Faecal incontinence

Faecal incontinence is when children who are past the age of toilet training regularly do poos in places other than the toilet. They can’t control when and where the poo comes. It can be very upsetting for children and parents.

Causes of faecal incontinence

A common cause of faecal incontinence in children is chronic constipation.

If your child has been constipated for a long time, poo builds up in his rectum, which can cause the rectum to stretch. Your child might lose the urge to go the toilet because his rectum always feels stretched. Then liquid poo might overflow around the old, stuck poo, without your child feeling it or meaning to let it go.

Emotional issues, like stress from premature or forceful toilet training or the birth of a sibling, might also lead to faecal incontinence.

Other causes of faecal incontinence include rare neurological disorders and abnormalities of the anus.

Faecal incontinence is also called soiling or encopresis.

Faecal incontinence is accidental and beyond your child’s control. But it can be difficult to live with, and it’s normal if you find it challenging or upsetting. If this sounds like you, talk to your GP about getting support.

Symptoms of faecal incontinence

Faecal incontinence can range from ‘skid marks’ to larger bits of poo in your child’s underwear.

Aside from pooing in places other than the toilet – usually in her underwear – your child might also have symptoms of constipation. These include pain when doing a poo, which can mean she tries to avoid going to the toilet. She might also have tummy pains that come and go, and she might go for long periods between poos.

It’s common for children with faecal incontinence also to have daytime or night-time wetting.

About 30-50% of children with faecal incontinence have emotional or behaviour problems too.

All children achieve bowel control at their own rate. Faecal incontinence isn’t generally considered a medical condition unless your child is at least four years old.

When to see your doctor

You should see your GP if your child is four years or older and has persistent faecal incontinence or constipation.

Treatment for faecal incontinence or soiling

The treatment for faecal incontinence depends on the cause of the problem.

If chronic constipation is the main cause, your doctor will help you work out a treatment plan based on using laxative medications and establishing good bowel habits.

You can help your child get into good bowel habits by encouraging him to sit on the toilet regularly and push. It’s good if he can do this for five minutes about 20-30 minutes after he finishes eating breakfast, lunch and dinner.

If your child has behaviour problems associated with faecal incontinence, she might need counselling, and group or individual psychotherapy.

Regardless of how it’s treated, faecal incontinence usually goes away in most children.

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Last updated or reviewed
13-06-2017

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References

Alex, G., Gibb, S., Hardikar, W., & Nightingale, M. (2015). Gastrointestinal conditions. In A. Gwee, R. Rimer & M. Marks (Eds), Paediatric handbook (9th edn, pp. 90-106). Melbourne: Wiley-Blackwell.
Benninga, M., Candy, D.C., Catto-Smith, A.G., Clayden, G., Loening-Baucke, V., Di Lorenzo, C., Nurko, S., & Staiano, A. (2005). The Paris Consensus on Childhood Constipation Terminology (PACCT) Group. Journal of Pediatric Gastroenterology & Nutrition, 40(3), 273-275.
Fiorino, K.N., & Liacouras, C.A. (2016). Encopresis and functional constipation. In R. Kliegman, B. Stanton, N. Schor, J. St Geme & R. Behrman (Eds), Nelson textbook of paediatrics (20th edn, pp. 1807-1809). Philadelphia: Saunders Elsevier.
Hoffenberg, E.J., Furuta, G.T., Kobak, G., Liu, E., Soden, J., Kramer, R.E., & Brumbaugh, D. (2016). Gastrointestinal tract. In W. Hay, M. Levin, R. Deterding & M. Abzug (Eds), Current diagnosis and treatment: Pediatrics (23rd edn, pp. 611-653). New York: McGraw-Hill.
International Foundation for Functional Gastrointestinal Disorders (IFFGD) (2014). Fecal incontinence in children. Milwaukee, WI: IFFGD. Retrieved 8 March 2017 from http://www.aboutincontinence.org/site/what-is-incontinence/children.
Katz, E.R., Kitts, R.L., & DeMaso, D.R. (2016). Encopresis. In R. Kliegman, B. Stanton, N. Schor, J. St Geme & R. Behrman (Eds), Nelson textbook of paediatrics (20th edn, p. 139). Philadelphia: Saunders Elsevier.
Kelsay, K., Burstein, A., & Talmi, A. (2016). Child & adolescent psychiatric disorders & psychosocial aspects of paediatrics. In W. Hay, M. Levin, R. Deterding & M. Abzug (Eds), Current diagnosis and treatment: Pediatrics (23rd edn, pp. 171-216). New York: McGraw-Hill.
Koppen, I.J., von Gontard, A., Chase, J., Cooper, C.S., Rittig, C.S., Bauer, S.B., Homsy, Y., Tang, S.S., & Benninga, M.A. (2016). Management of functional nonretentive fecal incontinence in children: Recommendations from the International Children’s Continence Society. Journal of Pediatric Urology, 12(1), 56-64. doi: http://dx.doi.org/10.1016/j.jpurol.2015.09.008.
Nijman, R. (2008). Diagnosis and management of urinary incontinence and functional faecal incontinence (encopresis) in children. Gastroenterology Clinics of North America, 37(3), 731-748. doi: http://dx.doi.org/10.1016/j.gtc.2008.06.007.
Rajindrajith, S., Devanarayana, N.M., & Benninga, M.A. (2013). Review article: Faecal incontinence in children: Epidemiology, pathophysiology, clinical evaluation and management. Alimentary Pharmacology & Therapeutics, 37(1), 37-48. doi: 10.1111/apt.12103.
Royal Children’s Hospital (2010). Constipation. Melbourne: RCH. Retrieved 15 May 2015 from http://www.rch.org.au/kidsinfo/fact_sheets/Constipation/.
Acknowledgements

This article was developed and reviewed in collaboration with Dr Misel Trajanovska, Senior Project Officer, Bowel and Bladder Dysfunction Project, Royal Children’s Hospital; Professor Sharon Goldfeld, paediatrician, Centre for Community Child Health, Royal Children’s Hospital; Associate Professor Sebastian King, colorectal surgeon, Department of Paediatric Surgery, Royal Children’s Hospital, Melbourne, and Dr Susan Gibb, paediatrician, Department of Developmental Medicine, Royal Children’s Hospital.