Constipation and Encopresis in Children
Watching your child struggle with repeated episodes of constipation (having difficulty pooping) or encopresis (pooping accidentally) can be difficult. These conditions can be effectively managed with the right care. Encopresis and constipation can be distressing conditions for both your child and your family. If your child is feeling constipated, experiencing symptoms of constipation or encopresis, don’t wait to seek help.
Our comprehensive pediatric gastroenterology specialists provide compassionate care to manage constipation and encopresis. Contact RWJBarnabas Health today to schedule a consultation and take the first step toward improved gastrointestinal health.
What Is Constipation?
Constipation is a common gastrointestinal disorder in which bowel movements are infrequent, stools are difficult to pass, or there's a feeling of incomplete evacuation. It occurs when stool moves slowly through the digestive tract, causing excessive water absorption and hardened stools.
What Is Encopresis?
Encopresis is a condition in which a child, typically over the age of four, experiences involuntary bowel movements and soils their underwear. This often occurs when chronic constipation leads to impacted stool in the colon and rectum, causing liquid stool to leak around the hard stool and out of the anus.
Types of Constipation We Treat
At RWJBarnabas Health, we treat the two primary forms of constipation: functional and secondary.
Functional constipation is defined by specific diagnostic criteria called the Rome IV criteria. To meet the criteria, two or more of the following symptoms in children with a developmental age of at least 4 years must occur, for a duration of at least one month:
- Two or fewer stools in the toilet per week
- At least one episode of fecal incontinence per week
- History of retentive posturing or excessive volitional stool retention
- History of painful or hard bowel movements
- Presence of a large fecal mass in the rectum
- History of large diameter stools that can obstruct the toilet
If, after appropriate evaluation the symptoms cannot be fully explained by another medical cause, the child’s condition will be diagnosed as functional constipation.
Secondary constipation is caused by underlying medical conditions such as:
- Hormonal imbalances
- Neurological disorders
- Medications affecting bowel function
Causes of Constipation and Encopresis
Constipation in children can be related to a variety of factors. Some common causes include:
- Dietary factors. Low fiber intake and inadequate fluid intake.
- Lack of physical activity. Sedentary lifestyles can slow bowel movements.
- Medications. Opioids, antidepressants and other medications.
- Medical conditions. Conditions such as hypothyroidism, neurological disorders or anatomical abnormalities in the colon.
- Withholding behavior. Children may withhold bowel movements due to fear of pain, embarrassment or lack of access to a toilet.
- Toilet training issues. Negative experiences during toilet training can lead to withholding behaviors.
- Emotional factors. Stressful life events, like starting school, family changes or other stressors, can also contribute.
Encopresis is typically caused by chronic constipation.
Constipation Symptoms
The symptoms of constipation pain in children can vary, but common signs to look out for include:
- Infrequent bowel movements (less than 3 times per week)
- Difficulty passing stools
- Abdominal discomfort or bloating
- Rectal pain or discomfort
- Sensation of incomplete evacuation
- Clogging of the toilet
- Soiling of underwear
Pediatric Constipation Diagnosis
Diagnosis typically involves a combination of medical history and physical examination. Occasionally, testing such as blood work or imaging may be necessary.
- History. Understanding bowel habits and medical history.
- Physical examination. Abdominal and occasionally rectal examination to assess for stool impaction or anatomical abnormalities.
- Diagnostic tests. Blood tests, imaging studies, or motility studies as needed.
Constipation Treatment
Treatment for constipation and encopresis aims to relieve symptoms, improve bowel function and address underlying causes. Options may include:
- Dietary changes. Increase fiber intake through fruits, vegetables, and whole grains and ensure adequate fluid intake.
- Lifestyle modifications. Regular exercise and a consistent bowel routine.
- Medications. Over-the-counter laxatives, stool softeners, or prescription medications to stimulate bowel movements or soften stools.
- Biofeedback therapy. Retraining the muscles involved in bowel movements.
- Surgery. Rarely, surgical interventions may be considered for severe, treatment-resistant constipation.
Help for Pediatric Constipation and Encopresis
If your child is experiencing symptoms of constipation or encopresis, contact RWJBarnabas Health for a consultation with our pediatric gastroenterology team today.