Encopresis is when an older child soils his pants. This type of problem is almost always caused by constipation (believe it or not). The lower colon gets so blocked and stretched out that it looses strength. Loose stool then slides past the blockage and the person is unable to hold it back. Most pediatricians, internists, or family physicians should be able to handle this, although sometimes I refer to a G.I. specialist if my treatment is unsuccessful. First, he needs to get unblocked with stool softeners or maybe even an enema (See Constipation). Once cleaned out, the stools must remain soft for several months as the colon slowly "un-stretches" and regains strength. During this time it is important to not "hold in" a bowel movement. When the feeling hits, find a bathroom! It is important to be seen by your doctor if you are not sure of the diagnosis, and especially if you are having pain with this.