Encopresis occurs when your child resists having bowel movements, causing impacted stool to collect in the colon and rectum. When your child's colon is full of impacted stool, liquid stool can leak around the impacted stool and out of the anus, staining your child's underwear. Encopresis may also be called stool holding.

Causes:

• Constipation.
• Hard stools.
• Other causes are low fiber diet, illness, decreased fluid intake, fear of the toilet during toilet teaching, or limited access to a toilet or a toilet that's not private (like at school).
• Emotional stress.

Risk factors

The following risk factors may increase your child's chances of having encopresis:

• Sex. Encopresis is more common in boys.
• Chronic constipation. This may cause your child to avoid passing stool.
• Not drinking enough fluids. This aggravates existing constipation.

When to seek medical advice

Although rectal surgery or birth defects such as Hirsch sprung disease and spina bifida can cause constipation or Encopresis without constipation, these are uncommon.

Call the doctor if your child shows any of the following symptoms:

• Stool or liquid stool in the underwear when your child isn't ill.
• Hard stool or pain during bowel movement.
• Toilet-stopping bowel movement.
• Abdominal pain.
• Loss of appetite.
  

Diagnosis:

• Medical history.
• Physical examination.
• Abdominal x-ray.

Treatment:

• Stool softeners, such as lactulose
• Colon lubricants, such as mineral oil
• Rectal suppositories
• Enemas
• More fluids.
• Psychotherapy.
  

Prevention:

• Increase fiber content in diet like fruits, vegetables, whole grains.
• Encourage drinking of water.
• Avoid dairy products and fats.
• Set a schedule: Adopt regular meal times and bed times.
• Arrange bathroom time: Allow the child to spend at least 3 minutes alone in the toilet after each meal each day.
• Don't blame, criticize or punish your child.