Understanding Symptoms, Causes, and Treatment

Learn about the symptoms, causes, and treatment options for encopresis, a condition where a person involuntarily passes stool or feces in their underwear or in inappropriate places.

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Understanding Symptoms, Causes, and Treatment

Encopresis, also known as fecal incontinence, is a condition where a child or adult involuntarily passes stool or feces in their underwear or in inappropriate places. It can be a distressing condition for both the person experiencing it and their family members. This article will cover the symptoms, causes, and treatment options for encopresis.

Symptoms of Encopresis:

The main symptom of encopresis is the involuntary passage of feces, often accompanied by a feeling of fullness in the rectum. Other symptoms may include:

  • Soiling of underwear or clothing
  • Holding back bowel movements
  • Bowel movements that are infrequent or difficult to pass
  • Abdominal pain or discomfort
  • Loss of appetite
  • Irritability


Encopresis is often caused by chronic constipation, which can lead to the impaction of stool in the rectum. This can cause the muscles of the rectum to stretch and weaken, making it difficult for the person to control bowel movements. Other possible causes of encopresis may include:

  • Emotional or behavioral problems, such as anxiety or oppositional defiant disorder
  • Physical or sexual abuse
  • Poor toilet training or lack of toilet training
  • Medical conditions, such as spinal cord injury or Hirschsprung's disease

Treatment of Encopresis:

The treatment of encopresis typically involves a combination of medical and behavioral interventions. The first step is to treat any underlying medical conditions, such as chronic constipation or Hirschsprung's disease.

Behavioral interventions may include:

  • Toilet training or re-training
  • Encouraging regular bowel movements
  • Rewarding successful toileting behavior
  • Creating a routine and schedule for toileting

In some cases, medications may be prescribed to help with constipation or to regulate bowel movements.

Therapy may also be recommended for children with emotional or behavioral problems that may be contributing to their encopresis.

In severe cases of encopresis, surgery may be necessary to remove impacted stool or to repair any structural abnormalities in the rectum.


Encopresis can be a challenging condition for both the person experiencing it and their loved ones. However, with the right treatment, most people can achieve successful bowel control and improve their quality of life. If you or someone you know is experiencing symptoms of encopresis, it is important to seek medical attention to determine the underlying cause and develop an appropriate treatment plan.

The individual may or may not also experience constipation. Children with encopresis may feel shame or guilt and may avoid social situations. For some, encopresis is a result of trauma or emotional dysregulation. Encopresis is seen in boys more than girls. Children with ADHD, Autism spectrum disorder, anxiety, or depression are at increased risks of experiencing encopresis. Encopresis can be treated with EMDR therapy, neurofeedback therapy, and/or positive reinforcement and patience.

Contact Serin Center to get more information on how we can help.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). doi:10.1176/appi.books.9780890425596

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