I considered myself an experienced parent who knew everything about bowel movements. In fact, I started maintaining a diary to track my baby’s bowel movements when my first child was born. Though it may seem gross, as a breastfeeding mom, it was important for me to ensure that my child was getting enough nutrition.
When I became a foster parent, I was exposed to encopresis, as explained in this Comprehensive Encopresis Overview from Cincinnati Children’s Hospital. I learned about encopresis for the first time. This Comprehensive Encopresis Overview from Cincinnati Children’s Hospital has helped me understand the condition and how to help others.
7 Things to Know About Encopresis
Are you caring for a child who has bowel movements outside of the toilet? Does your child have chronic constipation?
Maybe you are a foster parent who is unclear about why your child is having so many accidents. Here is some information to help.

What is Encopresis?
Encopresis is a condition in which a child intentionally withholds bowel movements, leading to soiling of clothing, accidents, or other behaviors.
When it comes to my foster children, their encopresis symptoms started with severe constipation. We attempted to alleviate the issue by increasing their physical activity and adjusting their diet. We also encouraged them to drink more water and added a glass of prune juice to their daily routine. Despite our efforts, they would sometimes go days or even a week without having a bowel movement.
After a particularly long stretch of constipation and vomiting, we ended up in the emergency room. It was then that we learned that our foster sons had encopresis.
Encopresis, a condition where a child involuntarily soils their clothes with stool, is more prevalent in kids aged four and above who have already completed their potty training. While some children may be retaining their stool due to constipation or pain during bowel movements, others may be doing so for psychological reasons like trauma or emotional distress.
What Causes Encopresis?
My now-adopted sons require daily medication and monitoring for encopresis. They both experience chronic constipation and require daily stool softeners and laxatives. Encopresis causes them to experience stomach aches and, eventually, a loss of appetite.
One of my sons will become so constipated that his breath will begin to smell of stools. This is traumatic for everyone involved.
When my sons use the toilet, they often clog it with their bowel movements. They feel embarrassed and try to hide the problem, causing the toilet to overflow. This has resulted in numerous incidents of water damage in our bathroom.
When we are away from home, it becomes even more stressful. I have to check the bathroom immediately after one of my sons uses it to ensure that they haven’t caused any blockages or left any stools on the ground.
When using a public restroom, I hope for the best. It’s difficult for me to enter the men’s room alone, and my sons are too old to come into the women’s room with me.
When stool is held for long periods, it can stretch the colon and cause leakage of fluid around the stool, which smells like stool and is noticeable to others. This can have a negative impact on my sons’ mental health, as their peers may tease them or call them names due to the odor.
Symptoms and Diagnosis
I have learned that when my sons complain of their legs hurting, it means they are constipated. They report the pressure in their lower bowels to be upper leg pain.
In other words, they are unclear on why or where the discomfort is coming from, and it wasn’t always clear when they experienced constipation.
Common signs of encopresis include
- Leakage of stool or liquid stool on underwear, which can be mistaken for diarrhea.
- Constipation with a dry, hard stool.
- Passage of large stools that clog or almost clog the toilet.
- Avoidance of bowel movements.
- Long periods between bowel movements.
- Lack of appetite.
- Abdominal pain.
Treatment for Encopresis
In our family, we consult with a pediatric gastroenterologist, monitor our sons’ bowel movements, and encourage them to tune into their bodies.
We teach our sons to listen to their bodies and recognize feelings of fullness, hunger, and constipation.
Teaching children from difficult backgrounds to trust their bodies and ask for help has been challenging for us.
This remains a challenge as we support them in managing their toileting habits, including planned bathroom breaks.
Coping with Encopresis: Help for Parents
Encourage your sons to be honest with us if they have an accident or clog the toilet, so that we can help them find a solution.
Do not shame or punish your sons for these incidents, as they are not able to control their bowel movements.
Suggest providing instructions to the school on allowing frequent bathroom breaks or encouraging a bathroom break at certain times of the day, such as after lunch or recess.
Provide your sons with guidance on how to handle accidents, with empathy, and encouragement to avoid secrecy.
Prevention and Long-term Outlook
If your child is experiencing encopresis or unusual stooling behaviors, it’s essential to consult a pediatrician. Home remedies may not be sufficient to help your child develop a long-term management plan.
Encopresis is a difficult condition that affects both children and their families. Although it can cause significant stress, there are professionals who can help you manage it.
Myths and Misconceptions
People may believe that the child is attention-seeking or that they should know better. I try to explain to people that my sons have not always had their needs met by a loving caregiver.
Because of this, they don’t know that adults can be trusted. This has resulted in them not trusting adults to take care of them. Additionally, they have learned to manage discomfort on their own, without the support of a nurturing adult.
After spending many years with our family, these lessons require time and consistency to master. We are teaching them to trust us by avoiding criticism or punishment.
When accidents happen, we handle them with compassion.
Addressing Encopresis with Care and Understanding
While caring for a child with encopresis can be challenging, having a plan can help. The condition of encopresis can lead to a lot of frustration for both the child and caregivers.
If the parent is able to address the condition with compassion and care, the child is more likely to be open and honest about accidents and prevention.
Seek the help of your pediatrician to better understand the causes and treatment of encopresis.
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