When a child is past potty training but still soils their underwear, it can leave families feeling concerned, confused and frustrated. This problem is called encopresis, sometimes called fecal soiling or poop accidents.
It's important to know that encopresis is common, treatable and not something your child is doing on purpose. With understanding and medical care, most children get better.
What is encopresis?
Encopresis means passing stool into underwear after the age when children usually use the toilet regularly. It often happens in children who were toilet trained but later began having accidents.
Encopresis is not a disease. It is a sign that the bowel is not working normally, most often because of long‑term
constipation.
Why does a potty‑trained child soil their underwear?
Encopresis usually begins with poop (stool) staying in the colon (large intestine) instead of being passed regularly. Over time, this stool builds up and stretches the colon.
What happens when the colon stretches?
The nerves that tell a child they need to poop become less sensitive
The child may not feel the urge to use the toilet
The bowel has trouble pushing stool out
As more stool builds up, it becomes larger, harder and painful to pass. This can cause children to avoid going to the bathroom, which makes constipation worse. Eventually, softer or liquid stool may leak around the hard stool and stain underwear.
Because feeling in the rectum (the part of the colon where stool is stored before it leaves the body) is reduced, many children do not realize this is happening. Some children also do not notice the smell. This can happen because the brain gets used to constant odors over time.
Is encopresis caused by behavior or parenting issues?
No. Encopresis is not caused by laziness, defiance or bad behavior. It is not caused by poor parenting or lack of discipline.
We know that encopresis:
Happens more often in boys than girls, though doctors do not know why
Is not related to family income, family size, or parents' age
Cannot be stopped by a child without medical help
Blaming, shaming or punishing a child does not help. Instead, it can increase stress and lower confidence.
Why is medical treatment important for encopresis?
Encopresis is a long‑term but treatable condition. The longer it goes on, the harder it can be to treat. That's why early care matters.
A pediatrician, especially one familiar with encopresis, can help guide treatment and support the whole family.
Treatment goals encopresis include:
Removing backed‑up stool from the colon
Helping the bowel regain normal feeling and movement
Creating regular, healthy toilet habits
Reducing stress and conflict at home
Treatment focuses on both physical and emotional needs.
How is encopresis treated?
Treatment happens in steps and should always be supervised by a doctor.
Clearing the bowel
At first, the bowel may need to be emptied so it can return to a more normal size. For a short time, a child may need laxatives or enemas.
Ongoing care and routine
After the bowel is cleared, children often:
Take daily stool‑softening medicine
Sit on the toilet at regular times, often after meals
Eat foods with fiber and drink enough fluids
This phase usually lasts several months or longer.
Positive support
Some families use simple reward systems, like stickers or charts, to encourage toilet sitting or staying clean. This works best when the child feels supported, not pressured.
How long does encopresis take to improve?
Progress is often slow. Accidents and setbacks are common, especially early in treatment. This is normal.
Many children need months, and sometimes longer, before bowel control fully returns. With patience, medical care and encouragement, most children improve and regain confidence.
If your child continues to have poop accidents or fecal soiling after potty training, talk with your pediatrician. Help is available, and your child is not alone.
More information