Sometimes a child who seems to be toilet-trained leaks runny stool into their pants. This is called encopresis (say "en-koh-PREE-sus"). It can start when a child does not have regular bowel movements and the stool becomes thick and hard to pass (constipation). There are many reasons for this. A child may be nervous about using the toilet (especially in public places, such as school). A child who once had a bowel movement that hurt may try to hold stool in to avoid pain. A child may get constipated if their diet does not have enough fiber. Whatever the reason, new stool builds up behind the hard stool, and then some of it escapes. Your child may not be aware that the runny stool comes out until it soils their pants.
If the problem continues, your doctor may look for other causes. How often your child has a bowel movement is not as important as whether the child can pass stools easily. Your doctor may suggest that you give your child medicine to help soften the stool. You can take steps at home, such as making diet and activity changes, to end the constipation and leaky stool. After your child is no longer constipated, it may take some time for leaky stool to get better.
It's an embarrassing problem for children. More so if they are at school. Stay positive. This helps your child stay positive even when progress is slow.
Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.
How can you care for your child at home?
- Give your child plenty of water and other fluids.
- Offer your child lots of high-fiber foods such as fruits, vegetables, and whole grains. Examples of whole grains include graham crackers, oatmeal, brown rice, and whole-grain bread.
- If your doctor prescribes medicine, give it as directed. Be safe with medicines. Call your doctor if you have any problems with your child's medicine.
- Make sure your child does not eat or drink too many dairy products. This includes milk and milk products, such as cheese, yogurt, and ice cream. Too much dairy may make stools hard.
- Make sure your child gets daily exercise. It helps the body stay regular.
- Dress your child in clothing that is easy for your child to remove.
- Be patient, and give your child time to sit on the toilet for as long as it takes. Help your child feel comfortable and safe on the toilet. But do not force your child to sit on the toilet.
- Encourage your child to go to the bathroom when they have the urge. But do not scold or punish your child for not using the toilet.
- If your child is afraid of flushing, it is okay for you to flush after your child leaves the room.
- Do not give laxatives or enemas to children without first talking to your doctor.
How can you get support for your child at school?
- Talk to your child's teacher or school counselor about things to do to support your child. This help can include giving your child permission to go to the restroom at any time.
- Encourage your child to tell their teacher when they have an urge to go the restroom.
- Send extra clothes to school with your child. Make a plan with your child's teacher about what to do with soiled clothing.
How can your school-age child help?
Self-care helps your child take an active role. And giving your child some control can help improve self-esteem. Help your child learn what they can do to help. For example:
- Your child can take off soiled clothes and put them in the washer.
- Your child could put a sticker on a chart that tracks the goal of sitting on the toilet every day.
When should you call for help?
Call your doctor now or seek immediate medical care if:
- There is blood in your child's stool.
Watch closely for changes in your child's health, and be sure to contact your doctor if:
- Your child has belly pain.
- Your child's constipation gets worse.
- Your child has a fever.
- Your child's leaky stool does not get better.