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There are many ways you can help children and their families get the care they need.
It can be upsetting to see your child suffer from the constipation. And the onset of constipation, which can lead to encopresis, can be so gradual that parents do not realize their child is having a problem. School-aged children go to the bathroom on their own, and it is natural for parents to assume everything is OK unless their child tells them otherwise.
Our physicians and nurse practitioners are experts in helping kids have regular bowel movements on the toilet. We’ve had years of experience treating kids just like yours. So not to worry — your child will be fine and you and your family will get through this challenging time.
Constipated children have fewer bowel movements than normal, and their bowel movements can be hard, dry, difficult to pass and so large that they can often even block up the toilet. Here are some examples why:
In kids who haven’t yet been toilet trained, struggling to hold in excess stool, or constipation that arises from refusing to have a bowel movement on the toilet, can also lead to encopresis.
It’s difficult to say for certain because many cases of encopresis are not reported. There seems to be a stigma attached to this condition that prevents many parents from reaching out and talking to other parents whose children may have had the same problem.
We estimate that between one and three percent of kids have this problem at one time or another in childhood.
Any child with chronic constipation may develop encopresis. Some situations that may contribute to your child’s constipation include:
For children who have never been toilet trained and who refuse to have a bowel movement on the toilet, additional concerns apply including:
Encopresis can cause your child to have both physical and emotional problems.
Your child might feel emotionally upset by soiling her clothes, leading to feelings of shame and embarrassment.
You, too, might feel guilt, shame and anger because of your child’s encopresis. It’s very important to try not to communicate this to your child, as this may worsen her emotional state.
While encopresis itself isn’t usually painful (unless the leaking stool leads to a rash on your child’s skin), the constipation that leads to it may be.
There are two basic causes: long-term constipation and toilet refusal. At Boston Children’s Hospital, we first determine the cause and then treat your child appropriately.
It’s rare that a child has an underlying medical condition that causes encopresis, but we do consider these causes when we see your child.
Here are some signs that your child might be constipated, which could lead to encopresis:
Though it may seem as though your child will suffer from encopresis forever, this isn’t the case. The vast majority of kids (the possible exceptions being those who have an underlying medical issue) will stop having stool accidents and have regular bowel movements on the toilet.
The end result of treatment is the same for both causes of encopresis, but the way we get there is different.
We understand this is a challenging time, but we’ve cared for many kids with this problem — and we’ve helped them (and their families) get through it.
You and your family are key players in your child’s medical care. It’s important that you share your observations and ideas with your child’s health care provider and that you understand your provider’s recommendations.
If your child is suffering from the constipation that leads to encopresis and you’ve set up an appointment, you probably already have some ideas and questions on your mind. But at the appointment, it can be easy to forget the questions you wanted to ask. It’s often helpful to jot them down ahead of time so that you can leave the appointment feeling like you have the information you need.
Some questions you may want to ask include:
Keep in mind that your doctor will want to ask you some questions, too. These may include:
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”