Encopresis refers to soiling with no physical basis. A child with encopresis passes feces in inappropriate places, such as underwear or on the floor, after the time when bowel control is physiologically possible and after the age at which toilet training is expected to be accomplished. Some children, in the process of toilet training, may have difficulty in mastering bowel control. By the age of four, if accidents occur at least once a month for three months and are not due to a physical abnormality or general medical condition, the child is considered to have encopresis. There are two basic categories of encopresis: a) primary - which refers to children who have never attained bowel control and b) secondary - children who begin to soil again after attaining control.