Encopresis is the involuntary discharge of feces (ie, fecal incontinence). The behavioral difficulties associated with encopresis are most likely the result of the condition rather than its cause. In the vast majority of cases, encopresis develops as a consequence of chronic constipation with resulting overflow incontinence. Many children with encopresis have a remote history of constipation or painful defecation or demonstrate incomplete evacuation during defecation on physical examination or radiographic assessment. Chronic constipation due to irregular and incomplete evacuation results in progressive rectal distention and stretching of both the internal anal sphincter and the external anal sphincter (EAS). As the child habituates to chronic rectal distention, he or she no longer senses the normal urge to defecate. Soft or liquid stool eventually leaks around the retained fecal mass, resulting in fecal soiling.
Signs and symptoms of encopresis may include: Leakage of stool or liquid stool on your child's underwear, constipation with dry hard stool, passage of large stool that clogs or almost clogs the toilet, avoidance of bowel movements, long periods of time between bowel movements, possibly as long as a week, lack of appetite, abdominal pain and repeated urinary tract infections. The first step involves clearing the colon of retained, impacted stool. After that, treatment focuses on encouraging healthy bowel movements. There are several methods for clearing the colon and relieving constipation. Your child's doctor will likely recommend one or more of the following: Stool softeners (lactulose), colon lubricants (mineral oil), rectal suppositories, enemas.
Although few prospective studies have been conducted to examine the prevalence of encopresis in childhood, it is estimated that 1-2% of children younger than 10 years have encopresis. In nearly all published series, boys are much more commonly affected than girls. In most series, approximately 80% of affected children are boys.