Development of control of bowel movements is a complex process involving the recognition of signals from the muscles of the pelvic floor and anus as well as recognition of distension of the rectum when the stool enters the rectum. Any processes that interfere with the development can lead to a retention of faeces and a loaded bowel. Stool eventually leaks out and soiling occurs. Most often the children do not know it is happening until it has happened. Behavioural factors can interfere with the development and maintenance of control of bowel motions.
Difficulties can lead to retention.
Harsh Toilet Training May occasionally interfere with development of control. This is especially true with commencement with kindergarten and school. Constipation Painful passage of stool may lead to holding on and result in retention of faeces. Most children with encopresis are not constipated in the sense of hard dry large stools but more have trouble with clearance or evacuation of stool. That is they have less awareness of stool in the rectum and hence difficulty controlling its release.