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Encopresis

Definition


Disease: Encopresis Encopresis
Category: Digestive diseases

Disease Definition:

When a child resists having bowel movements causing impacted stool to collect in the colon and rectum, encopresis occurs, which is also called stool holding. When the child’s colon is full of impacted stool, liquid stool can leak around the impacted stool and out of the anus, staining the child’s underwear.

 

In some rare cases encopresis could be the result of developmental and emotional issues; however, it is usually the symptom of a chronic constipation. Usually, this disease occurs after the age of 4, after the child has learned to use a toilet.

 

Treatment for encopresis is usually successful with patience and positive reinforcement.
 

Work Group:


Symptoms, Causes

Symptoms:

Some of the signs and symptoms of encopresis could be:

 

  • Lack of appetite
  • Abdominal pain
  • Avoidance of bowel movements
  • Constipation with dry, hard stool
  • Passage of large stool that almost clogs or clogs the toilet.
  • Leakage of stool or liquid stool on the child’s underwear. In case the leakage is large, it could be misinterpreted as diarrhea.

 

In case a child is experiencing one or more of the symptoms listed above, and is older than 4 years and toiled trained, the parents should call a doctor.
 

Causes:

In this condition, stool becomes impacted because it collects in the child’s colon and rectum. Some liquid stool may leak out of the anus and stain the child’s underwear when the colon is full of this impacted stool.

 

The two causes of encopresis are:

Emotional issues:

Encopresis could be due to emotional stress, such as stress from premature toilet training or an important life change, such as the birth of a sibling or the divorce of a parent.

Constipation:

Chronic constipation is the most common cause of encopresis. The child’s stool is hard, dry and may be painful to pass in constipation. Because of all this, the child may avoid going to the toilet, which makes the problem even worse, because the longer the stool remains in the colon, the more difficult it is for the child to push out. The colon stretches, and thus affects the nerves that signal when it’s time to go to the toilet, and when the colon becomes too full, soft or liquid stool could leak out.
 

Complications

Complications:

Embarrassment, frustration, shame and anger are some of the emotions that a child with encopresis could experience. A child may feel depressed or have low self-esteem when he/she is teased by friends or chastised by adults.

 

In order to help prevent the social and emotional impact of encopresis, early treatment is important, including spending time with a mental health professional.
 

Treatments:

Clearing the colon of retained, impacted stool and encouraging healthy bowel movements is what treatment of encopresis focuses on. It includes training the child to go to the toilet as soon as reasonably able when the urge to defecate occurs.

 

Some of the methods that may be recommended to the child in order to clear the colon and relieve constipation include:

 

  • Enemas
  • More fluids
  • Rectal suppositories
  • Lactulose or other stool softeners
  • Mineral oil or other colon lubricants

 

In order to check the progress of the colon clearing, the child may be recommended abdominal X-rays.

 

It is quite important to encourage the child to have regular bowel movements once the colon has been cleared. The use of stool softeners may be recommended to the child for 6 to 12 months, along with self-care measures, such as a high-fiber diet.

 

PSYCHOTHERAPY:

Psychotherapy could be helpful in case the child feels shame, guilt, depression or low self-esteem. In psychotherapy, the child could learn how to deal with these feelings and he/she could also be taught not to hold stool.
 

Prognosis:

Not available

Expert's opinion

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