💩 Soiling in Children (Encopresis): What It Is, Why It Happens, and When to Seek Help

🎯 “My child keeps having poop stains in their underwear, but they don’t seem to notice or care. Are they doing it on purpose?”

This is a common and often misunderstood issue.

Encopresis — involuntary stool leakage in children — is usually not behavioral or intentional, but a sign of chronic constipation that has gone untreated. With early recognition and the right support, it is completely manageable.

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📌 What Is Encopresis?

Encopresis is the involuntary leakage of stool in children older than 4 years, who should have already gained toilet control.

It can happen:

• Due to chronic constipation, leading to overflow soiling

• As a result of stress, trauma, or behavioral resistance

• Rarely, due to neurological or anatomical causes

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Types of Encopresis:

🧪 What Causes Encopresis?

✅ 1. Chronic Constipation

• Stool becomes hard and difficult to pass

• The child withholds stool, worsening the blockage

• The colon stretches, reducing the feeling of fullness

• Soft stool leaks around the impaction without the child realizing

✅ 2. Toilet avoidance

• Fear of using toilets (especially at school)

• Embarrassment or bad past experiences

• Inconsistent toilet routines

✅ 3. Emotional or psychological triggers

• New sibling, divorce, school changes

• Control issues or attention-seeking (especially if child was once trained)

✅ 4. Rare medical causes

• Spina bifida, Hirschsprung’s disease

• Nerve-related bowel issues (rare)

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👨‍⚕️ When Should You See a Pediatrician?

• Child is older than 4 and has weekly episodes of soiling

• Stool withholding behavior or fear of pooping

• Bedwetting or daytime urine accidents alongside soiling

• Complaints of stomach pain, poor appetite, or hard stools

• History of severe constipation

📌 Early medical evaluation helps avoid long-term bowel issues and emotional impact.

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🩺 How Is It Diagnosed?

Your pediatrician will ask about:

• Toilet training history

• Bowel movement frequency

• Diet and daily habits

• Emotional or life changes

Tests may include:

• Abdominal X-ray (to detect stool buildup)

• Stool or blood tests if needed

• Neurological exam in rare cases

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💊 Treatment Plan

Treatment takes time and requires patience and consistency.

1. Bowel Clean-Out

• Laxatives or enemas may be used initially to remove impacted stool

• This step is short-term and supervised by your doctor

2. Maintenance & Prevention

• High-fiber diet (fruits, vegetables, whole grains)

• Daily toilet routine (after meals is ideal)

• Plenty of water

• Avoid punishment, encourage with praise

3. Emotional Support

• Reassure your child — they are not doing this on purpose

• Celebrate small successes

• Consider support from a child psychologist if emotional triggers are involved

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📌 Helpful Tips for Parents

✅ Be patient — this is a medical, not disciplinary issue

✅ Use reward charts, stickers, or small incentives

✅ Avoid making soiling a source of shame or embarrassment

✅ Keep extra clothes handy at school or daycare

✅ Follow up regularly with your pediatrician

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📌 Final Thoughts

Encopresis can be frustrating for families, but it’s treatable and temporary.

Early recognition, supportive parenting, and proper medical care make a huge difference.

If your child struggles with stool accidents, don’t delay seeking help — the sooner the intervention, the better the outcome.

🩺 If you’re in İzmir and need support with chronic constipation or soiling issues, I’d be happy to welcome you to my pediatric clinic for a thorough evaluation and personalized care plan.