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Alternative names
Soiling; Incontinence - stoolDefinition Return to top
Encopresis is the voluntary or involuntary passage of stools causing soiling of clothes by a child over 4 years of age. Otherwise known as overflow incontinence, encopresis results from chronic constipation.
See also bowel incontinence.
Causes, incidence, and risk factors Return to top
Encopresis can be divided into two groups. The first in which there is a physiologic basis for the encopresis, the second in which there seems to be an emotional basis.Symptoms Return to top
Signs and tests Return to top
Treatment Return to top
The goal is to prevent constipation and encourage good bowel habits. Laxatives, and sometimes enemas, are used to remove fecal impaction. A stool softener is often prescribed.
A diet high in fiber, including fruits, vegetables, whole grain products, and adequate fluid intake will promote the passage of softer stools and minimize the discomfort associated with bowel movements.
Parents should be supportive and refrain from criticism or discouragement. Pediatric gastroenterologists often provide education to the parents and child and use biofeedback for the child to treat the more difficult cases. Psychotherapy can help the child deal with associated shame, guilt, or loss of self-esteem. For encopresis in the absence of constipation, psychiatric evaluation may help determine the underlying cause.
Expectations (prognosis) Return to top
Most children respond to treatment.Complications Return to top
The child may suffer from low self-esteem and peer disapproval related to this problem. If routine bowel habits are not developed, the child may suffer from chronic constipation.Calling your health care provider Return to top
Call for an appointment with your health care provider if this behavior is noted in a child over 4 years old.Prevention Return to top
Because the causes often are obscure prevention is difficult. As a general rule, refrain from too early and too coercive toilet training. Update Date: 10/30/2003 Updated by: Philip L. Graham III, M.D., M.S., F.A.A.P., Department of Pediatrics, Children's Hospital of New York, Columbia University, New York, NY. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |