What is it?
Encorpresis, or soiling/stool holding is a children’s anxiety/toileting disorder that many children struggle with from as young as four years old, and CAN suffer with it right up to their teen years, if not treated.
Some children suffer from constipation, and of course it makes them feel uncomfortable and may even hurt their tummy or their bottom if the faeces are very hard. If the child resists going to the toilet or using the potty because of the constipation – he or she may hold their stools inside and refuse to open their bowels. This is known as “stool holding”.
If this continues, they then become impacted with faeces in the bowel and they will struggle with faecal incontinence because the liquid faces will leak out around the impacted area.
Other children may not have constipation but for some reason may be anxious about opening their bowels in the toilet and will do it in other inappropriate places such as on the floor, in their pants, in a nappy which they have asked their mummy for! It can be related to many disorders, including conduct disorder or oppositional defiant disorder (ODD)
What should I be looking for?
If your child is showing any signs of the follow you should seek help from the GP or a Children’s Behavioural therapist/ Children’s Hypnotherapist:
- Not opening bowels for several days
- Constantly doing a poo in inappropriate places
- Constantly soiling underwear
- Appearing fearful of using the toilet
Encopresis can also be associated with emotional and developmental issues that express themselves in an unwillingness or inability to have regular bowel movements. Some children experience negative reactions to toilet training, not helped by a variety of parental responses. Others develop encopresis in reaction to changes in social circumstances, such as when moving house, or changing schools or nursery schools. Stress resulting from parents divorcing and other major changes to a child’s home or school environment can all trigger constipation that may eventually result in the cycle that leads to encopresis.
How is it Diagnosed?
To get a diagnosis of encopresis, a child must be at least 4 years old and experience the repeated passage of faeces ( both liquid and hard) into inappropriate places, such as the floor or his underwear, at least once a month, for at least three months. Naturally, any physical problems with the bowels will have to be ruled out before a true diagnosis can be made, as will food allergies.
What is the Treatment?
Treatment for stool holding will involve clearing out the colon and rectum, using stool-softening medications and beginning to build the habit of having frequent, bowel movements. The initial cleaning of the colon and rectum is done using something like Movicol or lactulose (laxatives)
Children with encopresis can become withdrawn due to the fear and the embarrassment of constantly soiling. They lose their self esteem so you must ensure you treat them gently and don’t shout at them constantly – they are normally NOT doing it out of naughtiness but fear.
Children with learning difficulties or on the spectrum may suffer with stool holding especially if they haven’t been taught properly how to use the toilet.
What can I do to help?
At my two hypnotherapy clinics, I treat many children of all ages with stool holding and soiling. I advise the parents on what to do on a regular basis, such as ensuring the child is eating a good healthy fibrous diet (lots of fruit and vegetables) and making sure the child is getting adequate liquids throughout the day. I then use some techniques to treat their fear of using the toilet.
One mum who came to me at an all time low because her 8 – year old was STILL stool holding and soiling said.
“I was at my wits end when someone recommended Elaine to me. I seemed to be washing soiled and smelly clothes constantly and it seemed that my daughter was doing it on purpose just to annoy me! She would actually sit on the toilet for over an hour, playing on my i- pad, she would do nothing and the minute she got off the toilet she would go and do it all over the lounge carpet in the corner – almost like a kitten or puppy would do because they knew it was wrong!”
She goes on to say: “Elaine made me realise that it wasn’t her fault – and that my getting angry and shouting at her would only make it worse, so I followed all her instructions and within two weeks, Lucy was using the toilet fine!”
School can be a problem because if the child is soiling his or her underwear, he will start to smell and the other children in class may start to make fun of him or even bully him. This is why this needs to be treated quickly so as to avoid these occurrences.
For further information on Stool holding or soiling (or any other toileting problems) do contact me at: