Problems of Bedwetting in Children & Teenagers | Elimination Disorder Psychology


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Elimination Disorder & Encopresis | Psychology | Child Psychologist | My Fit Brain

Mental disorders diagnosed in children are divided into two categories: Childhood Disorder and Learning Disorder. These disorders are usually first diagnosed in infancy, childhood or adolescence. These categories include disorders like Mental Retardation, Learning Disorders, Motor Skills Disorders, Communication Disorders, Pervasive Developmental Disorders, Attention-Deficit and Disruptive Disorders, Feeding and Eating Disorders, Elimination Disorders and many more disorders of infancy, childhood or adolescence.

In this article, we are going to discuss Elimination Disorders in Kids.

Elimination Disorders in Kids | Elimination Disorder Psychology

Elimination Disorders occur in children who have problems of going to the bathroom, both defecating and urinating. Although it is not uncommon for young children to have occasionally; there may be a problem if this behaviour occurs repeatedly for a longer period, longer than three months, particularly in children older than 5 years. There are two types of elimination disorders in kids, Encopresis and Enuresis.

Symptoms and Treatment of Encopresis

We are going to talk about the causes, symptoms and treatment of Encopresis in this article.


Encopresis is also known as faecal soiling. It occurs when a child usually over the age of 4, has bowel movements and soils their pants. This behaviour is often linked to constipation. Constipation occurs when stool becomes backed up in the intestine. Treating constipation is fairly easy and will typically eliminate soiling. This leakage may occur during the day or night and it is not under the conscious control of the child. It is three to six times more common in boys. Encopresis is not a disease, but rather a symptom that may have different causes. Many people mistakenly believe that Encopresis is a behavioural issue- a simple hack of self-control. But punishing and humiliating a child with Encopresis will only make matter worse. A child with Encopresis often feels ashamed and may wish to avoid situations (such as camps or schools) that might lead to embarrassment. This may also affect on child’s self-esteem. On the part of the caregiver, you should avoid anger, punishment and rejection.

 Symptoms of Encopresis:

  • Leakage of stool or liquid stool on underwear, which can be mistaken for diarrhoea.
  • Constipation with dry and hard stool.
  • Passage of large stool that clogs or almost clogs the toilet.
  • Avoidance of bowel movements.
  • Long periods of time between bowel movements.
  • Lack of appetite.
  • Abdominal Pain.
  • Problems with daytime wetting or bedwetting (Enuresis).
  • Repeating bladder infections, typically in girls.
  • Soiling in a child who is at least 4 years old.
  • Urinary tract infection.

Causes of Encopresis

Faecal matter can become hard and difficult to pass if your child doesn’t get enough fibre, water or exercise, or if they hold in bowel movements to be painful. Then, liquid faecal matter or a soft bowel movement can leak into a child’s underpants. This is known as soiling; sometimes child cannot consciously control soiling.

In some cases, the intestines may become so enlarged from a fecal blockage that your child loses the sensation of needing to poop. This problem may also begin because of controllable situations, such as fear of using public toilets or not wanting to be toilet trained, but it becomes involuntary overtime.

Most of the children suffering from Encopresis, the problem begins with painful passing very large stool. This may have happened long before the Encopresis starts and the child may not remember when asked. Over time, the child becomes reluctant to pass bowel movements and holds it in to avoid the pain. This “holding in” becomes a habit that often remains long after constipation or pain with passing bowel movements has resolved. Encopresis mainly causes from, constipation and emotional issues.


Most of the Encopresis is the results of chronic constipation. In constipation, the child’s stool is hard, dry and maybe painful to pass. As a result, the child avoids going to the toilet- making the problem worse.

The longer the stool remains in the colon, the more difficult it is for the child to push the stool out. The colon stretches, ultimately affecting the nerves that signal when it’s time to go to the toilet. When the colon becomes too full, soft or liquid stool may leak out around the retained stool or loss of control over bowel movements may occur.

Some causes of constipation include

  • Withholding stool due to fear of using the toilet (especially when away from home) or because stools are painful.
  • Not wanting to interrupt play or other activities.
  • Eating too little fibre.
  • Not drinking enough fluids.
  • Drinking too much cow’s milk or, rarely an intolerance to cow’s milk- through research results conflicts on these issues.

Emotional Issues: Emotional stress may trigger Encopresis. A child may experience stress from:

  • Pre-mature, difficult or conflict-fluid toilet training.
  • Changes in the child’s life such as dietary changes, toilet training, starting school or schedule changes.
  • Emotional stressors, for example, the divorce of a parent or the birth of a sibling.

Treatment of Encopresis

When Encopresis is occurring in school-age child, a physician experienced in Encopresis treatment and interested in working with the child and the family should be involved.

The treatment goals will probably be fourfold:

  • To establish regular bowel habits in the child.
  • To reduce stool retention.
  • To restore normal physiological.
  • Control over bowel functions.
  • To defuse conflicts and reduce concern within the family brought on by the child’s symptoms.

It is very important that you develop a routine and stick to it. Long term success depends on how well you can follow the care plan. This treatment will take many months of hard work for you and your child.

Although parents will be following a regime recommended by the child’s health care provider, most of the work treating Encopresis is done at home. It is very important that parents and other caregivers keep a complete record of the child’s medications. Use and bowel movements, during the treatment period. This record can be very helpful in determining whether the treatment is working.

If you seeking any help for your child, you may freely consult our Child Psychologist or Child Counselor online by booking an appointment at   


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