Encopresis (from Ancient Greek ἐγκόπρησις, enkóprēsis) 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.
[1] Encopresis is commonly caused by constipation in children,[4] by reflexive withholding of stool, by various physiological, psychological, or neurological disorders, or from surgery (a somewhat rare occurrence).
The hardened stool continues to build up and stretches the colon or rectum to the point where the normal sensations associated with impending bowel movements do not occur.
Strong emotional reactions typically result from failed and repeated attempts to control this highly aversive bodily product.
The usual onset is associated with toilet training, demands that the child sit for long periods of time, and intense negative parental reactions to feces.
In the subtype with constipation, the feces are usually poorly formed and leakage is continuous, and this occurs both during sleep and waking hours.
Many pediatricians will recommend the following three-pronged approach to the treatment of encopresis associated with constipation: The initial clean-out is achieved with enemas, laxatives, or both.
It is thought that creating a regular schedule of bathroom time will allow the child to achieve a proper elimination pattern.