My 8-year-old son won't go to the toilet at school

Question

My 8-year-old son won't poo in the school. He knows that he can do it, but when he is at school, he poos in his pants. I feel like I am not getting anywhere. I just need some advice please.

Answer 1

This is a well-known condition that affects a certain (small) percentage of children. It is called encopresis. The cause can be a variety of factors. But basically they boil down to four main types of causes as follows:

1. Physiological -- "Holding" can create a blockage in the intestines due to dried / encrusted waste not moving properly through the tube. This blockage causes newly made waste in the intestines to have a hard time exiting. And sometimes it seeps around the blockage reducing or eliminating the child's control over his bowel functions.

2. Behavioral -- Believe it or not, some children just choose to poop their pants. They can control it. But they, for whatever reason, just simply prefer soiling themselves over using the toilet. And they make the behavioral choice to do so. There can be a variety of reasons that I will leave you to speculate about on your own and I will not comment further here.

3. Developmental -- There is some evidence that when a traumatic event occurs to a child, it can cause the child to slow or stop their development at whatever stage the child was when the traumatic event occurs. If this happens during a child's potty training stage, it can cause or be a contributing cause of encopresis.

4. Psychological -- There is a school of thought that postulates psychological factors can cause encopresis. Mostly stemming from control issues. You have possibly heard of the term anally retentive? The opposite of that term is called anally expulsive. This stems from some of Freud's psychoanalysis which many in the field classify as pop psychology and not rooted in science or research.

My advice to you is as follows:

1. Take him to a doctor to see if their are any physiological issues that need to be addressed. Your family pediatrician can then refer you to a GI specialist if necessary.

2. As a parent, you can identify any behavioral component that might exist by trying, for example, a reward-based incentive approach to see if you can induce any different behavioral choices.

3. If available, consider having him speak to a therapist or clinician who can evaluate whether there might or might not be any psychological component to the problem.

4. Do further independent research to educate yourself on the condition. Again, the word for it is called: encopresis.