Encopresis: The Hidden Struggle Parents Face with Toddlers Afraid to Poop

Share with a Friend!

It’s not uncommon for toddlers to refuse to poop, especially when starting potty training. But when your toddler starts holding it in all the time due to fear, it can lead to a condition known as encopresis.

I had no idea what we were in for when my toddler first started showing signs of withholding his poop, which is why I want to share our story. If you are struggling with a child withholding their poop, know that you are not alone, but also realize that many won’t “grow out of it” and they need your help to get back on track.

This article will highlight what encopresis is, why your child might have developed this issue, how you can help them get back on track with their toilet habits again, and what resources are available if this becomes a regular struggle in your household.

Continue reading to the end where I also share our personal story of encopresis and what we are doing now to help our toddler with this condition.

What is Encopresis?

Epopresis is a condition that results when a child holds their poop in, often due to fear or anxiety. This can lead to the child having accidents in their underwear and even cause them physical pain from constipation.

Although traditionally the diagnosis is given once a child has already been potty trained and is going in their underwear, the symptoms and severity are equally evident in infants and toddlers who are still in diapers, which is why early detection is so critical.

Symptoms Of Encopresis

• Leaking Poop In Underwear Or Diapers
• Avoiding Going Poop
• Going For Long Periods Of Time Without Pooping
• Abdominal Pain
• Poops 3 or fewer times/ week

Why Can’t My Toddler Just Poop?

The most complicated aspect of Encopresis is the psychological one. The fear of pooping becomes a phobia, and becomes irrational. It doesn’t matter if their poop is soft all the time now, they are still scared to go.

All it takes is ONE hard poop for your child to start withholding. They learn that if they hold it in, the feeling of needing to poop will go away, hence no pain.

They continue doing this over and over until the body starts making involuntary contractions when the feeling of pooping comes. At this point, it’s out of your toddler’s control.

You might also be interested in:

• 5 Steps to the Perfect Bedtime Schedule for Toddlers
• 10 Ways To Shift From Mainstream Parenting To Gentle Parenting
• Survival Guide For Moving With A Toddler
• 60 Positive Things To Say To Your Child That Really Matter

How Long Can My Toddler Go Without Pooping?

My son is almost 4-year old and has gone 14 days without pooping, but for the most part, he will go once a week.

You’ll know that something isn’t right when you notice their stool frequency changing or they refuse to poop because of perceived pain. They will also start complaining about stomach aches when there is no evident reason for them.

The important thing to know here is that healthy bodies should be pooping 1-2 times a day. If your child is consistently pooping 3 or fewer times a week, don’t discount it as being normal for them.

How Is Encopresis Treated?

There are a few different ways to treat encopresis, but the most common one is by retraining the child’s bowel habits. This means helping them relearn how to go poop on their own again and having patience along the way.

The best resource I have found for treating Encopresis is Dr. Tom’s book The In’s and Out’s Poop.

In his book, he outlines 6 steps for treating Encopresis

1. Educate Family – Learn about the disorder and how it’s different from regular constipation.
2. Empty The Rectum – With guidance from your doctor, the rectum is emptied using high volumes of laxatives.
3. End Withholding – Help your toddler poop regularly while continuing maintenance laxatives and practicing pushing.
4. Shrink The Rectum – Have your child poop daily to help the rectum shrink back to normal size.
5. Withdraw Laxatives – Slowly reduce laxatives once normal bowel movements are achieved and fear no longer persists.
6. Remain Vigilant – Keep track of your child’s bowel movements to ensure they continue pooping daily and have don’t get constipated again.

What Happens If Encopresis Is Not Treated?

If encopresis is not treated, it can lead to stool incontinence, which means they no longer feel the urge to poop and go in their pants unwillingly.

What happens is the child will experience a buildup of stool inside their rectum when avoiding to go poop. This build-up of stool stretches the rectum to be larger than it should.

As the rectum expands in diameter it also starts to become less sensitive. It has a harder time feeling the need to expel the stool which helps your child hold it for longer periods.

Eventually, this pattern of withholding will lead your child to no longer have the urge to poop at all, hence going in their underwear/ diapers unknowingly (stool incontinence).

Our Ongoing Story Of Encopresis

When our now 3.5 year old was a little over 1yo he became severely constipated after traveling to visit family in Europe. It was a very scary experience for him as he tore and bled a bit too when pooping.

After that time he has been scared to poop. I can’t recall at what point I realized it was a real problem. We started him with additional stool softening food at first and then Miralax shortly after per consultation of our pediatrician. 

Our thought was that if he had soft stools long enough he’d just not be scared anymore. -instead, it just got worse-

About a year ago (can’t recall exactly) I noticed he had learned how to move in such a way to prevent himself from pooping. He calls it “his struggle”. The use of daily Miralax helped him poop every 2-5 days on his own but now he has become strong enough to hold it in what seems indefinite. 

Since this summer more or less it started feeling totally out of our hands because he is so good at withholding and I can’t get him to poop at home unless I force to hold him up, (something I’ve learned now is not good as he needs to feel control over the process).

Seeking Help

We have now exhausted our personal repertoire of tools to help our toddler with his fear of pooping and are seeking professional help. Going to your regular pediatrician will often not suffice, as very likely they don’t have experience with the psychological aspects of this condition and will tell you to just continue giving them laxatives.

We did a Consultation with Dr. Tom which might allow us to avoid scary procedures at a children’d hospital for our very sensitive boy.

We are just at the beginning phases of following professional help but in many ways it feels like there is some light at the end of the tunnel. For more information on what we are doing, I highly recommend reading Dr. Tom’s book, although scheduling a consultation with him through his website afterwards is highly recommended!

Resources For Parents

Encopresis is a difficult childhood issue that can be treated if parents and doctors know about it. If your child has been struggling with encopresis, there are resources to help you navigate this journey. You can contact Dr. Tom on his website: https://www.theinsandoutsofpoop.com. You can also find his book on his website or via Amazon

I also highly recommend the Facebook group HELP! My Child Has Encopresis. Here you can connect with other families going through the same struggles. I have learned so much from this group already!

If your toddler refuses to poop, know that this is not his fault (or yours for that matter). These are just things that can happen, but please reach out for help so that your child doesn’t have to struggle alone.

Share with a Friend!