- When a large amount of hard, dry stool is filling the rectum, over time the child becomes unable to recognize the sensation of fullness and the need to go to the bathroom.
- Liquid stool may leak around the hard mass of stool, causing staining of the underwear.
- May be associated with a diet low in fiber and fluids, and lack of exercise
- Poor toilet training or refusal to use the toilet for bowel movements
- Emotional problems
- Organic causes (rare)—result of problems or malformations in the intestines
- Passage of firm stool that causes a painful tear or "fissure" at the opening of the anus
- Children who have suffered sexual abuse (according to some researchers)
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- Low self-esteem
- Feelings of embarrassment, shame, or guilt
- Infrequent bowel movement
- Pain or bleeding with defecation
- Abdominal pain
- Bed wetting
When Should I Call the Doctor?
- Abdominal x-ray —may show excessive stool in the rectum
- Other imaging tests to look for organic causes if the constipation is not relieved with treatment or if your child passes blood with their stool
- Short-term treatment with laxatives.
- Long-term treatment (up to one year) with stool softeners. This can make it easier for your child to pass stool. It may also decrease your child's reluctance to pass stool.
- Eat a healthy diet that is high in fiber .
- Drink plenty of liquids.
- Has severe problems with toilet training
- Has emotional problems, including family problems
- Is experiencing shame, guilt, or low self-esteem due to fecal incontinence
American Academy of Family Physicians—Family Doctor http://familydoctor.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
Canadian Digestive Health Foundation http://www.cdhf.ca
Health Canada http://www.hc-sc.gc.ca
Encopresis (soiling). Nemours Kid's Health website. Available at: http://kidshealth.org/parent/general/sick/encopresis.html. Updated January 2012. Accessed December 18, 2014.
Fecal soiling. American Academy of Pediatrics Health Children website. Available at: https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Fecal-Soiling.aspx. Updated May 11, 2013. Accessed December 18, 2014.
Fecal incontinence in children (encopresis). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900450/Fecal-incontinence-in-children-encopresis. Updated September 15, 2016. Accessed September 28, 2016.
Stool soiling and constipation in children. American Family Physician Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/kids/toileting/stool-soiling-and-constipation-in-children.html. Updated November 2010. Accessed December 18, 2014.
- Reviewer: Daus Mahnke, MD
- Review Date: 12/2015 -
- Update Date: 12/20/2014 -