Encopresis: what it is, causes, symptoms and treatment

Encopresis is a condition characterized by the leakage of feces into the child’s underwear, which most of the time happens involuntarily and without the child noticing, especially after the age of 4.

This leakage of feces generally occurs due to constipation, but it can also occur in children who are afraid to use the toilet or who hold on to their feces so as not to have to evacuate outside the house, for example.

If encopresis is suspected, it is important to consult your pediatrician or a pediatric gastroenterologist. Treatment depends on the cause and may involve changes in diet, psychological support, use of laxatives and, in some cases, surgery.

Encopresis symptoms

The main signs and symptoms of encopresis are:

• Exit of feces on underwear, spontaneously;
• Harder stools;
• Decreased sensitivity in the anal region.

Furthermore, due to these changes, it is also common for children with encopresis to also have enuresis, which is urinary incontinence at night. Find out when it is normal for your child to wet the bed.

Possible causes

The main causes of encopresis are:

• Constipation;
• Discomfort when evacuating;
• Fear or shame of using the toilet;
• Difficulty reaching or accessing the bathroom;
• Not being able to use the bathroom outside the home;
• Do not go to the bathroom when you feel like having a bowel movement;
• Anxiety while learning to use the bathroom;
• Diseases such as hypothyroidism, celiac disease or anal fissure.

Furthermore, encopresis can be a consequence of the use of some medications, such as antidepressants or opioids.

How to confirm the diagnosis

The diagnosis of encopresis is made by the pediatrician taking into account the symptoms and the child’s age, and is normally suspected only after the age of 4, because before this age it is common to have difficulty controlling evacuation.

In addition, sometimes the pediatrician may also recommend tests such as measuring thyroid hormones in the blood and/or MRI, especially when there is a suspicion that encopresis is being caused by diseases such as hypothyroidism or changes in the spinal cord.

How the treatment is carried out

The treatment of encopresis depends on its cause and, especially in the case of constipation, it is important to help the child develop the habit of using the toilet regularly, in addition to improving their diet, increasing their intake of fruits, vegetables and liquids. Find out what to do to combat constipation in children.

Additionally, the pediatrician or pediatric gastroenterologist may recommend the use of laxatives, in syrup, tablet or suppository form, such as lactulose or polyethylene glycol, to prevent the development of encopresis.

If encopresis is caused by a disease that affects the child’s digestive tract, it may be necessary to carry out specific treatment for the disease and, in rarer situations, surgery to allow normal evacuation.

Psychological support

Psychotherapy can also be recommended in the treatment of encopresis, especially when it is identified that the child has psychological obstacles, such as anxiety or fear, that do not allow them to be comfortable using the toilet.

Consequences of encopresis

Encopresis can have negative consequences for the child, especially on a psychological level, such as low self-esteem, irritation or social isolation. Therefore, it is important that, during treatment, parents offer support to the child.