Encopresis

Definition

Encopresis is an elimination disorder that involves repeatedly having bowel movements in inappropriate places after the age when bowel control is normally expected. Encopresis is also called "soiling" or "fecal incontinence."

Description

By four years of age, most children are toilet trained for bowel movements. After that age, when inappropriate bowel movements occur regularly over a period of several months, a child may be diagnosed with encopresis. Encopresis can be intentional on unintentional. Intentional soiling is associated with several psychiatric disorders. Involuntary or unintentional soiling is often the result of constipation.

Causes and symptoms

The only symptom of encopresis is that a person has bowel movements in inappropriate places, such as in clothing or on the floor. This soiling is not caused by taking laxatives or other medications, and is not due to a disability or physical defect in the bowel. There are two main types of encopresis, and they have different causes.

Involuntary encopresis

With involuntary encopresis, a person has no control over elimination of feces from the bowel. The feces is semi-soft to almost liquid, and it leaks into clothing without the person making any effort to expel it. Leakage usually occurs during the day when the person is active, and ranges from infrequent or almost continuous.

Involuntary soiling usually results from constipation. A hard mass of feces develops in the large intestine and is not completely expelled during a regular bowel movement in the toilet. This mass then stretches the large intestine out of shape, allowing liquid feces behind it to leak out. Up to 95% of encopresis is involuntary.

Although involuntary encopresis, called by the American Psychiatric Association (APA) encopresis with constipation and overflow incontinence, is caused by constipation, the constipation may be the result of psychological factors. Experiencing a stressful life event, harsh toilet training, toilet fear, or emotionally disturbing events can cause a child to withhold bowel movements or become constipated. Historically, children separated from their parents during World War II are reported to have shown a high incidence of encopresis, indicating that psychological factors play a role in this disorder.

Content licensed from:

Author Info: Tish Davidson A.M., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Mental Disorders, 2003

This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.