Health · England
Getting help with touching or smearing poo
Your browser or device provides the reading voice.
This guide is for adults.
You can read it with someone you trust.
You deserve respect
Sometimes people touch poo or spread it on things.
There can be different reasons.
You should not be shamed or punished.
Check your health
Tell someone if your tummy or bottom hurts.
Hard poo can get stuck.
Watery poo can leak around it.
Ask a health professional for help.
Get urgent help
Sudden, severe tummy pain needs emergency help.
Tummy pain with being unable to poo or pass wind at all needs emergency help.
Call 999 or go to A&E.
Help to get clean
You can ask for privacy and gentle help with washing.
Wash your hands with soap and water after touching poo.
Ask for clean clothes if needed.
Using the toilet
Tell someone if using the toilet feels difficult or uncomfortable.
Ask for help when you need it.
You may need equipment or a different way to clean yourself.
Show what you need
Words, pictures or signs can help you ask for the toilet.
You can show pain or ask for help in your own way.
People should listen.
Activities you enjoy
You might like the feel of some materials.
Ask about safe activities that you enjoy.
Health problems still need treatment.
Your choices matter
People should explain personal care in a way you understand.
Tell them what feels comfortable.
Ask for help if people ignore your wishes.
Make a support plan
Your health team can help work out what is happening.
Agree what help you need.
Ask who will check that the plan is helping.
Keep asking for help
Tell the team if pain or difficulties continue.
You and your supporters can ask for more help.
What you can do next
Ask a health professional to check pain and bowel problems.
Ask for support that respects your dignity and choices.
Read NHS constipation information Web pageThis link opens another website.
It may use harder words.
More useful links
- NHS England: constipation and learning disability Web page
Easy Read information and resources for people, carers and health teams.
- National Autistic Society: smearing Web page
Possible reasons and support ideas for autistic people. Adapt advice to consent, individual needs and health assessment.
- Challenging Behaviour Foundation: finding the reasons Web page
A quick read and further information about assessment and keeping helpful records.
- NHS: helping someone keep clean Web page
Practical support with washing, comfort and dignity.
These links open other websites.
They may use harder words.
Touching or smearing poo: support for adults
Understand possible reasons, check health and comfort, and plan respectful support with toileting and hygiene.
Adults · England · Information for individuals, families and supporters
Understand what is happening
Smearing means spreading poo on the body, clothing or surroundings. Touching poo does not have the same explanation for everyone. Possible reasons include discomfort, difficulties with wiping or toilet use, and sensory needs. Describe what actually happens without labels such as dirty or naughty. The person’s own experience matters; do not assume they are trying to upset someone.
Check health before making assumptions
Ask the GP or bladder and bowel service about constipation, pain, skin soreness, bowel changes and medicine effects. Watery poo can leak around a build-up of hard poo; it does not rule out constipation. Discomfort may show as changes in sleep, appetite, activity or behaviour. Do not attempt to remove stuck poo yourself or change prescribed medicines without advice. Tell the clinician specifically if any poo is being eaten, as this needs separate advice.
Know when medical help is urgent
Call 999 or go to A&E for tummy pain that starts suddenly and is severe, or tummy pain with being unable to poo or pass wind at all. A bloated tummy with vomiting, constipation or tummy ache needs an urgent GP appointment or NHS 111 advice; use emergency help for the severe symptoms above. Do not wait for a routine support assessment when the person may be acutely unwell.
Respond calmly and help with hygiene
Keep your voice calm and give the person privacy. Offer help to wash and change soiled clothing in a comfortable way. Support handwashing with soap and water after contact with poo and before food. Clean affected areas and follow the care service’s infection-prevention procedures where relevant. Do not express disgust, threaten punishment or make cleaning a punishment. A calm response still includes prompt care and reassurance.
Make using the toilet easier
Check whether the person can find and reach the toilet, manage clothing and get help when they need it. Ask about fear, noise, lighting, position and discomfort from wiping. A predictable toilet routine and clear steps may help. Ask the continence team or occupational therapist about suitable adaptations and comfortable cleaning methods. Avoid delaying toilet access or relying only on pads.
Support communication
Help the person show pain, needing the toilet, needing help, or wanting to stop. This may involve words, gestures, pictures or a communication aid. Use short explanations and enough processing time. Ask speech and language therapy for help if needed. Notice and respond to the person’s existing communication rather than waiting for speech.
Explore safe sensory alternatives
If touch, texture or movement seems important, ask an occupational therapist or the assessment team to explore the person’s sensory needs. Offer preferred activities that meet those needs safely, such as suitable painting or modelling activities. Consider swallowing risks and allergies when choosing materials. The activity should be a choice, not a punishment or a substitute for treating pain or bowel problems.
Keep a short, respectful record
Record when it happens, what happened just beforehand, what the person did, what happened afterwards and what helped. Include bowel patterns, signs of discomfort and access to support. Distinguish observations from guesses about reasons. Keep intimate information private and share it only as appropriate for care. Records help assessment; they do not prove a cause.
Ask for an individual support plan
If it continues, ask the GP or social care team about help from the community learning disability team or another appropriate specialist. A functional assessment explores how health, communication, surroundings and responses relate to the behaviour. The plan should improve comfort and quality of life, explain what supporters will do, and include a review date. Everyone providing support needs to understand the agreed approach.
Respect consent and avoid unnecessary restrictions
Explain personal care in an accessible way and seek consent. A learning disability does not automatically remove someone’s ability to decide. If capacity is in question, the correct decision-specific process is needed. Restraint or clothing that prevents an adult reaching the toilet or their body should not be a routine solution. Any proposed restriction needs lawful justification, professional assessment and review, with less restrictive options considered. Ask for advocacy if the person’s wishes are being overlooked.
Review support and help supporters too
Review the plan if pain, skin problems, distress or smearing continues, or needs change. Ask whether help arrives promptly and whether the person enjoys enough meaningful activities. Family carers and staff may need practical training and emotional support. Ask for help early if providing care is becoming difficult; the person should not be left without appropriate support.
Words you could use
“Please check pain and bowel health, listen to how I communicate, and help us make a respectful support plan.”
More useful links
- NHS England: constipation and learning disability Web page
Easy Read information and resources for people, carers and health teams.
- National Autistic Society: smearing Web page
Possible reasons and support ideas for autistic people. Adapt advice to consent, individual needs and health assessment.
- Challenging Behaviour Foundation: finding the reasons Web page
A quick read and further information about assessment and keeping helpful records.
- NHS: helping someone keep clean Web page
Practical support with washing, comfort and dignity.
These links open other websites.
They may use harder words.
Where the information comes from
Links checked 9 November 2026.
These links open other websites.
They may use harder words.
- National Autistic Society: smearing Web page
Possible medical, toileting and sensory reasons; calm support and alternative activities.
- NHS: constipation Web page
Missed constipation, overflow leakage, assessment and avoiding untrained removal of stuck poo.
- NHS: stomach ache Web page
Emergency advice for sudden severe tummy pain and inability to poo or pass wind with tummy pain.
- NHS: bloating Web page
Urgent GP or NHS 111 advice for bloating with vomiting, constipation or tummy ache.
- NHS: handwashing Web page
Soap and water, washing after toilet use and before eating or handling food.
- NHS: helping someone keep clean Web page
Comfort, privacy and sensitive support with personal hygiene.
- Challenging Behaviour Foundation: finding the reasons Web page
Health checks, understanding context and recording observations before planning support.
- Challenging Behaviour Foundation: communication Web pageFuller information
Accessible communication, expressing needs and communication aids.
- NICE NG11: assessment and support Web pageProfessional guidance
Individual functional assessment, health, sensory needs, support planning and review.
- CQC: dignity and respect Web page
Privacy, respectful communication and personal care preferences.
- CQC: consent Web page
Accessible consent and the Mental Capacity Act where a person cannot consent.
- CQC: safeguarding and improper treatment Web page
Protection from degrading treatment and unnecessary or disproportionate restrictions.