Soiling (encopresis) in children: causes & treatment

Last Reviewed: October 2022

Soiling is when bowel movements happen in places other than the toilet such as underwear or pooing in the bath. It can be a really upsetting problem for children and their parents to deal with.

There are lots of myths about bowel incontinence in children. Soiling is not caused by laziness or naughtiness. Children don’t have a leaky bum because they are looking for attention or just can’t be bothered to go to the toilet.

On this page there is information about the causes of encopresis (a word some people use for soiling) in children and how to stop it happening.


What is soiling (encopresis)?

Soiling is when children have poo in their underwear after being potty trained.

There are several different types of soiling including:

  • Runny, liquid poo
  • Soft ‘cow pat’ type poo
  • Sticky, tar like poo which can be hard to wipe and very smelly
  • Hard pellets or rabbit droppings which can be crumbly and dry
  • Smudges of poo in their pants

Take a look at our Poo Checker to see the different types of poo that indicate soiling:

Poo checker stool chart

Is soiling common?

If your child is having soiling accidents they are certainly not alone. It is one of the most common problems doctors see in children.


Why does soiling happen?

The most common reason for anal leakage or faecal incontinence in children is constipation. Soiling is a symptom of an overloaded bowel (faecal impaction) that can’t empty properly. It is not a disease.

Watch The Poo in You animated video to see how constipation can cause soiling accidents:


Here's how constipation can cause soiling accidents:

  • When underlying constipation isn’t diagnosed or treated properly, poo stays in the bowel and rectum longer than it should.
  • This poo becomes harder as water is absorbed by the body.
  • As fresh poo arrives, the rectum stretches and becomes a 'loading bay' for lots more poo. A poo traffic jam has happened.
  • Soft runny poo can then leak round these lumps and bits of hard poo can break away into their underwear.
  • When the bowel gets overstretched, a child can stop feeling the urge to pass a poo. It also makes it harder for them to fully empty their bowel when they go to the toilet.
  • Soiling accidents can easily happen because of a poo traffic jam.

Is soiling a sign of another condition?

Soiling is a physical problem which is nearly always caused by underlying constipation. Soiling rarely happens for psychological, behavioural or emotional reasons.

Other possible reasons for soiling include:

  • Rarely, there can be a physical cause of soiling, but these are usually diagnosed at birth or soon after.
  • Children avoiding doing a poo because they are worried it will hurt.
  • Feeling nervous to use a toilet away from home.
  • Not being allowed to use the toilet when they need to go, at school for example.
  • Being distracted when watching TV or playing a computer game.
  • Food allergies or toddler diarrhoea can cause soiling, but these reasons are less common.
  • A short-term illness such as a tummy bug.

How do you treat soiling?

The advice for treating soiling is the same as relieving constipation in children.

Your child needs to be seen by a GP who can prescribe laxatives to clear any lumps of poo.

For more information about treating soiling, see our advice for children with constipation. It explains how laxative treatment and a toilet routine can help a child who is soiling.


How can soiling affect a child's behaviour?

Soiling is nearly always caused by a physical rather than a psychological or behavioural problem. However, the stress of living with this issue can cause behavioural changes in children.

It can have a big impact on their mental well-being, education and friendships. Imagine trying to manage a physical problem (constipation) you have no control over?

Poo accidents can make children behave in various different ways including:

  • Hiding their underwear. It’s very common for children to act as if they’re not bothered by their poo problem because they find it embarrassing and feel guilty.
  • Being angry and defensive. Not knowing how to resolve a physical problem such as soiling can cause children to feel stressed and sad.
  • Going into denial. Some children won't even be aware they have a problem because to them it feels ‘normal.’ We don't always notice our own smell so they may genuinely not know they’ve had an accident.

Try to stay calm and don’t shout or punish your child if they have a soiling accident. Remember: they are not doing it on purpose.


Can a child recover from soiling?

Yes. With the right treatment a child’s bowel can recover allowing them to poo normally again.

After treatment children are likely to become constipated again so it’s important to use our poo checker to keep an eye on their bowel movements and follow these everyday tips:

  • Make sure your child has at least 6-8 water based drinks every day.
  • Include fruit and vegetables in their diet.
  • Encourage them to follow a regular toilet routine: sitting on the toilet or potty after every meal and using a footstool to support their feet.
  • Give them plenty of opportunities to exercise and move around.
  • Don’t stop giving laxatives too early.

Resources


FAQs

Find out what causes some children to smear their poo and ways to stop them doing it.

Constipation is the most common cause of soiling in children. Find out how to spot the signs and get treatment.

Why do some children try to hold on to their poo and how you can help them to overcome their fear.

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