Children's Hospital Colorado
Digestive Health

Constipation and Fecal Soiling (Encopresis)

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What is constipation and fecal soiling?

Constipation, or the infrequent passage of stools, is a common problem in children. When a constipated child passes stool, it is usually hard and painful from sitting in the rectum for a long time. To avoid passing another painful stool, children will tighten their bottom and withhold stool which sets up a cycle of developing large, hard stools that are painful to pass. For some children, the large intestine fills with hard stool and liquid stool leaks around the hard stool, through the anus and into the child's underwear. This is called fecal soiling, or encopresis.

What causes constipation?

For most children the exact cause of constipation is unknown. Some things that might contribute to constipation include:

  • Not drinking enough fluids
  • Consuming too much milk and cheese
  • Eating a diet that is low in fiber
  • Not getting enough exercise
  • Playing too hard and ignoring the body's signals to use the restroom
  • Too much pressure around potty training
  • Avoiding public restrooms

In a few rare cases, constipation might be due to structural, neurologic, endocrine or metabolic disorders.

Fecal soiling is usually a result of constipation which has occurred for a long time or has been difficult to manage. Children with fecal soiling have a large amount of stool in the large intestine, resulting in unintentional soiling accidents. There are a few other cases of fecal soiling such as spinal abnormalities or anorectal abnormalities but these are less common.

Who gets constipation?

Anyone can develop constipation, but it is more common in boys. Common times for constipation to develop are when solid foods are started, around toilet training, birth of a sibling, the start of a new school year, when on vacation or after a time of illness.

Next steps

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Get to know our pediatric experts.

Lindsey Gumer, MD

Lindsey Gumer, MD

Gastroenterology - Pediatric, Pediatrics

Nichole Combest, PA-C

Nichole Combest, PA-C

Physician Assistant

Patient ratings and reviews are not available Why?

Renee Herrman, CPNP-PC

Renee Herrman, CPNP-PC

Certified Pediatric Nurse Practitioner, Certified Pediatric Nurse Practitioner

Patient ratings and reviews are not available Why?

Pooja Mehta, MD

Pooja Mehta, MD

Gastroenterology - Pediatric