Encopresis Causes

There are two main types of encopresis

1. retentive encopresis and
2. nonretentive encopresis

and they have different causes.

Retentive Encopresis - Causes

Retentive Encopresis frequently results from chronic constipation, which over time results in fecal impaction and in leakage of soft or liquid stool accumulated around the impacted stool or feces. (see Constipation in Toddlers and Children)

The leakage may occur during the day or night and it is NOT under the conscious control of the child.

The frequency of leakage varies infrequent occurances to a continuous flow.

Many children have a history of constipation that has been present since infancy and can extend back as far as five years.

Nonretentive Encopresis - Causes

Nonretentive Encopresis is also called Functional Encopresis, Bowel Movement Resistance, Bowel Movement Withholding or even Stool Toileting Refusal (STR).

About 5-20% of ALL encopresis cases are nonretentive encopresis and have no physical condition that bars normal toileting behaviors.

This type, functional encopresis, is a behavioral condition in which the child refuses to defecate in a toilet.

The information presented here are general guidelines and are meant to provide you the parent with some knowledge and information, so that you can have a more informed conversation with your physician or your child's pediatrician.

While 99% of the cases of non retentive encopresis do not have an organic / medical basis, however the 1% of the cases do.

Medical reasons such as

• irritable bowel syndrome
• severe ulcerative colitis
• acquired spinal cord disease (i.e. sacral lipoma, spinal cord tumor)
• rectoperineal fistula with imperforate anus
• postsurgical damage to anal sphincter

may be causing your child to withhold his Bowel Movements.

These medical reasons can be diagnosed and treated by your child's pediatrician

The other and more likely reasons for nonrententive encopresis are:

• that the child may not be developmentally ready for potty training
• the child may have emotional or behavioral disturbances such as Oppositional Defiant Disorder or Conduct Disorder
• the child refuses to defecate in a toilet because he is afraid. The child will urinate in the potty or toilet, but will refuse to poop in the potty or the toilet. Some children will also refuse to poop in the underwear and will only poop in a pull up or diaper. Yet, other children will simply refuse to poop at all and end up with chronic constipation.