Brief Answer:
This needs both behavioral and medical treatment

Detailed Answer:
Hello

Thanks for the query

Passage of involuntary stool at inappropriate places in children above 4 years of age when they cross their bowel training age is called Encoperesis. I would like to rule out encoperesis first.
It is usually a complication of constipation or improper bowel training.In a long standing constipation case when there is impaction of large amount of hard stool occurs in the lower intestine it causes dilatation and slight weakness of that part and thus liquid part leaks out from the surrounding causing frequent soiling.

I can understand your problem as this is very frustrating for parents and then have to clean the cloths or make the child bath frequently.

Encoperesis is very rarely associated with any anatomical abnormality like in Hirshsprung disease and thus no investigation is needed.A barium enema test can be done but usually not needed.

As your physician said it is a behavioral disorder as due to constipation (painful passage of stool)child usually learned to avoid stool.

But both medical and behavioral treatment is needed.

The main aim of treatment is to make the bowel pattern soft and regular.
Regular and serial use of laxatives like polyethylene glycol or use of enema causes disimpaction of hard stool and thus removes the main cause of soiling.
Initially for few days soiling may persist even after emptying the intestine.For this bowel training is needed.
Child should be encouraged to go to toilet everyday at a fixed time at least three to four times if possible immediately after meals as this causes gastrcolic reflex and early training.
Give him some gift or stars or marks for regular use of toilet.This is called positive enforcement.
I would suggest you to consult a doctor for proper instruction and councelling.

I hope this would help.
Regards

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