What is soiling?
Soiling occurs when your child is unable to control a bowel movement. The child soils his pants, or has an “accident” before reaching the toilet. Soiling is also called encopresis (say: en-ko-PREE-sis).
All children who have been toilet trained have the occasional accident. This is normal, especially in 2 to 4 year-olds. Concerns arise when your child is soiling often after being toilet trained.
Please see Toilet Training for more information.
Causes of soiling
Constipation is the most common cause of soiling. When children are constipated, it is difficult and painful to pass the hard stool. Fecal liquid leaks around the hard retained stool, and out of the anus.
Some children, especially toddlers, will start to hold their stool, because they are not ready to toilet train, or because of painful bowel movements due to constipation. This can start a cycle of holding, constipation, and soiling.
Another cause is illness. Children with diarrhea may have a hard time controlling their bowel movements.This usually goes away when the diarrhea improves.
Sometimes, soiling is associated with severe emotional or behavioural difficulties.
Some very rare neurologic or spinal cord diseases can cause soiling. These children may also have peeing accidents and clumsiness or weakness of their legs.
When to seek medical assistance
See your child’s doctor if your child:
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is also having trouble peeing, walking, or with balance (this is an emergency)
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is passing stool in places other than the toilet or potty, or hiding soiled underwear
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is soiling very often
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is stillsoiling after the age of 3 or 4 years
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starts soiling often after toilet training
Your child’s doctor will examine your child, and may order some tests If there is no physical cause for the soiling, your doctor may suggest certain toilet training tips. A child with encopresis may be referred to a child psychiatrist.
How you can help your child control their bowel movements
Prevent and cure constipation
Make sure your child is not constipated. If he is not interested in toilet training, be patient and give him time. Do not punish your child. Humiliation and anger are not good ways to prevent soiling.
Be helpful, not hurtful
Encourage other members of the family to offer support. One way to do this is to reduce anxiety as much as possible. Another option is to encourage your child to pass stools frequently. If your child prefers to go in a diaper, that is OK.
Establish routine
One toilet training tip is to have your child sit on the toilet for about 5 minutes after every meal. Give your child a book to read or have music playing in the bathroom. Reward your child every time he passes stool into the toilet. Support and praise this behaviour. Continue this pattern for 3 to 6 weeks, or until soiling stops.
Key points
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Soiling occurs when your child is unable to control a bowel movement or is leaking liquid fecal matter.
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Constipation is the main cause of soiling. Illness, stress and toilet training problems are other causes.
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See your child’s doctor if your child has other symptoms, is passing stool the wrong places, or if the soiling is not getting better.