Encopresis

Description

Encopresis (en-ko-pree-sis), sometimes called fecal incontinence or soiling, is the repeated passage of feces (usually unintentionally) in the clothes. Usually this occurs when the impacted stool accumulates in the colon and rectum: colon gets too full and liquid stool leaks around the impacted stool, the stain on the underwear. Finally, the retention of the feces can cause stretch (strain) of the intestines and the loss of control over bowel movements.

Encopresis occurs usually after 4 years of age, when the child has already learned how to use a bathroom. In most cases, the dirt is a symptom of long-standing constipation. Much less frequently it occurs without constipation and may be the result of emotional problems.

Encopresis can be frustrating for parents — and embarrassing for the child. However, with patience and positive reinforcement, the treatment of encopresis is usually successful.

Symptoms

The signs and symptoms of encopresis may include:

  • Leakage of stool or liquid stool in the underwear, which can be confused with diarrhea
  • Constipation with hard, dry stool
  • Passage of large stools that obstructs, or almost clogged the toilet
  • The avoidance of bowel movements
  • Long periods of time between bowel movements
  • Lack of appetite
  • Abdominal Pain
  • Problems with daytime wetting and bedwetting (enuresis)
  • Repeated infections of the bladder, usually in girls

When to see a doctor

Call your doctor if your child is already trained to go to the bathroom and start to experience one or more of the symptoms listed above.

Causes

There are several causes of encopresis, including constipation and emotional problems.

Constipation

The majority of the cases of encopresis are the result of chronic constipation. In constipation, the child of the stool is hard, dry, and can be painful. As a result, the child avoids going to the bathroom — making the problem worse.

The longer the stool remains in the colon, the more difficult it is for the child to push the stool out. The colon extends, ultimately, affect the nerves that signal when it is time to go to the bathroom. When the colon becomes too full, soft or liquid stool may leak around the preserved stool or the loss of control over bowel movements can occur.

Some of the causes of constipation include:

  • The withholding of the stool because of the fear of using the toilet (especially when they are far away from home) or because passing stool is painful
  • Not wanting to interrupt the game play or other activities
  • Eating too little fiber
  • Not drinking enough fluids
  • Drinking too much cow's milk or, rarely, an intolerance to cow's milk — despite the fact that the results of the investigation of the conflicts in these topics

Emotional problems

Emotional stress can trigger the encopresis. A child may be experiencing stress:

  • Prematurity, difficult or conflicting training to go to the bathroom
  • The changes in the child's life, such as changes in diet, training to go to the bathroom, from the school or schedule changes
  • Emotional stressors, for example, the parents ' divorce or the birth of a brother

Risk factors

Encopresis is more common in boys than in girls. These risk factors may increase the chances of having encopresis:

  • The use of drugs that can cause constipation, such as a cough suppressant
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Autism spectrum disorder
  • Anxiety or depression

Complications

A child has encopresis can experience a range of emotions, including embarrassment, frustration, shame, and anger. If your child is a victim of ridicule by friends or criticized, or punished by the adults, he or she may feel depressed or have low self-esteem.

Prevention

Below are some of the strategies that can help to prevent the encopresis and its complications.

Avoid constipation

Help your child to avoid constipation by providing a balanced diet that is high in fiber and encourage your child to drink enough water.

Learn about the effectiveness of toilet training techniques

Learn about the effectiveness of toilet training techniques. Avoid starting too early or too forceful in their methods. Wait until your child is ready, and then, use positive reinforcement, and encouragement to help them thrive. Ask your doctor about the resources in the training.

Get early treatment for encopresis

Principles of treatment, including the guidance of your doctor or mental health professional can help prevent the social and emotional impact of the encopresis. Regular follow-up visits with your doctor will help to identify ongoing or recurring problems so that adjustments in the treatment can be performed as needed.

Encopresis

Diagnosis

For the diagnosis of encopresis, your child's doctor may:

  • Perform a physical exam and discuss your symptoms, bowel movements and eating habits to rule out physical causes for the constipation or the dirt
  • Do a digital rectal exam to check for the presence of impacted stool using the insertion of a lubricated, gloved finger into the anus of the child, while pressing on your abdomen with the other hand
  • We recommend an abdominal x-ray to confirm the presence of impacted stool
  • Suggest that a psychological evaluation is performed if emotional problems are those that contribute to the symptoms of his son

Treatment

Usually, before the start of the treatment of encopresis, the better. The first step is to remove the colon of preserves, impacted stool. After that, the treatment focuses on the promotion of healthy bowel movements. In some cases, psychotherapy can be a useful addition to the treatment.

Clear the colon of impacted stool

There are several methods to cleanse your colon and relieve constipation. Your doctor will likely recommend one or more of the following:

  • Certain laxatives
  • The rectal suppositories
  • Enemas

Your child's doctor may recommend a close follow-up to check the progress of the two points of compensation.

Promote healthy bowel movements

Once the colon is cleared, it is important to encourage your child to have regular bowel movements. Your child's doctor may recommend:

  • Changes in the diet to include more fiber and drinking the right amount of liquid
  • Laxatives, gradually discontinued once the bowel to return to normal
  • Training your child to go to the bathroom as soon as possible when the urge to have a bowel movement occurs
  • A short essay going out to milk the cow or the checking of cow's milk intolerance, if indicated

Behavior modification

Your child's doctor or a mental health professional can talk about techniques for how to teach your child have regular bowel movements. This is sometimes called the modification of the conduct or in the intestine of the conversion.

Your child's doctor may recommend psychotherapy with a mental health professional if the encopresis may be related to emotional problems. Psychotherapy may also be useful if your child feels shame, guilt, depression, or low self-esteem associated with encopresis.

Self-care

Avoid the use of enemas or laxatives — including herbal or homeopathic products — without first speaking with your child's doctor.

Once your child has been treated by the encopresis, it is important that you encourage regular bowel movements. These tips may help:

  • The approach of the fiber. Feed your child a balanced diet that includes plenty of fruits, vegetables, whole grains, and other foods rich in fiber, which can help form soft stools.
  • Encourage your child to drink water. Drinking enough water helps to keep the stool to harden. Other liquids may help, but be careful with the calories.
  • Organize the toilet time. Have your child sit on the toilet for 5-10 minutes at regular times each day. This is best done after meals because the bowel becomes more active after eating. Praise your child for sitting on the toilet requested and trying to.
  • Put a stool next to the toilet. This can make your child more comfortable, and change the position of your legs can put more pressure on the belly, making bowel movement easier.
  • Stick with the program. It can take months to resume normal bowel sensation and function and to develop new habits. Following the program also can reduce relapses.
  • Be encouraging and positive. As you help your child overcome the encopresis, be patient and use positive reinforcement. Not to blame, criticize or punish your child if he or she has an accident. Instead, they offer their unconditional love and support.
  • Limit of cow's milk if that is what the doctor recommends. In some cases, cow's milk can contribute to constipation, but dairy products also contain important nutrients, so ask the doctor how much milk your child needs each day.

Preparing for your appointment

It is likely that the first to bring 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) if it is necessary, or a mental health professional if your child is distressed, very embarrassed, frustrated or angry because of the encopresis.

What you can do

It is a good idea to be prepared for your child's appointment. Ask if there is something that you need to do in advance, such as altering the diet of your child. Before your appointment, make a list of:

  • Your child's symptoms, including how long they have been going
  • Key personal information,such as any of the major stresses or recent life changes
  • All medications, including over the counter medications and vitamins, herbs, or other supplements that you are taking your son, and the dose
  • What your child eats and drinks in a typical day, including the amount and types of dairy products, the types of solid foods, and the amount of water and other liquids
  • Questions to ask your child's doctor

Some basic questions to ask the doctor include:

  • What is the most likely cause of the symptoms of my son?
  • There are other possible causes of these symptoms?
  • What kind of evidence does my child need? Do these tests require any special preparation?
  • How long could this last problem?
  • What treatments are available, and which do you recommend?
  • What side effects can be expected with this treatment?
  • There are alternatives to the primary approach you're suggesting?
  • Are there changes in the diet might help?
  • It would be more physical activity help my child?
  • Are there brochures or other printed material I can have?
  • What sites do you recommend?

What to expect from your doctor

Your child's doctor will have questions for you. Be prepared to answer to reserve a time to go over any points you want to focus on. The questions may include:

  • How long your child has been trained to use the bathroom?
  • Did your child experience any problem with the training to go to the bathroom?
  • Does your child have a hard, dry stools that sometimes clog the toilet?
  • How often does your child have a bowel movement?
  • Your child take any medication?
  • Does your child regularly to resist the temptation to use the toilet?
  • Does your child experience painful bowel movements?
  • How often do you notice the appearance of dark spots or stool in your underwear?
  • There have been significant changes in your child's life? For example, he or she started a new school, moved to a new city, or experienced a death or divorce in the family?
  • Is your child embarrassed or depressed by this condition?
  • How has the management of this problem?
  • If your child has siblings, how was your training to go to the bathroom experience?
Symptoms and treatment of Encopresis