A lot of kids soil themselves without knowing. This condition is called encopresis. Know more about it from paediatrician Dr. Shalini Pandey.
Parents get frustrated and embarrassed when children soil their clothes at odd places and times. While it is mostly seen as the child was unable to control the pressure and hence passed out in the clothes but if this happens frequently, it could be encopresis. This is the medical term for soiling where kids above the age of 4 years cannot control their bowel movement and give up to the urge to soiling their clothes. Onlymyhealth contacted Dr. Shalini Pandey, Senior consultant- Paediatric at Batra Hospital, New Delhi to know more about this condition. Parents who are encountering this issue with their child must read this article for more understanding.
What is Encopresis or Soiling?
Encopresis or soiling of underwear or clothes is defined as both voluntary and involuntary passage of faeces in inappropriate places in a child aged four years or older after organic causes have been ruled out. It is more stigmatised than urinary incontinence and highly distressing for both parents and the suffering child. Let us clear that this is not a disease. Soiling could happen due to different reasons. Most parents consider this a case of diarrhoea but when kids soil frequently, it is a must to take them to a paediatrician.
Also, there are different types of soiling seen in children. The two types of soiling seen in clinical practice are:
- Encopresis with constipation
- Encopresis without constipation
More commonly found Encopresis is one associated with constipation and we will be discussing it here.
Why child soil themselves: Encopresis Causes
Encopresis arises due to constipation. Children suffering from this condition tend to retain stools in the rectum resulting in hard mass collecting and blocking the anal opening. This causes pressure on the anus and soft stool which is lying behind this hard mass bypasses it and passes through the anus causing soiling.
If your child doesn’t consume enough fibre or drink water, passing faecal matter can become very difficult. Some kids also hold their bowel movements which may also be a reason behind soiling. Liquid faecal matter can easily leak around their pants without children having any control over the motion. In some cases, faecal blockage causes enlargement of the intestines which affects the sensation or ability to identify the need to poop. Here are the probable causes of encopresis caused due to constipation:
- Consuming low-fibre diet
- Drinking very less water
- One or less bowel movement in 3 days
- Early toilet training
- Anxiety over toileting
- Behavioural problems
- Stressors like school, familial, etc.
An important note for the parents here is that most kids do not soil themselves on purpose. This is not in their control. Most kids who do not wish to use the toilet control their pee for longer durations and when it starts to leak, it causes soiling.
While the most prominent sign of encopresis is soiled or wet underclothes, there are several other warning signs and symptoms of this condition that parents should watch out for. Since most of the time, encopresis is with constipation, parents should see if their child is constipated. If they are facing problems in passing stools or they haven’t had a bowel movement in 3-4 days, they may be constipated. The other symptoms of soiling are:
- Abdominal pain
- Lack of appetite
- Urinary tract infections
While these are visible symptoms, there are certain behavioural symptoms also that they may exhibit. For example, hiding the soiled clothing every time they soil them. Children may even feel shame and guilt if they are accused of soiling their clothes. Children are very sensitive and these things can affect them psychologically. They may be even teased at school. In such a case, you must talk to them and support them. Don’t hold them responsible of this behaviour. This may even help them overcome the solution over time.
What are the factors causing constipation?
Constipation can be triggered by a wide variety of factors such as stressful life events, losses, family conflict, as well as somatic causes like anal fissures, anal tags, perianal infections, changes of diet, intensive toilet training and wrong diet. Acute constipation leads to very hard and large stool leading to painful defecation. The child starts to avoid defecation, inducing a paradoxical contraction of the external anal sphincter, which becomes a habit. Avoidance of bowel movements leads to the accumulation of fecal material in the rectum and colon.
What are the signs that my child is suffering from constipation?
Many times parents notice child standing in the corner silently straining with legs crossed trying to stop stool from coming out. Also, there can be soiling of underclothes. The child cries during the passage of stools. Parents can also notice that child is passing hard, nut-like stools. The child does not want to sit at the pot. There can also be Eneuresis ( involuntary passage of urine) or bedwetting also. What are the times when parents should be careful about the start of constipation? As per Dr. Shalini Pandey, change of school, change of class or friends, changes in diet, travelling, family conflict, death of near one, hospitalisations, certain infections and medications can all precipitate constipation.
What to do if the child is soiling or has constipation?
It is not easy for the child to deal with the situation. Thus, parents need to be their biggest support during this time. Here are some tips from Dr. Shalini to help a child with encopresis and constipation.
- Be supportive, do not scold or punish the child.
- Try to find the cause of constipation like conflict at school or at home.
- Look closely at diet and try to include fruits and salads in diet.
- Avoid refined foods.
- Consult a doctor who can prescribe medicines for constipation and examine for fissures, tags or any abnormal perianal infections or reflexes.
- Toilet training may also help in combating the issue. For that, make the child sit at the pot for 10-15 minutes after meals three times a day.
- During this time the child should be relaxed and happy.
- His feet should be touching the floor otherwise a small footstool can be provided.
- He can be indulging in a book reading or listening to stories or music. Encourage him to relax and have positive thoughts. Maintain a stool diary and note the consistency of stools. Parents should make sure that When they visit a doctor, all these points are ready.
Soiling is not a rare but quite a common problem with children. But one thing to note is that soiling or encopresis is different from bed-wetting. Generally, kids soil themselves at inappropriate places and most of the time, they don’t even know that they have soiled themselves. As a parent, you must notice the signs and symptoms of soiling in them and helping them cope with it. Give them toilet training so that they know how to do it. Besides, provide them with a nutritious fiber-rich diet and ask them to drink water often to better their bowel movements. The main reason behind this issue is constipation that is caused either due to poor diet or improper toilet training. If you can teach your child both, it would become very easy to tackle encopresis as this is not a disease but just a condition that can easily improve over time. Be a responsible parent.
Read More Articles in Children's Health
All possible measures have been taken to ensure accuracy, reliability, timeliness and authenticity of the information; however Onlymyhealth.com does not take any liability for the same. Using any information provided by the website is solely at the viewers’ discretion. In case of any medical exigencies/ persistent health issues, we advise you to seek a qualified medical practitioner before putting to use any advice/tips given by our team or any third party in form of answers/comments on the above mentioned website.