The first in which there is a physiologic basis for the encopresis, the second in which there seems to be an emotional basis.
Encopresis frequently is associated with constipation and fecal impaction .
Often, hard fecal material is retained in the colon, with a passage of soft or semi-liquid stool around the impacted stool. This problem is not under the conscious control of the child. Leakage of stool may occur during the day or night. Other causes may be related to a lack of toilet training or training at too early an age or an emotional disturbance such as Oppositional Defiant Disorder or a Conduct Disorder. Whatever the cause the child may develop associated shame, guilt, or loss of self-esteem.