The FIRST step to treating encopresis is to identify the CAUSE behind the condition​. 1. Functional constipation (persistent constipation with incomplete defecation without evidence of a structural or biochemical explanation) is one of the main causes of encopresis, accounting for 90% of cases amongst children. 2. Psychological factors: Overall 30-50% of children with encopresis have a comorbid emotional or behavioural disorder like separation anxiety, specific phobias, generalized anxiety. Rarely some may have neurological problem causing encopresis. Detailed clinical examination by pediatrian, investigations like X-ray abdomen, barium enema, anorectal manometry etc. may help in diagnosing exact cause of encopresis. Once cause of encopresis is established, NEXT STEP is to proceed towards TREATMENT. In some cases of encopresis, behavioral therapy alone, such as offering rewards or reasoning with the child, usually is not effective. Rather, a combination of medical and behavioral therapy works best. Ask your doctor about medical treatment options like enemas, suppositories, osmotic or stimulant laxatives, establishing bathroom times, age appropriate behavioral therapy, treatment of conditions like stress, anxiety, phobias etc. I hope going by this approach, your child will be diagnosed correctly and will respond to treatment.