Encopresis is the term used for lack of control of bowel movements for anyone over the age of 4. It is NOT uncommon. In fact it is reported that 1%-2% of children over age 4 are known as “fecally incontinent.” For unknown reasons it is more common for boys than girls.

It has incorrectly been assumed that this is the result of emotional disorders (which are more often the result-not the cause-of it) or by lax toilet training. A child can also be born with poor muscle tone in the bowel or anal sphincter.

It seems, however, the majority of cases are the result of chronic constipation, though, of course, it can be complicated by other stresses in either toilet training or life situations. With chronic constipation, colon tissue can be stretched to the point that nerves fail to receive proper signals and the muscles no longer contract properly so that a child no longer feels the urge to go.

A child may even have no awareness of when stool pushes out into the underwear. Watery stools can also seep past harder stool, soiling pants without a child being aware of it until after the fact. Regardless of the basis of the problem, both parents and children need to know they are not alone here and no one is to blame for this problem.

Not all doctors are trained in successful therapy for this problem so look for one who is, as this problem needs to be approached medically as well as psychologically. If your county medical association can’t help, seek out a children’s hospital or university teaching hospital. Encopresis is treated by a gradual retraining of the bowel which includes dietary changes, supplements, and behavior modification. There is not an overnight cure for this condition.

The first step toward treating constipation should be changing your child’s diet.

Praise your child for every bowel movement made in the potty or toilet. Also praise a child for even sitting and trying to go.