What is soiling?
Soiling occurs when a child withholds their stool over a long period of time. The stool enters the rectum causing it to stretch. Sensory nerves then inform the brain that the bowel needs to be emptied. If the child withholds in response to this urge, the rectum enlarges over time until the stretch ceases. No message is sent to the brain and at this point, the child is unable to detect whether their rectum is full. This can lead to hard stools impacting in the rectum and softer faceal matter leaking out. The amount of leakage as it is occurring, or rather until its too late.
Foster carers who have an understanding of this process and the child’s inability to prevent their soling, are better placed to work proactively with a child, and understand that in most cases this is not a deliberate behaviour.
Encopresis (faecal soiling not associated with constipation or any other physical problem) is an issue many foster carers can struggle with, particularly when it concerns a teenager. Clearly, dealing with the issue is going to be complex and sensitive for you, your family and the young person concerned.
Factors contributing to soiling
- Physical factors such as constipation or other medical conditions
- Psychological factors such as stress, neglect, trauma, abuse, fear of the toilet
- Social factors ineffective or absence of toilet training
- Secondary soiling refers to soiling after the young person has previously established bowel control during childhood-often related to a physical or emotional issue
Understanding how how the soling occurs is crucial to overcoming the issue and you can start by providing the teenager with a website or leaflet, as they may be horrified in actually talking about the problem. ERIC is the only UK charitable organisation which provides information and support to families and young people who are dealing with incontinence issues. Their website is great place to start researching the issues associated to this problem.
Foster carers would like to put a quick end to this unwanted behaviour, however resolving the issues completely can never be guaranteed in the short term. If soiling has been a lifetime’s behaviour or is a medical condition, this will need a lot of work to change or adapt the behaviour. It may be a case of managing the problem in the long term and using all support that is available. Practical advice is available at NHS Direct