How to Help a Child With Encopresis at Home

Encopresis can be an overwhelming and confusing diagnosis for parents. Simply put, encopresis is a big fancy word for fecal incontinence or poop accidents. This condition often stems from chronic constipation, sometimes beginning as early as infant constipation, and occurs when a child passes poop (stool) anywhere other than a toilet. If your child is experiencing stool accidents, you may feel frustrated, worried, or unsure of how to help. The good news is that encopresis is a common and treatable condition. With the right support, children can learn to improve their bowel control, establish healthy bowel and bladder routines, and thrive in daily life without bowel accidents holding them back. At OWN Pediatric Therapy, we specialize in helping families navigate challenges like encopresis with compassion and evidence-based care.

What Is Encopresis in Children?

Encopresis is the medical term used when a child who is past the age of toilet training has ongoing stool accidents in their underwear or anywhere other than the toilet. It often results from chronic constipation, where stool builds up in the rectum, stretches it, and makes it harder for a child to sense when they need to go. As new stool moves in, it can leak around the blockage and cause soiling.

Encopresis is not a sign of laziness, bad behavior, or poor parenting. It’s a physical and neurological condition that requires patience, support, and treatment. Most children with encopresis desperately want to stay clean but can’t feel when accidents happen.

Signs and Symptoms of Encopresis

The first sign of soiling is often the smell. You may also notice your child has soft, loose or liquid poop in their pants that looks like diarrhea or skid marks in their underwear.

Other symptoms of fecal incontinence may include:

• Large, painful bowel movements that may clog the toilet

• Avoidance of the toilet or withholding behaviors (hiding, crossing legs, standing stiffly)

• Hard, dry stools alternating with loose accidents

• Abdominal pain, bloating, or decreased appetite

• Urinary accidents or bedwetting (caused by stool pressing on the bladder)

• Emotional distress such as shame, anxiety, or social withdrawal

• Hiding bowel movements or keeping them a secret

• Hiding soiled clothes

• Loss of appetite

• Rash around their anal area 

Recognizing these symptoms early can help prevent the cycle from worsening and get your child the support they need.

What Causes Encopresis in Kids?

Many parents are surprised to learn that encopresis is most often the result of chronic constipation. It may seem confusing that stool accidents can happen because a child is constipated, but here’s why: when stool sits in the rectum for too long, the rectum stretches and begins acting more like a storage area. Over time, this stretching dulls the body’s sensory signals, making it harder for a child to feel when they need to have a bowel movement. As the rectum stays full, softer or looser stool can slip around the blockage and leak out—often without the child realizing it’s happening.

The reasons constipation develops can be complex. Contributing factors may include:

• Withholding behavior: Children may avoid pooping because of past pain, busy schedules, or fear of public restrooms.

• Diet: Low fiber intake, limited water consumption, or diets high in processed foods can slow bowel movements.

• Routine disruptions: Life changes such as starting school, moving, or traveling can disrupt regular bathroom habits.

• Medical conditions: Some children have underlying issues such as slow motility, pelvic floor dysfunction, or sensory processing challenges.

• Emotional stressors: Anxiety, transitions, or trauma can contribute to holding behaviors and constipation.

When constipation isn’t the cause, the condition is called non-retentive encopresis. Encopresis may be a symptom of an underlying medical condition, but this is rare. Symptoms may include poor growth, bloody poop, vomiting and weight loss. Possible conditions include:

• Birth defects, like tethered spinal cord 

• Cerebral palsy

• Hirschsprung disease 

• Infection or tear in your child’s rectum

• Pelvic floor dysfunction 

• Spinal cord trauma or tumor

• Vagus nerve damage causing problems in their digestive tract

• Celiac disease or inflammatory bowel disease

Because every child is different, it’s important to look at both the physical and emotional components when understanding the root cause of encopresis.

How to Help a Child With Encopresis at Home

Parents play a crucial role in supporting a child with encopresis. While professional therapy may be needed, there are several ways you can help at home:

• Assess and treat constipation. Talk to your child’s healthcare provider or reach out to a pediatric pelvic floor therapist to see if constipation is the underlying cause and what treatment methods can be done to manage it.

• Create a bathroom routine: Encourage regular toilet sits after meals to take advantage of the body’s natural reflexes. Make sure your child has good posture, knees above hips (using a stool), sitting up and slightly leaning forward.Encourage deep belly breaths to help the pelvic floor muscles relax and get all the poop out. 

• Use positive reinforcement: Celebrate efforts and successes with trying to get all of our poop out on the potty. Remind the child that this is not their fault and you are working together as a team to help the “sneaky poops” go away. 

• Encourage hydration and fiber: Offer water throughout the day and provide fruits, vegetables, and whole grains to keep stool soft.

Support relaxation: Deep breathing, movement breaks, or calming activities can reduce anxiety that interferes with toileting.

When to See a Doctor for Encopresis

If your child is experiencing frequent stool accidents, abdominal pain, or ongoing constipation, it’s important to seek medical guidance. A pediatrician may recommend an evaluation to rule out medical conditions and to begin treatment.

You should contact your doctor if:

• Accidents happen more than once a week for a month or longer

• Your child complains of stomach pain or painful bowel movements

• You notice blood in the stool

• Home strategies are not improving symptoms

Early intervention can prevent complications, ease your child’s distress, and make treatment more effective.

How to Talk to Your Child About Encopresis

Children with encopresis often feel embarrassed or ashamed. How you approach the conversation can make a big difference in their confidence and motivation.

• Normalize the experience: Explain that their body is having trouble knowing when to go, but it’s something you can fix together. Remind them that they are truly “sneaky poos” and it is not their fault, rather make it a team effort to help their body overcome the challenge.

• Avoid blame: Reassure them it’s not their fault, and that many kids experience the same thing.

• Encourage open communication: Let them know it’s safe to tell you if they feel the urge or if they had an accident.

• Focus on progress, not perfection: Celebrate small wins, like sitting on the toilet or talking about how they feel.

Long-Term Management and Prevention of Encopresis at OWN Pediatric

At OWN Pediatric Therapy, we understand that encopresis is more than just a bathroom issue—it impacts a child’s physical comfort, emotional well-being, and confidence in daily life. Our team takes a whole-child approach that includes:

• Pelvic floor therapy: Helping children learn how to relax and coordinate their muscles for healthy bowel movements.

• Sensory and body awareness strategies: Supporting children who may not feel or respond to their body’s signals.

• Behavioral and routine support: Guiding families in creating structured, stress-free bathroom habits.

• Collaboration with providers: Working with pediatricians, GI specialists, and schools to ensure consistent care.

With consistency, compassion, and the right tools, most children fully overcome encopresis. Our goal is to empower both kids and families with knowledge and strategies that restore comfort and confidence for the long term.

Encopresis can feel overwhelming, but you and your child are not alone. With early support, the right therapy, and a patient, compassionate approach, children can regain control of their bodies and their confidence. At OWN Pediatric Therapy, we’re here to walk alongside families every step of the way—empowering every child to thrive in their OWN way.