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.
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Soiling
Also known as encopresis
Key points about soiling
- Soiling is when your child does poo in their pants after the age when you would expect them to be toilet-trained.
- It's not deliberate and your child didn't develop this problem to upset you or be manipulative.
- Soiling is usually caused by long-lasting constipation and an overloaded bowel.
- It can be frustrating and upsetting for parents and children, but you're not alone – many children have this problem.
- The treatment of constipation and soiling takes time – most children need to take medicine for many months and often years to manage the problem.
- The content on this page comes from KidsHealth(external link)
- Soiling is usually caused by long-lasting constipation and an overloaded bowel.
- For a few children, emotional and behavioural problems are a factor rather than constipation – you may need professional help for these issues.
Hard poos
Poo usually comes down and passes out in 'single file'. If for some reason your child does a hard poo and it hurts, they may try to avoid pain again by 'holding on' to the next poo.
Bowel wall and nerves get stretched
If your child 'holds on' to their poo, the poo gets bigger and harder and stretches the bowel wall and the nerves around the bowel.
More poo gets stuck in the bowel which becomes more stretched. Overloading becomes worse – a vicious cycle begins.
The sensation or 'the urge' to have a poo is lost because the nerves have been stretched.
Overloading can be present even without the constipation being obvious. Your child can produce poo daily but the backlog continues
Leaking poo
When the bowel gets overloaded, poo trickles down or overflows without the child noticing. This often happens when they are relaxing, exercising, or after eating.
This is terrible for your child who has no idea what is happening to them. They won't be able to understand why this is happening and so won't be able to explain it.
If your child is soiling, you should take them to your healthcare provider. Public health nurses can also be very helpful for your child with soiling. You could ask your healthcare provider about talking to a local public health nurse.
Your healthcare provider may suggest your child sees a specialist nurse or doctor if:
- your child's soiling is proving difficult to treat after standard treatments or,
- they think there may be another condition causing your child's constipation and soiling.
Treatment for soiling focuses on:
- Unblocking and emptying the bowel – usually with a bowel washout.
- Taking laxatives to help your child do a soft poo at least once a day. This keeps their bowel empty so that it returns to a normal size. It may take a few months.
- Establishing a regular routine of sitting on the toilet.
Treatment should continue for enough time to allow the bowel size and feeling (sensation) to return to normal. This is usually for months, or sometimes years.
Read about constipation in children.
Soiling problems can be frustrating and upsetting for parents and children. It's important to understand the cause and not to blame your child for soiling. It can be hard to understand that stretched nerves really do mean your child isn't aware when they've soiled. Soiling is upsetting and can cause other behaviour problems which usually improve when the soiling is treated.
Remember the poo is the problem, not your child. Don't blame them.
Video: Poo Hoo
You could watch a video with your child. 'Poo hoo' is a story about Tim Thompson who is having problems with sore tummies and sneaky poos. The video may take a while to load.
Information on constipation, soiling, bedwetting and daytime wetting (Continence NZ)
The Continence NZ website provides information and a range of resources about bedwetting, daytime wetting and soiling. You can call 0800 650 659 for further help.
Parent to Parent
Through a network of regional groups and trained volunteer support parents, Parent to Parent provides information and emotional support to families who have a child with a disability, special need or health impairment. Parent to Parent can help if you want to contact another parent whose child has similar needs. Call free on 0508 236 236.
Bristol stool chart at Wikipedia(external link)
The Bristol stool scale/chart is a medical aid, with diagrams, designed to classify poo into 7 groups indicating constipation, normal poo or diarrhoea.
ERIC (Education and Resources for Improving Childhood Continence), UK(external link)
ERIC provides information for parents, children and adolescents and for health professionals on continence issues. The website has a number of leaflets to download.
Soiled pants – a guide for parents and children(external link)
A brochure with diagrams for printing.
References
- Evaluation and treatment of functional constipation in infants and children – evidence-based recommendations from ESPGHAN and NASPGHAN(external link), 2014
- Clinical practice guideline – constipation(external link) Royal Children's Hospital, Melbourne, Australia
- Constipation in children and young people(external link) National Institute for Health and Clinical Excellence, UK, 2017
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Credits: Content shared between HealthInfo Canterbury, KidsHealth and Healthify He Puna Waiora as part of a National Health Content Hub Collaborative.
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