Question:

My son is almost 5. HE has been potty trained since 3 with very few accidents. Now for the last several months he has been soiling his pants pretty much eveyday. It never has happened at preschool though. What suggestions do you have for dealing with this? He has been seen by our Dr. where no physical cause was detected.

Answer:

Encopresis, the inappropriate passage of feces in children older than 4 years old, affects about 1% of school age children. It is much more common in boys. The first step in dealing with this is to find out if your son is actually constipated. Some children avoid using the bathroom (for a variety of reasons) and become so constipated that stool starts to leak out and soil their clothing. Does your son have normal bowel movements in the toilet? Is he having symptoms of constipation, such as abdominal cramping? If he does appear to be constipated, discuss with your doctor the possibility of using enemas or laxatives to relieve the constipation, then place him on a high-fiber diet to help prevent future occurrences of constipation. If your son is not constipated, another cause of his soiling might be from recent stress in his life. Is he having a difficult time adjusting to pre-school? Are there new stresses at home? Helping him deal with the stress might also help with his encopresis. Some children also benefit from sitting on the toilet for 10-15 minutes after each meal, with rewards for stooling in the toilet. Rewards can also be given at the end of the day if he has not soiled all day. If the problem persists, child and family counseling may also be beneficial in helping your son to have normal bowel movements. I hope this information has been helpful. Please feel free to write in additional questions on this or other topics.

For more information:

Go to the Children’s Health health topic.