Is passing stools in underwear without knowledge a psychological problem?

Hi,

Welcome to icliniq.com.

I saw the attached files and your child's history (attachment removed to protect patient identity). Your child has encopresis (involuntary fecal soiling), and probably he might also be having constipation. The standard treatment is dietary modification. I believe you know all as it has already been done. I have four concerns. The first one is to go for a thyroid profile check that is T3 (triiodothyronine), T4 (thyroxine), and TSH (thyroid-stimulating hormone) check. The second one, does the child have pain on defecation? Is the child developmentally normal? Have anyone checked the anal opening for any cracks or fissures? The third one, have you seen some behavior abnormality in your child, or is there any problem in the family? If so, you should also see a psychologist or psychotherapist.

The last is if everything fails, then you should go for an MRI (magnetic resonance imaging) spine to rule out if anything is wrong there.

Kindly revert with the answers to the above questions.

Hi,

Welcome back to icliniq.com.

Yes, it is a psychological condition. But, you also rule out other things such as constipation, as it also happens when a child is chronically constipated. If constipation improves, then this condition may also improve. Also, your child needs some psychotherapy.