The frustration, mess, smell and embarrassment when a school-aged child poops his pants can make parents desperate for a solution. The condition is called encopresis, or soiling after being toilet trained. It is important for parents to understand that punishment and humiliation is not likely to solve the situation and may make it worse.
Characteristics
Encopresis is more common in boys than girls, affects children between the ages of 4and 12, and can happen during the day or night. According to the National Institutes of Health, children with encopresis have bowel movements in inappropriate places, such as their clothing, and their behavior may be secretive, such as hiding soiled clothing. It is characteristic of encopresis for children to sometimes pass very large stools. The problem is thought to stem from chronic constipation, which stretches the colon and effects nerves that normally signal a need to go to the bathroom. Children report they did not know the stool was coming and had no time to get to the toilet. Abdominal pain is common. Soft stools leak around impacted feces and escape accidentally.
Causes and Tests
According to the NIH, physical causes for encopresis other than constipation are rare. A rectal exam is used to find fecal impaction, which can be confirmed by X-rays. The NIH suggests that possible causes of constipation include emotional disturbance, maladaptive toilet training, or a history of a painful bowel movements.
Treatment/Solutions
Laxatives or enemas are recommended to correct constipation. The Mayo Clinic suggests that once the colon is clear, dietary and lifestyle changes are necessary to prevent a recurrence of the problem. Increasing fiber by serving whole grains, fruits and vegetables can remedy constipation when accompanied by six to eight glasses of water daily. Fatty foods and dairy products should be restricted because they slow down elimination. Regular meals, bedtimes, and trips to the bathroom may need to be structured for several months, as encopresis can be difficult to overcome. Parents should treat children with compassion and help them not to become discouraged.
Theories/Speculation
Sue Dengate, author of "Fed Up" and founder of the Food Intolerance Network, coined the term "sneaky poos" to describe encopresis, which she suggests is a result of an overload of dietary chemicals. Dengate explains that amines, and especially salicylates, can cause behavior reactions that include soiling. Salicylates are found in aspirin and ibuprofen, food colors, flavor enhancers, preservatives and artificial antioxidants as well as many fruits and vegetables, particularly those that are picked early and shipped long distances.
Complications
Children who have encopresis may feel angry, ashamed, and suffer from low self-esteem. Stress and depression can negatively impact a child's life. Without treatment, chronic constipation may persist. S. Khan and other researchers from the Alfred Dupont Hospital for Children in Wilmington, Delaware, studied long-term outcomes of childhood constipation. Their findings, published in "Digestive Diseases and Sciences" in February 2007, found the condition to be a predictor of adult irritable bowel syndrome. IBS, also known as spastic colon, is characterized by abdominal pain with alternating bouts of constipation and diarrhea.
