As children head into a new school year and spend more time in social settings over the summer, issues like bedwetting or toilet accidents can become a source of real stress for the whole family. Parents often feel unsure whether what their child is experiencing is a medical problem, a behavioural one, or simply something they will grow out of. The answer is usually more nuanced than either extreme.
Enuresis and encopresis in children are more common than most people realise, and both are very treatable. Understanding what each condition involves, why it happens, and what the right steps are can make a significant difference, not just for your child’s physical health, but for their confidence and emotional well-being too.
This post walks through what parents in Calgary need to know, including when to see your family doctor, what to check for at home, and when psychological support becomes part of the picture.
What Is Enuresis?
Enuresis refers to repeated, involuntary urination in children who are at an age where bladder control would typically be expected. It is most often associated with bedwetting (nocturnal enuresis) but can also occur during the day.
To give a sense of how common this is: approximately 15 to 20 percent of five-year-olds wet the bed, and around 5 percent of ten-year-olds still do. It is not a sign of laziness or defiance. In most cases, it reflects a combination of developmental timing, deep sleep patterns, and bladder capacity, sometimes alongside other factors.
For families in French-speaking communities, the term enuresie enfant refers to the same condition in children and is often used in francophone clinical settings.
What Is Encopresis in Children?
Encopresis in children involves the repeated passing of stool in inappropriate places, such as underwear, after the age of four. It is less commonly discussed than bedwetting, but it affects roughly 1 to 3 percent of school-aged children and can have a meaningful impact on a child’s social life and self-esteem.
In the majority of cases, encopresis is closely connected to chronic constipation. When stool builds up and becomes impacted, liquid stool can leak around the blockage without the child having any real control over it. This is known as overflow incontinence, and it is important for parents to understand that the child is usually not choosing to have accidents.
In less common cases, encopresis occurs without constipation and may be linked to emotional difficulties, anxiety, or significant stressors in the child’s environment.
The Connection Between ADHD and Enuresis / Encopresis
One thing that surprises many parents is the relationship between ADHD and enuresis/encopresis. Research consistently shows that children with ADHD are significantly more likely to experience encopresis than their peers. The same pattern is seen with enuresis.
There are a few reasons why they tend to co-occur. Children with ADHD often have difficulty recognising and responding to internal body signals in a timely way. They may be so engaged in an activity that they ignore the urge to use the toilet until it is too late. Executive function challenges can also make it harder to establish and follow through on consistent routines around toileting.
If your child has an ADHD diagnosis and is also experiencing toileting difficulties, it is worth raising both with your healthcare provider. The two often need to be addressed together for treatment to be effective.
Do Enuresis or Encopresis Ever Go Away on Its Own?
This is one of the most frequent questions parents ask, and it is a fair one. The short answer is: sometimes, but not reliably, and waiting without support can make things harder over time.
For enuresis, the spontaneous resolution rate is around 15 percent per year, meaning many children do eventually outgrow day time accidents or bedwetting without intervention. However, for older children, or those for whom the issue is causing anxiety or affecting their social participation, waiting it out may not be the most helpful approach.
Encopresis is less likely to resolve without some degree of intervention, particularly when constipation is involved. The longer constipation is left untreated, the more the bowel can stretch and lose its normal sensitivity. This makes it harder for the child to recognise when they need to go, which perpetuates the cycle. Early, consistent treatment produces much better outcomes.
Step 1: Start with Your Primary Care Physician
The first and most important step for any child experiencing enuresis or encopresis is a visit to your family doctor or paediatrician. Before anything else, medical causes need to be ruled out.
For enuresis, your physician will want to check for urinary tract infections, structural issues with the urinary tract, diabetes, and other conditions that can affect bladder control. For encopresis, the priority is assessing for physical causes, including Hirschsprung’s disease, thyroid conditions, and other gastrointestinal factors.
This step is not optional. Jumping straight to behavioural or psychological approaches without first clearing a medical cause can delay appropriate treatment and, in some cases, make things worse. Your physician is the right starting point.
Step 2: Check for Constipation
If your child is experiencing encopresis, constipation is the most common underlying factor and needs to be assessed carefully. Many parents are surprised to learn that their child is constipated, because the child may still be passing some stool regularly. Overflow encopresis can create the misleading appearance of normal or even frequent bowel movements.
Your physician may recommend an abdominal examination or X-ray to assess the degree of impaction. Treatment typically involves a structured cleanout phase using a laxative, followed by a maintenance phase with dietary changes, increased hydration, and scheduled toilet sits.
It is worth knowing that resolving constipation alone does not always resolve encopresis completely. The bowel needs time to return to its normal size and sensitivity, and habits around toileting often need to be rebuilt. This is where behavioural support becomes relevant.
Step 3: When to Involve a Psychologist
Once medical causes have been ruled out and constipation is being managed, a psychologist can play an important role in supporting your child’s progress. Enuresis and encopresis treatment delivered by a trained psychologist typically combines several evidence-based approaches.
What psychological support for encopresis and enuresis typically involves:
- Psychoeducation about the way your child’s body works, that is, how you pee and poop.
- Establishing consistent and structured toileting routines that fit with the child’s daily schedule
- Using positive reinforcement to build motivation and reduce resistance around bathroom habits
- Addressing anxiety or shame that has developed around accidents, which can itself become a barrier to progress
- Supporting parents with practical strategies and helping the whole family approach the issue calmly and consistently
- For children with ADHD, tailoring strategies to account for attention and impulse control challenges
Treating encopresis is not about disciplining a child or placing blame. It is about rebuilding a healthy, sustainable relationship with toileting in a way that accounts for everything going on for that particular child, medically, developmentally, and emotionally.
The same applies to enuresis. Where bedwetting persists beyond what would be expected and is causing distress, psychological support can include motivational strategies, bladder training techniques, and working with families to use tools like enuresis alarms effectively.
What Parents Can Do in the Meantime
While you are working through the steps above, there are some things that genuinely help at home and some that tend to make things harder.
Helpful approaches:
- Keep a calm, matter-of-fact tone around accidents. Children pick up on parental stress and frustration, and shame can worsen both conditions.
- Ensure your child is drinking enough water throughout the day and eating a fibre-rich diet.
- Encourage regular toilet visits after meals, when the bowel is naturally more active.
- Celebrate small wins. Progress with encopresis and enuresis is often gradual, and consistent encouragement matters.
Things to avoid:
- Punishing or shaming a child for accidents. This is rarely effective and often increases anxiety around toileting.
- Assuming the child is choosing to have accidents. In the vast majority of cases, they are not.
- Waiting too long before seeking support, particularly if the issue is affecting your child’s school participation or social confidence.
Getting the Right Support in Calgary
Enuresis and encopresis in children are genuinely common, and with the right support, most children do very well. The key is following the right sequence: start with your primary care physician to rule out medical causes, address any constipation, and then work with a psychologist when behavioural and emotional support is needed.
If your child is heading into the new school year or the summer months and you have concerns about bedwetting or accidents, now is a good time to take action. These issues do not have to define your child’s experience at school or in social settings, and the right support can make a real difference.
Our team in Calgary works with children and families navigating exactly these challenges. If you would like to learn more about how we can help, we would be glad to hear from you.
Questions Parents Often Ask
My child is seven and still wetting the bed. Should I be worried?
Bedwetting at seven is more common than most parents realise. That said, if it is causing your child stress or making them anxious about sleepovers or school trips, it is worth looking into rather than waiting. Start with your family doctor to rule out anything physical.
My child has accidents daily but also goes to the bathroom every day. Could it still be encopresis?
Yes, and this surprises a lot of parents. A child can be significantly constipated even while passing some stool daily. Loose stool can leak around an impacted blockage, mimicking a normal pattern. It is worth asking your doctor to check.
Is my child doing this on purpose?
In the vast majority of cases, no. With encopresis, leakage is often completely outside their control. With bedwetting, most children are deeply asleep and do not register the urge to go. Treating accidents as intentional tends to increase shame and anxiety, which usually makes things worse.
My child has ADHD. Is that connected?
Very likely. Children with ADHD experience enuresis and encopresis at higher rates than other children. ADHD affects body awareness, so kids can tune out the signal that they need to go, especially when engaged in something they enjoy. Strategies that account for how your child’s brain works make a real difference here.
How long does treatment usually take?
It varies. Some families see meaningful progress within a few weeks. Where constipation has been present for a long time, it can take several months for the bowel to recover and new habits to form. Progress tends to be gradual, so consistency matters more than speed.
When should I make an appointment?
If accidents are happening regularly, your child seems embarrassed or anxious, or it is affecting school or social life, that is reason enough to reach out. There is no benefit to waiting once it is having an impact on your child’s daily life.
If your child is struggling with bedwetting, encopresis, ADHD, anxiety, or emotional challenges related to toileting, our team of psychologists and therapists can help. We provide assessment and treatment services for children and families across Calgary. Contact us today to learn more or book an appointment.
