When a child is constipated and is unable or unwilling to pass a stool regardless of its size, the child may develop leakage of partially formed or liquid stool, soiling his or her underwear. Encopresis is soiling that occurs in a child past the time of normal toilet training. Encopresis is present if a child age 4 or older has involuntary bowel movements in inappropriate places at least once a month for 3 months or more.

Encopresis is a symptom of constipation, not a disease. Some children develop constipation because of psychological and environmental stresses, such as:

• Unsuccessful toilet training. A child may have fought the toilet training process, been pushed too fast, or been punished for having accidents. Struggling with their parents for control, children may strain to hold stool as long as they can.
• Fear of the toilet. Some children think that they might be flushed away.
• Limited access to a toilet, or shyness or embarrassment about using the toilet.
• Stressful life events, such as family arguments, a move to a new neighborhood, physical or mental illness in family members, or new siblings.

Encopresis is a complex problem that will go away when the cause of the constipation is corrected. However, the longer encopresis exists, the more difficult it is to treat. If your child has leakage of formed or liquid stool, a visit to a health professional is needed to help develop a plan to relieve and prevent constipation.

Diarrhea can cause the leakage of stool when a child cannot control the release of stool or cannot get to a toilet soon enough.