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Encopresis

Fecal soiling after toilet training is most often associated with chronic constipation.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Encopresis?

Encopresis is defined as fecal soiling in inappropriate places (underwear, bed, etc.) at least once a month in a child aged 4 years or older. 80-90% of cases are retentive (constipation-based): chronic stool accumulation leads to dilation of the rectum and colon, with consequent anal sphincter dysfunction.

In chronic retentive encopresis 'overflow incontinence' occurs as liquid fecal material seeps around accumulated hard stool; families often misinterpret this as diarrhea and intervene incorrectly. Psychological factors may accompany or trigger the picture.

The cornerstone of treatment is medical disimpaction of constipation followed by long-term laxative therapy to ensure regular bowel movements.

Symptoms

Soiling underwear (smear or full consistency)
Hard, large stool masses palpable in the abdomen
Abdominal pain and bloating
Loss of appetite
Fear of defecation or toilet avoidance
Fullness or anal fissure on rectal examination

Risk Factors

Chronic constipation and pain on passage of hard stool
Early or coercive toilet training
Stress and behavioral problems
Low-fiber diet and low fluid intake
Sedentary lifestyle
Anatomical causes (Hirschsprung — must be excluded)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When fecal soiling begins after age 4
  • If there is an abdominal mass or severe abdominal pain
  • When Hirschsprung disease or spinal anomaly must be ruled out
  • For pediatric psychiatry support if a psychological component is prominent

Treatment Methods

01
Disimpaction: high-dose oral or rectal polyethylene glycol (PEG) enema
02
Maintenance therapy: low-dose daily PEG for months
03
Diet: high fiber, plenty of fluids, restriction of refined carbohydrates
04
Toilet training: sit-on-toilet routine 15-20 minutes after meals
05
Behavioral support: positive reinforcement, no punishment
06
Pediatric gastroenterology or psychiatry consultation in complex cases

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.