Encopresis occurs when your child resists having bowel movements, causing impacted stool to collect in the colon and rectum. When your child's colon is full of impacted stool, liquid stool can leak around the impacted stool and out of the anus, staining your child's underwear. Encopresis may also be called stool holding.
Encopresis usually occurs after age 4, when your child has already learned to use a toilet. In most cases, encopresis is a symptom of chronic constipation. Less frequently, it may be the result of developmental or emotional issues.
Encopresis can be frustrating for you — and embarrassing for your child. However, with patience and positive reinforcement, treatment for encopresis is usually successful.
Signs and symptoms of encopresis may include:
When to see a doctor
There are several causes of encopresis. The most common are:
The following risk factors may increase your child's chances of having encopresis:
A child who has encopresis may experience a range of emotions, including embarrassment, frustration, shame and anger. If your child is teased by friends or chastised by adults, he or she may feel depressed or have low self-esteem.
Early treatment, including spending time with a mental health professional, can help prevent the social and emotional impact of encopresis.
Preparing for your appointment
You'll probably first bring up your concerns with your child's doctor. He or she may refer you to a doctor who specializes in digestive disorders in children (pediatric gastroenterologist), or a mental health professional if your child seems to be very embarrassed, frustrated or angry because of encopresis.
Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be prepared for your child's appointment.
What you can do
Preparing a list of questions can help you make sure that you cover all of the points that are important to you. Some basic questions to ask your child's doctor include:
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Your child's doctor may:
Treatments and drugs
Generally, the earlier treatment begins for encopresis, the better. The first step in treatment focuses on clearing the colon of retained, impacted stool. After that, treatment includes encouraging healthy bowel movements. This includes training your child to go to the toilet as soon as reasonably able when the urge to defecate occurs.
There are several methods for clearing the colon and relieving constipation. Your child's doctor will likely recommend one or more of the following:
Your child's doctor may recommend abdominal X-rays to check the progress of the colon clearing.
Once the colon has been cleared, it's important to encourage your child to have regular bowel movements. In addition to recommending self-care measures such as a high-fiber diet, your child's doctor may recommend the use of stool softeners for six months or more.
Lifestyle and home remedies
Don't use enemas or laxatives — including herbal or homeopathic products — without talking to your child's doctor first.
Once your child has been treated for encopresis, it's important that you take steps to encourage softer stools and regular bowel movements. The following tips can help:
As you help your child overcome encopresis, be patient and use positive reinforcement. Don't blame, criticize or punish your child if he or she has an accident. Instead, offer your unconditional love and support.
Educate yourself on effective toilet training techniques. Avoid starting too early or being too forceful in your methods. Wait until your child is ready, and then use positive reinforcement and encouragement to help him or her progress. Most children are not ready for toilet training until after their second birthdays.
Help your child avoid constipation by providing a diet high in fiber and encouraging your child to drink plenty of water.
Last Updated: 2011-01-04
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