What is Encopresis (Fecal Incontinence) in Children?

Fecal incontinence in children (encopresis) is characterized by the development of bowel control and muscle control, but the child is still incontinent or leaves feces in inappropriate places.

It is a process that definitely requires follow-up and treatment. If the problem of fecal incontinence is postponed and not solved in a short time, it may cause major problems.

To be diagnosed with encopresis, a child must be older than 4 years and have recurrent fecal incontinence every 15 days without a medical reason.

Causes of Fecal Incontinence

1. Physiological Causes: It may be caused by the lack of control of the muscles at the anus exit, which is located at the end of the intestine. The development of muscles related to defecation is completed by the age of 4. If the problem of defecation continues in a child over the age of 4, it should be considered that he/she has difficulty in maintaining muscle control. Diarrhea and constipation are also among the causes of fecal incontinence in children.
2. Cognitive Causes: Developmental delay compared to their peers can be seen frequently in children with developmental disorders, mental retardation, neurological and physical developmental retardation.
3. Psychological Causes:
   1. Tensions within the family, problems in the mental functioning of the mother and father
   2. Other factors include late toilet training, the mother being overly meticulous, parents having obsessive-compulsive attitudes and behaviors, parents being overly obsessed with cleanliness, too strict and punitive toilet training.
   3. Illness or sudden loss of a caregiver parent, sudden and significant changes involving the family and family members. Moving, changing schools, migration, illness or loss of a parent or loved one can cause defecation problems in children.
   4. Other psychological reasons include the child's generally stubborn temperament and refusal to toilet train, reluctance to defecate in the toilet or fear of going to the toilet.

What are the Psychosocial Problems in Children with Fecal Incontinence (encopresis)?

1. Decline in social communication skills
2. Decline in course success or academic failure
3. Childhood depression
4. Impulse control disorder
5. Hyperactivity and attention deficit
6. Childhood depression, excessive guilt
7. Anxiety disorder, shyness

What Can Be Done for Incontinence in Children?

1. The course of treatment should be determined immediately.
2. Medical support should be sought for physiological problems.
3. Specialist support is also required for psychological reasons.
4. The main source of family problems or the child's defecation problem should be understood and the cause should be discussed and a solution found. Problems within the family should be solved immediately. If necessary, support from family and couple therapists should be sought.
5. Family relationships or parental attitudes that are too controlling or too permissive, toilet training issues need to be addressed.
6. Punitive, critical or accusatory attitudes and behaviors towards the child should be avoided.
7. The child should never be diapered. Diapers cause the child to delay the muscle control effort in this process. If the diaper is tied, the problem of fecal incontinence may continue for a longer period of time.

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