Encopresis is a problem that children can develop due to chronic constipation. With constipation, children have fewer bowel movements than normal, and the bowel movements they do have can be hard, dry and difficult to pass. Once a child becomes constipated, a vicious cycle can develop.
The child may avoid using the bathroom to avoid discomfort. Stool can become impacted and unable to move forward. The rectum and intestine become enlarged due to the hard, impacted (backed up) stool. Eventually, the rectum and intestine have problems sensing the presence of stool, and the anal sphincter (the muscle at the end of the digestive tract that helps hold stool in) loses its strength. Liquid stool can start to leak around the hard, dry, impacted stool, soiling a child's clothing.
For unknown reasons, boys develop encopresis six times more than girls do. Any child with chronic constipation may develop encopresis. Some of the situations that lead to constipation include:
- Eating a high-fat, high-sugar, "junk-food" diet
- Drinking mainly soft drinks and sugared drinks
- Lack of exercise
- Reluctance to use public bathrooms
- Stress in the family, with friends or at school
- Being too busy playing to take time to use the bathroom
- Change in bathroom routine, such as when a child is adapting to fewer bathroom breaks in a structured situation, like school
Encopresis can cause both physical and emotional problems. Impacted stool in the intestine can cause abdominal pain, as well as loss of appetite. Some children develop bladder infections. Other health problems may cause chronic constipation, including diabetes, hypothyroidism, Hirschsprung disease and inflammatory bowel disease.