Encopresis affects 1 to 4% of children: why does my child have fecal leaks?

This condition, in which children pass feces in their underwear or in unusual places, is called encopresis. It’s not uncommon, and it does not matter. Here’s what you need to know and how to take care of it.

It can be very destabilizing, worrying, even annoying for parents to see your child get screwed up, have fecal “leaks” or even make stools outside the toilet and potty when he is already “clean”. Children who experience this suffer from encopresis, a disorder which is not uncommon and which by accompanying the child can be resolved.

What is encopresis?

Encopresis, is “the regular emission of formed or semi-shaped feces in underwear or “unusual” places (on the ground …) after the age of 4 years“, specifies the French National Society of Colo-Proctology. It should not be confused with a problem of incontinence, because these children have neither a neurological disease nor an abnormality in the function of the colon, which explains their loss. It does not concern the urine, which often easily controlled by the child.

Intestinal mechanisms

Before we explain how it works, let’s go back to how our feces move through our digestive system. The latter gradually falls along the intestine thanks to contractions of its wall. As the day progresses, it contracts to move them forward, more intensely after a meal (to make room). When they reach the rectum, we feel the need to go to the toilet. We manage to poop thanks to a “reflex and involuntary relaxation of a part of the anus’ sphincter (smooth sphincter also called internal sphincter)”, explains SNFCP.

This mechanism requires a form of control that is learned, generally around the age of 3, the famous “cleanliness”, which is the moment when the child learns to voluntarily contract the other part of his anal sphincter. He also feels the urge via reflex contractions in his gut. It is estimated that the normal rhythm is between 1 time every 3 days and 3 times a day for a child.

Why is the baby leaking?

If he does not urinate voluntarily, if he holds back (voluntarily or unconsciously), then the rectum continues to fill up. And it can lead to uncontrolled stool leaks. The child does not get over it on purpose, he no longer receives the information about the need to tremble, because by being filled, the rectum expands and holds more container. But the sphincter relaxes and can no longer hold it: it is an overflow phenomenon that grips the child.

This can be pieces of feces or even colored secretions. This is because it is due to stagnation in the rectum, the stool becomes harder and forms a solid mass called “fecal impaction”. The latter can weigh up to 1 kilo. Due to its consistency, the fecal impact irritates the wall of the intestine, which secretes a colored fluid that escapes in children with encopresis. It is not diarrhea.

Who is affected by encopresis?

Most of the time it hits boys between 6 and 10 years old. But encopresis can last longer. Children suffering from constipation are most likely to develop this disorderbecause it “facilitates the stagnation of feces in their gut and especially in their rectum,” the SNFCP explains.

This does not turn out not necessarily at the time of toilet training, the child may develop later: we talk secondary encopresis. Primary encopresis manifests itself in a child who has not yet learned to control his sphincter.

Leaks can occur day or night. When it is daytime, it often happens when the child is playing or engaging in a sports activity, it is not necessarily aware of it and sometimes it does not bother him. But it is important to note that the escape is not the result of a conscious process on the part of the childhe does not do it “on purpose.”

What does that explain?

Encopresis is often an unconscious way for the child to try to communicate. This is due to a combination of factors (especially constipation), which can also be psychological. The child may have experienced the potty training period badly (too quickly, with too little attention from the parents or on the contrary having felt a pressure …), or be connected to an external event that tests him (a separation parent, for example).

“In some cases, there is no psychological cause: encopresis may be transient in a constipated child who has an anal fissure due to having a bowel movement a little harder than usual. The pain from this fissure makes him afraid of getting stool. It can then hold back until it leaks at overflow “, specifies SNFCP.

Why consult a doctor? What treatment?

At least to help an encopresic child, it is important to consult to find the cause of the problem. Encopresis can be completely cured if we accompany the child, without rushing him, through various approaches. Psychological help can be helpful.

For those who do constipation, it is important to treat this problem, through a high-fiber diet, does not try to engage in a food conflict with the child. As far as possible, it is better to avoid enemas or suppositories, which can block the child from a psychological point of view.

“In the event of a crack, local care with a mild soap and a healing ointment will be connected,” the SNFCP adds. At the same time, as long as the leaks continue, there are panty liners adapted to this disorder, developed by the brand Absalom and available for all age groups from 3 years to adult.

Sources: SNFCP, Absalon

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