M ost children can control their bowels and are toilet trained by the time they are four years of age. Problems controlling bowel movements can cause soiling which leads to frustration and anger on part of the child, parents, teachers and other people important in the child's life. These problems can cause children to feel badly about themselves. Soiling which is not caused by an illness or disability is called encopresis. Children with encopresis may have other problems, such as short attention span, low frustration tolerance, hyperactivity and poor coordination.
Encopresis is more common in boys than in girls.
School-age children with soiling or bowel control problems should have a complete physical evaluation by a family physician or pediatrician. If no physical causes are found, or if problems continue after examination by a family physician, the next step is an evaluation by a child and adolescent psychiatrist. The child and adolescent psychiatrist will review the results of the physical evaluation and then decide whether emotional problems are contributing to the encopresis. Child and adolescent psychiatrists treat encopresis with a combination of educational, psychological and behavioral methods. Most children with encopresis can be helped, but progress can be slow and extended treatment may be necessary.