Poop in Your Child's Underwear: Encopresis or Not Wiping?
The treatment of encopresis requires parents to keep track of poop accidents so that they can appropriately add or change the laxative or other treatment their child may be on (see the “Weekly Laxative and Stool Record” in my book, The Ins and Outs of Poop).
When I ask parents to describe the size and consistency of their child’s accidents, they will sometimes say, “I’m not sure if it’s an accident or if he/she just didn’t wipe, or wipe completely.” This is an important distinction because changes in laxatives or their doses is often based on the frequency, size and appearance of a child’s accidents. If a parent doesn't know or is just guessing whether a child had an accident, the data they are using to make this decision is problematic.
Generally, poor or no wiping results in a brown stain or a thin smear. Anything more than a stain or thin smear is defined as an accident.
(One caution, however, about loose or liquid-like stools. These are sometimes mislabeled as accidents caused by constipation when they are not. As described in detail in my book, too much of a laxative (e.g. Miralax) can cause incontinence.)