Fecal incontinence is when children who are past the age of toilet training regularly do poops in places other than the toilet. They can’t control when and where the poop comes. It can be very upsetting for children and parents.
Causes of fecal incontinence
A common cause of fecal incontinence in children is chronic constipation..
If your child has been constipated for a long time, poop builds up in the rectum, which can cause the rectum to stretch. Your child might lose the urge to go the toilet because their rectum always feels stretched. Then liquid poop might overflow around the old, stuck poop, without your child feeling it or meaning to let it go.
Emotional issues, like stress from premature or forceful toilet training or the birth of a sibling, might also lead to fecal incontinence.
Other causes of fecal incontinence include rare neurological disorders and abnormalities of the anus.
Fecal incontinence is also called soiling or encopresis.
Fecal incontinence is accidental and beyond your child’s control. But it can be difficult to live with, and it’s normal if you find it challenging or upsetting. If this sounds like you, talk to your doctor about getting support.
Symptoms of fecal incontinence
Fecal incontinence can range from smears in their underwear to larger bits of poop.
Aside from pooping in places other than the toilet – usually in underwear – your child might also have symptoms of constipation. These include pain when doing a poop, which can mean they try to avoid going to the toilet. They may also have tummy pains that come and go, and might go for long periods between poops.
It’s common for children with fecal incontinence also to have daytime or night-time wetting.
About 30-50% of children with fecal incontinence have emotional or behavior problems too.
All children achieve bowel control at their own rate. Fecal incontinence isn’t generally considered a medical condition unless your child is at least four years old.
When to see your doctor
You should see your doctor if your child is four years or older and has persistent fecal incontinence or constipation.
Treatment for fecal incontinence or soiling
The treatment for fecal incontinence depends on the cause of the problem.
If chronic constipation is the main cause, your doctor will help you work out a treatment plan based on using laxative medications and establishing good bowel habits.
You can help your child get into good bowel habits by encouraging them to sit on the toilet regularly and push. It’s good if they can do this for five minutes about 20-30 minutes after finishing breakfast, lunch and dinner.
If your child has behavior problems associated with fecal incontinence, they may need counseling, and group or individual psychotherapy.
The good news is, regardless of how it’s treated, fecal incontinence usually goes away in most children.