Key points to remember
- soiling (encopresis) is when your child does poo in their pants after the age when you would expect them to be toilet-trained
- soiling is usually caused by chronic constipation and an overloaded bowel
- soiling problems can be frustrating and upsetting for parents and children (see What can I do to help my child?); older children with soiling are often teased
- you are not alone; there are many children with this problem
- most children with soiling problems have had pain doing poo in the past
- soiling often occurs without your child knowing; it is not deliberate and your child did not develop this problem to upset you or be manipulative
- the treatment of constipation and soiling takes time; most children need to take medication for many months and often years to manage the problem
- children who soil sometimes have other behaviour problems which improve when the soiling is treated
What is it?
Soiling (encopresis) is when your child does poo in their pants after the age when you would expect them to be toilet-trained. Soiling is a common problem affecting many children. It can happen in any child, toddler or teenager.
What causes it?
- soiling is usually caused by chronic constipation and an overloaded bowel (see How does my child get an overloaded bowel?)
- for a few children, emotional and behavioural problems are a factor rather than constipation; these children and families need professional help to address these issues
How does my child get an overloaded bowel?
|See Acknowledgements for this graphic.|
What is the treatment?
Treatment for soiling is the same as for constipation.
See the following sections in the constipation fact sheet:
- What is the toileting habit I should encourage for my child?
- What are laxatives?
- Bowel flush out to empty the lower bowel
- How long are laxatives for constipation necessary?
Treatment focuses on:
- unblocking and emptying the bowel
- keeping the bowel emptying regularly for a few months to allow it to come down to a normal size
- establishing a regular routine of sitting on the toilet
- developing the habit of a soft motion at least once a day
Taking laxatives is important in helping to resolve the problem.
Treatment should continue for enough time to allow the bowel size and feeling (sensation) to return to normal. This is usually for months or years.
What can I do to help my child?
- learn about the causes of constipation and soiling
- establish a regular and consistent routine of sitting on the toilet and taking laxatives; this is the key to helping resolve the problem
- educate and encourage the whole family to be supportive and understanding
- stay calm and be supportive of your child; getting angry will make you feel bad and make your child tense and less likely to be successful
- it is often best to ignore suggestions from friends and family who give unhelpful advice
- remember the poo is the problem, not your child
Where to go for more information
- The Royal Children’s Hospital (Melbourne) Kids Health Info. Adapted October 2006 by Child Development Centre, Waikato Hospital.
Paediatric Department, Christchurch Hospital
Paediatric Department, Nelson Hospital
The animated soiling graphic comes from Constipation and encopresis: A multimedia tutorial, at the University of Virginia Health System website (U.S.). Thank you to The University of Virginia Health System for permission to reproduce this.
- NASPGHAN Constipation Guideline Committee. September 2006. Clinical practice guideline: Evaluation and treatment of constipation in infants and children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
http://www.naspghan.org/user-assets/Documents/pdf/PositionPapers/constipation.guideline.2006.pdf [Accessed 4/03/2011]
- Royal Children's Hospital, Melbourne. November 2010. Clinical Practice Guideline: Chronic constipation.
http://www.rch.org.au/clinicalguide/cpg.cfm?doc_id=11659 [Accessed 4/03/2011]
- National Institute for Health and Clinical Excellence, U.K. May 2010. Constipation in children and young people.
http://guidance.nice.org.uk/CG99 [Accessed 4/03/2011]
© Paediatric Society of New Zealand and Starship Foundation 2005 – 2014
Printed on 23 July 2014. Content is regularly updated so please refer to www.kidshealth.org.nz for the most up-to-date version