many children who have chronic constipation and/or encopresis do not use their muscles in a coordinated fashion during bowel movements. […] The main objective of a manometry test is to confirm increased pressure within the anus. […] If Hirschsprung disease is the likely cause of your child’s encopresis, a biopsy the removal of a tiny piece of tissue for examination under a microscope of the rectum may be necessary.

• #18 Encopresis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/encopresis/diagnosis-treatment/drc-20354500

  To diagnose encopresis, your child’s doctor may: […] Conduct a physical exam and discuss symptoms, bowel movements and eating habits to rule out physical causes for constipation or soiling […] Do a digital rectal exam to check for impacted stool by inserting a lubricated, gloved finger into your child’s rectum while pressing on his or her abdomen with the other hand […] Recommend an abdominal X-ray to confirm the presence of impacted stool […] Suggest that a psychological evaluation be done if emotional issues are contributing to your child’s symptoms. […] Your child’s doctor may recommend psychotherapy with a mental health professional if the encopresis may be related to emotional issues. Psychotherapy may also be helpful if your child feels shame, guilt, depression or low self-esteem related to encopresis.

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

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

  It is not uncommon for a student with encopresis to deny both the visible and olfactory signs of soiling of their underwear. […] Students with encopresis should also be evaluated for psychological symptoms, including anxiety, depression, and behavioral symptoms. […] 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 (Sood, 2022). […] The goal of therapy is the passage of soft stools, ideally once per day and no less than every other day. This goal of frequent defecation is important to overcome constipation.

• #20 Encopresis |Understanding & Managing Encopresis In Children

  https://www.childpsychologist.com.au/resources/encopresis-soiling-in-school-aged-children

  Overall 30-50% of children with encopresis have a comorbid emotional or behavioural disorder (von Gontard, 2012). […] Encopresis can have a severe effect on the child, family and school environment. Encopresis is often a family preoccupation, as parents and siblings become increasingly frustrated as family activities may be disrupted due to the constant soiling. […] Studies have shown that encopresis children experience a greater amount of anxiety and depression symptoms, difficulties with attention, more social problems, disruptive behaviours and lower levels of academic performance (Mosca Schatz, 2014). […] While encopresis is a chronic and complex problem amongst many families, it is treatable. […] The first step to treating encopresis is to identify the cause behind the condition and seek medical advice from a pediatrician or GP. Medical examinations are important in order to rule out the existence of organic causes. […] Behavioural modification with the assistance of a Psychologist is an integral treatment component for encopresis. […] Comorbid emotional and behavioural disorders should be treated separately according to evidence-based recommendations (von Gontard, 2013).

• #21 Encopresis – StatPearls – NCBI Bookshelf

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

  The provider should perform a comprehensive assessment with an extensive medical history, including the history of rectal or anal surgery due to possible malformation or congenital disabilities. […] The patient may present with diurnal or nocturnal enuresis and other urinary infections in children with chronic constipation and soiling problem. […] Encopresis is mainly a clinical diagnosis, and the majority of patients do not need any further testing. […] The treatment of non-retentive encopresis has not been well defined. The treatment consists of education, keeping a bowel diary, and toilet training four times a day following meals and immediately after arriving home from school. […] The differential diagnosis for encopresis includes organic non-functional causes such as 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. […] Most children treated for retentive encopresis are eventually cured, although the time required for treatment varies, and relapses are frequent.

• #22 Fecal Incontinence (Soiling): Causes, Treatment and Prognosis | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/fecal-incontinence

  Fecal incontinence (accidentally having bowel movements) is a very common problem in children. It can be caused by medical conditions like chronic constipation or congenital conditions that may disrupt bowel control, including: spina bifida, anorectal malformations and Hirschsprung disease. […] Fecal incontinence can be caused by medical conditions like chronic constipation or congenital conditions that may disrupt bowel control, including: spina bifida, anorectal malformations and Hirschsprung disease. […] Children with true fecal incontinence lack the ability to voluntarily have a bowel movement, so they require daily interventions to empty the colon of stool. However, there are two different types of true fecal incontinence and treatment for each varies: […] Physicians are usually able to predict which children with these issues will go on to have fecal incontinence so that parents can set expectations for potty training.

• #23 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.

• #24 Encopresis – Help For Your ChildVisit our FacebookVisit our YouTube channelsearchcrosslinkedinfacebookpinterestyoutubersstwitterinstagramfacebook-blankrss-blanklinkedin-blankpinterestyoutubetwitterinstagram

  https://helpforyourchild.com/encopresis/

  Various terms have been used to describe this problem, including functional encopresis, primary nonretentive encopresis and stool toileting refusal. […] The family physician is likely to be the first to identify this problem and to provide „front line” intervention. […] A consistent soiling pattern characterized by stools that are normal in size and consistency and the absence of constipation usually suggests nonretentive encopresis. […] The history and physical examination may be the only diagnostic tools necessary to identify retentive encopresis and related organic factors. […] If obtaining frequent, soft and well-formed bowel movements continues to be a problem, the addition of stool softeners or laxatives may be considered. […] It is critical to ensure that the child is having relatively frequent, soft and well-formed bowel movements before engaging in any intervention for soiling.

• #25 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. […] 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. 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. […] 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. […] Emotional stress may trigger encopresis. […] Early treatment, including guidance from your child’s doctor or mental health professional, can help prevent the social and emotional impact of encopresis.

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

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

  Encopresis is the soiling of underwear with stool by children who are past the age of toilet training. […] This stool or fecal soiling usually has a physical origin and is involuntary the child doesn’t do it on purpose. […] In most children with encopresis, the problem begins with painfully passing very large stools. […] Over time, the child becomes reluctant to pass bowel movements and holds it in to avoid the pain. […] This „holding in” becomes a habit that often remains long after the constipation or pain with passing bowel movements has resolved. […] Often in the beginning, only small amounts of stool leak out, producing streaks in the child’s underwear. […] As time goes on, the child is less and less able to hold the stool in, and more and more stool leaks. […] Eventually, the child passes entire bowel movements into their underwear.

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

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

  Often the child is not aware that they have passed a bowel movement. […] Because the stool is not passing normally through the colon, it often becomes very dark and sticky and may have a very foul smell. […] In many children, the anal sphincter contracts rather than relaxes when they are trying to push out bowel movements. […] This disturbed coordination of muscle function, which causes fecal retention, is a key to the diagnosis and is also called anismus or paradoxic contraction of the pelvic floor to defecation. […] 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. […] Soiling episodes usually occur during the day, while the child is awake and active.

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

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

  Often the child is not aware that they have passed a bowel movement. […] Because the stool is not passing normally through the colon, it often becomes very dark and sticky and may have a very foul smell. […] In many children, the anal sphincter contracts rather than relaxes when they are trying to push out bowel movements. […] This disturbed coordination of muscle function, which causes fecal retention, is a key to the diagnosis and is also called anismus or paradoxic contraction of the pelvic floor to defecation. […] 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. […] Soiling episodes usually occur during the day, while the child is awake and active.

• #29 Encopresis DSM-5 307.7 (F98.1)

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

  In order to make a definitive diagnosis, a complete medical examination must be conducted. […] 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. […] In other cases, fecal smearing may result when an embarrassed child attempts to hide or clean up feces that were involuntarily passed. […] A more effective approach is to try and help the child better understand the problem and helping to maintain regular bathroom routines. […] If there are comorbid mental health disorders (anxiety, depression, etc), these disorders must be addressed. […] No matter which treatment modality is chosen (dietary changes, behavioral strategies, biofeedback, psychotherapy or medications), it remains a fact that if the bowel is kept empty, soiling cannot occur.

• #30 Encorpresis Treatment in Kids: Facts on Potty Training

  https://www.emedicinehealth.com/encopresis/article_em.htm

  It is important to remember that in almost all cases, encopresis is involuntary – the child does not soil on purpose. […] Most children with encopresis have experienced constipation or painful defecation in the past. […] Any of the following warrants a visit to your child’s primary health care professional: Soiling in a child who is at least four years of age. […] In some cases, anorectal manometry may be performed. […] The health care professional may insert a gloved finger into the child’s rectum to feel for stool and make sure the anal opening and rectum are of normal size and that the anal muscles are of normal strength. […] Encopresis can have a variety of causes, including inability to control the anal sphincter muscle or gastrointestinal problems, particularly chronic diarrhea and Crohn’s disease. […] Treatment of encopresis usually involves treatment of the underlying disorder; cognitive behavioral therapy or behavior modification is also sometimes helpful.

• #31 Q&A With Dr. B | Pedia-Lax

  https://www.pedia-lax.com/child-constipation-education/advice-from-dr-b/qa-with-dr-b

  My child recently started a new school and hasnt gone to the bathroom in days. But she sometimes has loose stools in her pants. If she was constipated, she would not soil her pants, right? Not necessarily. A child who suffers from constipation does not have the same control over their rectal muscles as an average child without these issues. She could have a very hard, large stool that is difficult to pass within her rectum and loose stool passes around the lodged stool. Constipation can present as loose stools and soiling in between periods of having no bowel movements. Furthermore, the fact that the child just started school could indicate anxiety about the new school, using a public bathroom, being separated from parents/caregivers, etc. These stressful situations could, and often do, cause constipation.

• #32 Q&A With Dr. B | Pedia-Lax

  https://www.pedia-lax.com/child-constipation-education/advice-from-dr-b/qa-with-dr-b

  What is being described is called soiling. Soiling is what happens when liquid feces leak out around hard, compacted stool. It can happen once or several times a day and is often confused with diarrhea. There is nothing a child can do to withhold soiling, and parents dont often make the connection between what they think is diarrhea and what is actually constipation, making the right diagnosis difficult. It is a vicious cycle that starts with hard feces. When the child experiences the pain of passing a hard stool, they withhold the stool, which makes it bigger, harder, and more difficult to pass as days go by. The child will voluntarily withhold the stool until, literally, the rectal vault is filled with stool. Then smaller bowel movements or even diarrhea leak around the stool, since the childs small anatomy cannot hold it any longer. The way to create a break in the cycle is to help create softer stools by increasing fiber in the childs diet, keeping the child well hydrated, and using a stool softener like Pedia-Lax Liquid Stool Softener. Then maintain the child on a high-fiber diet with lots of fluids.

• #33 Encorpresis Treatment in Kids: Facts on Potty Training

  https://www.emedicinehealth.com/encopresis/article_em.htm

  Encopresis is the soiling of the underwear with stool by children who are past the age of toilet training. […] Because the stool is not passing normally through the colon, it often becomes very dark and sticky and may have a very foul smell. […] In most cases, blood tests are not part of the evaluation of constipation and/or encopresis. […] Your child’s health care professional will ask many questions about the child’s medical history, toilet training history, diet, lifestyle, habits, medications, and behaviors. […] The main objective of manometry is to determine whether there is normal pressure within the anus. […] Encopresis is a very frustrating condition for parents. […] In most instances, this is not the case. […] Many parents assume the soiling is the result of the child being lazy or that the child is soiling intentionally to annoy them.

• #34 Encorpresis Treatment in Kids: Facts on Potty Training

  https://www.emedicinehealth.com/encopresis/article_em.htm

  It is important to remember that in almost all cases, encopresis is involuntary – the child does not soil on purpose. […] Most children with encopresis have experienced constipation or painful defecation in the past. […] Any of the following warrants a visit to your child’s primary health care professional: Soiling in a child who is at least four years of age. […] In some cases, anorectal manometry may be performed. […] The health care professional may insert a gloved finger into the child’s rectum to feel for stool and make sure the anal opening and rectum are of normal size and that the anal muscles are of normal strength. […] Encopresis can have a variety of causes, including inability to control the anal sphincter muscle or gastrointestinal problems, particularly chronic diarrhea and Crohn’s disease. […] Treatment of encopresis usually involves treatment of the underlying disorder; cognitive behavioral therapy or behavior modification is also sometimes helpful.

• #35 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.

• #36 Toileting and autistic childrencurve-rightcurve-right

  https://www.autism.org.uk/advice-and-guidance/professional-practice/toileting

  Learning to use the toilet, particularly in a way that others see as appropriate, can be a challenge for some autistic children. […] Common toileting difficulties for autistic children can include: knowing when they need to use the toilet; communicating the need to use the toilet; learning to use different toilets; sensory and environmental challenges; wiping themselves; smearing their poo. […] One of the biggest areas of concern that we have found delivering our training has been the number of children with undiagnosed constipation. A child may appear to be pooing but can still be constipated. […] When addressing specific continence difficulties such as constipation or bedwetting, there are specific National Health and Care Excellence (NICE) guidelines: constipation, bedwetting. […] It is vital to support children, families and caregivers with clear information about the potential difficulties and the fact that many of these can be overcome.

• #37 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.

• #38 Fecal Incontinence (Soiling): Causes, Treatment and Prognosis | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/fecal-incontinence

  Fecal incontinence (accidentally having bowel movements) is a very common problem in children. It can be caused by medical conditions like chronic constipation or congenital conditions that may disrupt bowel control, including: spina bifida, anorectal malformations and Hirschsprung disease. […] Fecal incontinence can be caused by medical conditions like chronic constipation or congenital conditions that may disrupt bowel control, including: spina bifida, anorectal malformations and Hirschsprung disease. […] Children with true fecal incontinence lack the ability to voluntarily have a bowel movement, so they require daily interventions to empty the colon of stool. However, there are two different types of true fecal incontinence and treatment for each varies: […] Physicians are usually able to predict which children with these issues will go on to have fecal incontinence so that parents can set expectations for potty training.

• #39 Fecal Incontinence (Soiling): Causes, Treatment and Prognosis | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/fecal-incontinence

  For children born with anorectal defects or Hirschsprung disease, doctors are able to predict the potential for bowel control fairly accurately. […] Whether the prognosis for bowel control is considered good or poor, its important to note that most children who have undergone surgery to correct anorectal malformations or Hirshsprung disease will need some type of consistent dietary or medical intervention to prevent constipation or true fecal incontinence.

• #40 Fecal Incontinence (Soiling): Causes, Treatment and Prognosis | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/fecal-incontinence

  For children born with anorectal defects or Hirschsprung disease, doctors are able to predict the potential for bowel control fairly accurately. […] Whether the prognosis for bowel control is considered good or poor, its important to note that most children who have undergone surgery to correct anorectal malformations or Hirshsprung disease will need some type of consistent dietary or medical intervention to prevent constipation or true fecal incontinence.

• #41 Encopresis (Fecal Soiling) – Harvard Health

  https://www.health.harvard.edu/a_to_z/encopresis-fecal-soiling-a-to-z

  Encopresis is when a child who is toilet trained passes stool (bowel movements) into his or her underwear. To have encopresis, the child must be at least four years old, the age by which most children can control bowel movements. Encopresis is also called fecal incontinence. […] In most cases, your doctor can diagnose encopresis based on your child’s: Age, History and symptoms of chronic constipation, Physical examination. […] The doctor will begin by asking about your child’s bowel habits, including: How often he or she has bowel movements, The size of your child’s bowel movements, Whether the outside of the stools have been streaked with blood. […] Call your doctor if your child is older than age four and consistently soils his pants with stool. Also call if your child has started soiling after being clean for many months or years. Call your doctor if your child frequently has constipation, even if he or she is not having a problem with encopresis. […] Most children with encopresis either outgrow the problem or respond to treatment. Treatment may involve changes in diet, medication and motivational therapy.

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

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

  If the soiling does not resolve, your child’s health care provider may refer you to a specialist in digestive and intestinal disorders (pediatric gastroenterologist), a behavioral psychologist, or both. […] The best way to prevent encopresis is to prevent constipation in the first place. […] If your child is consistently struggling with constipation, see their pediatrician.

• #43 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. […] A GP may refer your child to a specialist for treatment if they think soiling could be caused by another medical condition.

• #44 Diagnosis and management of fecal incontinence in children and adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9623001/

  Fecal incontinence (FI) is a commonly occurring disease of high concern. It is characterized by voluntary and involuntary defecation in children and adolescents. […] Currently, no consensus guidelines for diagnosis and management strategies of FI in children and adolescents exist, and the criteria for selecting optional methods had to learn from the practice guidelines in adults which could not cover all aspects of FI in children. Therefore, it is imperative to improve the efficacy of diagnosis and management strategies of FI and to pay attention to the physical and mental development and behavioral status of such children. […] The causes of FI in children are different from those in adults. Congenital malformations are common in children and adolescents, while tumor, trauma, and inflammation are common in adults. Behavioral disorders such as autism, attention-deficit hyperactivity disorder, and affective development disorders are also common causes of FI in children.

• #45 Diagnosis and management of fecal incontinence in children and adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9623001/

  The key information on the diagnosis and management of FI in children and adolescents are listed in Table 1. The medical history and outcomes of physical examination are mainly considered to determine the causes and risk factors. […] An appropriate scoring system is essential to both predict the severity of the disease and quantify the effect of treatment. […] Colonic transit time (CTT) is routinely recommended to diagnose FI in children with constipation and neurogenic abnormalities. CTT is the most important method used for distinguishing between FNRFI and FRFI; relevant studies show that 90% of children with FNRFI have normal CTT results. […] The basic treatment is the first-line treatment option of FI in children and adolescents. It has been reported that 22%54% of patients with FI achieve a high QoL through diet, toilet training, and cognitive behavioral therapy.

• #46 Diagnosis and management of fecal incontinence in children and adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9623001/

  The key information on the diagnosis and management of FI in children and adolescents are listed in Table 1. The medical history and outcomes of physical examination are mainly considered to determine the causes and risk factors. […] An appropriate scoring system is essential to both predict the severity of the disease and quantify the effect of treatment. […] Colonic transit time (CTT) is routinely recommended to diagnose FI in children with constipation and neurogenic abnormalities. CTT is the most important method used for distinguishing between FNRFI and FRFI; relevant studies show that 90% of children with FNRFI have normal CTT results. […] The basic treatment is the first-line treatment option of FI in children and adolescents. It has been reported that 22%54% of patients with FI achieve a high QoL through diet, toilet training, and cognitive behavioral therapy.

• #47 Encopresis |Understanding & Managing Encopresis In Children

  https://www.childpsychologist.com.au/resources/encopresis-soiling-in-school-aged-children

  Overall 30-50% of children with encopresis have a comorbid emotional or behavioural disorder (von Gontard, 2012). […] Encopresis can have a severe effect on the child, family and school environment. Encopresis is often a family preoccupation, as parents and siblings become increasingly frustrated as family activities may be disrupted due to the constant soiling. […] Studies have shown that encopresis children experience a greater amount of anxiety and depression symptoms, difficulties with attention, more social problems, disruptive behaviours and lower levels of academic performance (Mosca Schatz, 2014). […] While encopresis is a chronic and complex problem amongst many families, it is treatable. […] The first step to treating encopresis is to identify the cause behind the condition and seek medical advice from a pediatrician or GP. Medical examinations are important in order to rule out the existence of organic causes. […] Behavioural modification with the assistance of a Psychologist is an integral treatment component for encopresis. […] Comorbid emotional and behavioural disorders should be treated separately according to evidence-based recommendations (von Gontard, 2013).

• #48 Encopresis: is your child having a potty accident or is it something more?

  https://www.arnoldpalmerhospital.com/content-hub/encopresis-is-your-child-having-a-potty-accident-or-is-it-something-more/

  Encopresis is defined as involuntary passage of feces as a result of constipation. […] Encopresis is a very frequent symptom in a pediatric gastroenterology practice (like the one where I work). […] Failure to achieve toilet training in the early years the child’s life should not be confused with encopresis secondary to severe constipation. […] When children develop significant constipation, sometimes loose stool leaks out of the rectum unintentionally. […] The ability of the external anal sphincter muscles to contract and keep stool in the rectum is overcome by the stretch of the enlarged rectum and stool then leaks out. […] The key to resolving the problem is to treat the constipation. […] It is very important not to respond to the child with punishment or embarrassment for the soiling. […] Children with encopresis often suffer from low self-esteem and bullying.

• #49 Encopresis |Understanding & Managing Encopresis In Children

  https://www.childpsychologist.com.au/resources/encopresis-soiling-in-school-aged-children

  Overall 30-50% of children with encopresis have a comorbid emotional or behavioural disorder (von Gontard, 2012). […] Encopresis can have a severe effect on the child, family and school environment. Encopresis is often a family preoccupation, as parents and siblings become increasingly frustrated as family activities may be disrupted due to the constant soiling. […] Studies have shown that encopresis children experience a greater amount of anxiety and depression symptoms, difficulties with attention, more social problems, disruptive behaviours and lower levels of academic performance (Mosca Schatz, 2014). […] While encopresis is a chronic and complex problem amongst many families, it is treatable. […] The first step to treating encopresis is to identify the cause behind the condition and seek medical advice from a pediatrician or GP. Medical examinations are important in order to rule out the existence of organic causes. […] Behavioural modification with the assistance of a Psychologist is an integral treatment component for encopresis. […] Comorbid emotional and behavioural disorders should be treated separately according to evidence-based recommendations (von Gontard, 2013).

• #50 Soiling: Understanding Encopresis in Children – DoveMed

  https://www.dovemed.com/health-topics/focused-health-topics/soiling-understanding-encopresis-children

  Soiling, often referred to as encopresis, is a pediatric condition where children, typically older than four years, involuntarily pass feces into their clothing or underwear. […] Diagnosing encopresis involves ruling out medical conditions and evaluating the child’s medical history. […] A healthcare provider may conduct a physical examination to assess for signs of constipation or underlying medical issues. […] Take a detailed medical history, including information about the child’s toilet training, diet, and emotional well-being. […] Perform imaging tests like X-rays or ultrasounds to assess for fecal impaction. […] Timely intervention, including medical treatment, behavioral therapy, and dietary changes, can help children overcome this condition and regain control of their bowel movements.

• #51 Frustrated by Your Child’s “Potty Refusal” or „Lying” About Accidents? It’s Physical, Not Behavioral

  https://www.bedwettingandaccidents.com/single-post/frustrated-by-your-child-s-potty-refusal-or-lying-about-accidents-it-s-physical-not-behavioral

  There are several benign reasons a child might not acknowledge an accident, she says: Maybe the child feels their parents will be disappointed by the accident and wants to minimize the disappointment. […] Or, maybe the child doesn’t fully understand that they’re not registering the cue to poop. […] I promise: No child wets their pants because they don’t feel like getting out of bed. No child avoids the toilet for the purpose of making you mad. No child skips an enema because they don’t care about resolving their bedwetting. […] This mom described the cycle of shame and frustration that stopped when she and her husband realized their daughter wasn’t purposefully ignoring the urge to go. […] It’s physical, not behavioral, she wrote. Knowing that has made all the difference.

• #52 Addressing withholding behaviours in infants and children with constipation | Nursing Times

  https://www.nursingtimes.net/bladder-and-bowel/addressing-withholding-behaviours-in-infants-and-children-with-constipation-12-09-2022/

  Managing constipation requires a team approach between health professionals, parents/carers and the child. […] Explain to parents that it is not unusual for children to need laxative therapy for several years, but that constipation causes more problems than medication as a full dilated bowel can stretch the bowel walls. […] The laxative macrogol (also known as polyethylene glycol) is the recommended first-line approach to ensure effective bowel emptying. […] Constipation management and treatment needs monitoring to ensure effective long-term treatment and prevent recurrence. […] Better awareness of childhood constipation is needed by parents, professionals and the wider community, including the importance of early identification. Interventions should address the physical problem and include strategies to manage emotional responses and anxiety that can cause the constipation to persist.

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

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

  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.

• #54 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. […] Diagnosis starts with a complete medical history that includes questions about the child’s toilet training and a physical exam. This often provides enough information to diagnose encopresis. […] Treatment for encopresis depends on the root cause. […] If encopresis is caused by constipation, treatment may include laxatives to help the child pass the impacted stool. […] 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 physicians and nurse practitioners in the Division of Gastroenterology, Hepatology and Nutrition at Boston Children’s Hospital are experts in helping children have regular bowel movements on the toilet.

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