My Big Kid Started Pooping His Pants Again — Let's Talk About Encopresis
Did you know that constipation can make your potty-trained child involuntarily soil their pants? I had never heard of this symptom, called encopresis, until it happened to my son.
A couple summers ago, the day after our family returned home from a week at the beach, my kindergarten-aged son had an accident in his pants for the first time since he potty trained. He said, “It came out by itself! I didn’t even tell my butt to poop!” That sounded strange to me, but I got him cleaned up, and put it out of my mind. I figured maybe all the fast food on the long drive home didn’t agree with his stomach.
The next morning, he woke up with some stool in his underpants again. He said his bottom “was telling him to poop” but it felt “big and spiky.” I told him he needed to sit on the toilet and go anyway. Holding it would make it worse. He shed a few nervous tears, but he was able to go. He didn’t have any more accidents, and I didn’t give it much thought again. I honestly forgot it had ever happened.
Later that fall, he got into the car after school and the smell was overwhelming. I asked him what was happening, and he told me he “went poop and didn’t wipe.” I was so confused why he would do that suddenly, but he was adamant that he had decided not to wipe after using the restroom. How annoying! I scolded him for a few minutes about hygiene and how important it was to take care of himself in the bathroom, even at school.
I took him to the nearest store to clean him up. When we got into the bathroom it was clear that his story was not the truth. He burst into tears and told me he had “pooped his pants” and was embarrassed to tell his teacher. He explained that the poop “just came out” without any warning. The incident from the previous summer came rushing back to me. I felt awful for scolding him about hygiene when it was so clearly something else entirely. (I apologized sincerely that day, but I’ve never quite shaken the guilt of shouting at him about it. Total mom fail.)
Obviously, I was very concerned that my child had suddenly lost the ability to hold his stool after using the toilet for years.
When it happened several more times that evening, I knew he needed to see his pediatrician. We made an appointment the next morning. As we waited for the doctor, my mind was racing with possible causes. Was it related to the incident from the summer time? Had I waited too long? I was filled with dread, wondering if something was seriously wrong. Was he very ill? Was it an emotional response to trauma? Had someone hurt him?
Dread turned to relief when his pediatrician came in and said, “Sounds like you’re pretty constipated, kiddo! Let’s see if we can fix that.”
Constipated? I was so confused. As an adult, I’ve been constipated a few times, and it doesn’t involve pooping my pants.
My son’s doctor explained that what my son was experiencing is called “encopresis.” According to the Mayo Clinic, “Encopresis…is the repeated passing of stool (usually involuntarily) into clothing. Typically, it happens when impacted stool collects in the colon and rectum: the colon becomes too full and liquid stool leaks around the retained stool, staining underwear. Eventually, stool retention can cause swelling (distention) of the bowels and loss of control over bowel movements.”
Encopresis can happen for a few reasons, but constipation is the most common cause in children. Despite all my worries, nothing physically or emotionally horrible was happening to my baby. He was just constipated. Impacted stool was the culprit of our poop woes.
His doctor ordered some imaging tests to make sure there was no other kind of obstruction, then worked with us to create a plan to get his bowels moving again. Within a few days, he was back to normal.
It’s been a couple years now, and once in a while, constipation hits my kid. Even if nothing about his eating habits or schedule changes, he can find himself unable to poop. He is prone to it, and his doctor says he might deal with it on and off his entire life. We do our best to manage it, but sometimes, despite our best efforts, he has some bathroom troubles. He is still just a little too young to recognize early symptoms and let me know before it gets bad. Encopresis is usually my first sign.
Encopresis is not a fun symptom for a kid to deal with. It’s embarrassing for him. No matter how many times I explain that he can’t help it, he feels like it makes him look like a silly baby who can’t make it to the bathroom. He’s always terrified it will happen at school. I send him with a little bag in his backpack containing wipes, a change of clothes and ointment for his tush. He’s never had to use it yet, but he worries that someone will smell it before he can get to the bathroom. Kids can be so cruel.
It’s difficult for me as his mom to see him uncomfortable. The laundry is overwhelming. We throw away a lot of undies when he has an episode. The constant leaking and cleaning cycle can create a really painful situation on his little bottom. Sometimes, he cries while he washes up, and he hates the feeling of wearing creams and ointments to aid in healing. I’ve cried in my closet a few times after seeing the pain on his face and hearing his cries. I know it could be much worse, but nobody likes seeing their baby in pain.
I wish I had known about encopresis because it’s a fairly common constipation symptom. It’s not a reason to panic. Knowing that ahead of time would have saved me so much worry when it started.
If your potty-trained child starts having accidents, it’s worth a trip to the pediatrician. There’s a good chance that your kiddo is fine! They just need a little help going to the bathroom.
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