Encopresis in Kids: Why Accidents Happen (and How to Help)
- El Hall
- Jul 7
- 4 min read
If your child is having stool accidents, especially if they’re older than potty training age, it can feel confusing, frustrating, and honestly… a little overwhelming.
You might be wondering:
“Why is this still happening?”
“Are they doing this on purpose?”
“How do I even fix this?”
If this sounds familiar, you’re not alone.
Encopresis (also called stool leakage or fecal incontinence) is more common than most families realize. And despite how it may look from the outside, these accidents are almost never intentional.
What Is Encopresis?
Encopresis is when a child has repeated stool accidents, typically after they’ve already been potty trained.
Parents often describe:
Poop accidents in older children
Skid marks in underwear
Small amounts of stool leaking throughout the day
A child who “doesn’t seem to notice” it’s happening
This last part, not noticing, is often the most confusing.
But there’s a very real, physical reason behind it.
Why Do Stool Accidents Happen?
Encopresis is almost always connected to chronic constipation.
Here’s what’s happening inside the body:
1. Stool builds up in the rectum
When a child holds their poop (often due to pain, fear, or habit), stool begins to accumulate in the rectum.
2. The rectum stretches over time
The rectum is designed to stretch, but when it stays stretched for too long, it starts to lose its normal sensitivity.
Think of it like a balloon that’s been overfilled for a long time, it doesn’t snap back as easily.
3. Sensation becomes decreased
As the rectum stretches, the child may no longer feel the urge to go the way they used to.
This is why some kids truly don’t realize they need the bathroom, or that an accident is happening.
4. Stool leaks around the blockage
Softer stool can move around the built-up stool and leak out without the child having much control over it.
This is what leads to stool accidents or “skid marks” in underwear.
Why It’s Not Behavioral
From the outside, it can look like a child is ignoring their body, or even being defiant.
But in reality:
Their sensation is reduced
Their coordination may be off
Their body is working against them
This is not about laziness, stubbornness, or lack of effort.
It’s a body-based issue, not a behavior problem.
If your child is experiencing this, it’s not something they’re choosing—and it’s not something you caused.
Signs Your Child May Be Dealing with Encopresis
Frequent stool accidents or leakage
Skid marks in underwear
Large, infrequent bowel movements
Avoidance of the toilet
Belly pain or bloating
Not recognizing when they need to go
Many kids also have a history of constipation or stool withholding leading up to this.
If you want to understand that earlier stage, you can read more in our post on constipation in kids.
How to Help Your Child
The goal isn’t just to stop the accidents. It’s to address what’s happening underneath.
That usually means focusing on three key areas:
✔ 1. Reducing stool buildup
This may involve working with your pediatrician to ensure stool is soft and easier to pass.
✔ 2. Restoring normal sensation
As the rectum returns to a more typical size, the body can begin to recognize the urge to go again.
This takes time, but it’s an important part of the process.
✔ 3. Improving coordination and habits
This is where many families need extra support.
How Pediatric Pelvic Floor Physical Therapy Helps
Pediatric pelvic floor physical therapy (PFPT) focuses on helping kids retrain the muscles and patterns involved in bowel movements.
At Bonneville Pelvic Health, we work with children in a way that feels approachable and supportive, never overwhelming.
PFPT can help your child:
✔ Learn how to properly relax during bowel movements
Some kids unknowingly tighten their pelvic floor muscles, making it harder to fully empty.
✔ Improve body awareness
We help kids recognize earlier signals from their body so they can respond before accidents happen.
✔ Build consistent bathroom routines
Simple changes in timing and positioning can make a big difference.
✔ Reduce anxiety and rebuild confidence
As accidents decrease, kids often feel more comfortable in their daily lives, at school, with friends, and during activities.
Sessions are always age-appropriate, and there is typically no internal treatment for pediatric patients.
You can learn more about our approach on our pediatric pelvic health services page.
What You Can Do at Home
While your child is working through this, a few small shifts can help:
Keep bathroom time consistent (especially after meals)
Use a footstool to support proper positioning
Stay calm and neutral around accidents
Avoid punishment or shame
Focus on progress, not perfection
Even small improvements can build momentum over time.
This Is More Common Than You Think
Encopresis can feel isolating, but many families are navigating the same thing.
And with the right support, kids do get better.
Their bodies can relearn how to sense, coordinate, and respond the way they’re meant to.
Not Sure What the Next Step Is?
If your child is having stool accidents or you’re concerned about encopresis, you don’t have to figure it out alone.
We’re here to help you understand what’s going on and create a plan that feels realistic for your family.
Reach out to schedule an evaluation. We’re here to support both you and your child.
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