Encopresis is the voluntary or involuntary passage of stools in a child over age 4, which causes the soiling of clothes.

See also: Bowel incontinence

Encopresis is frequently is associated with constipation and fecal impaction. Often, hard fecal material remains in the colon and the child only passes a soft or semi-liquid stool around the impacted stool. Leakage of stool may occur during the day or night. There are rarely physical causes other than constipation (sometimes present since infancy).

Other causes may be related to:

• A lack of toilet training
• Toilet training at too early an age
• Emotional disturbance such as oppositional defiant disorder
• Conduct disorder

Whatever the cause the child may develop associated shame, guilt, or loss of self-esteem. The child may try to hide the discovery of the problem.

The following may increase the risk for encopresis:

• Being male
• Chronic constipation
• Low socioeconomic status

• Inability to retain feces (bowel incontinence)
• Passing stool in inappropriate places (generally in the child's clothes)
• Secretive behavior associated with bowel movements
• Constipation and hard stools
• Occasional passage of very large stool that almost blocks up the toilet

Digital examination of the rectal area may show a fecal impaction. An abdominal x-ray may confirm impacted stool in the colon.