Encopresis Treatment at Home
Although parents will be following a regimen recommended by the child’s health care provider, most of the work of treating encopresis is done at home.
It is very important that parents and other caregivers keep a complete record of the child’s medication use and bowel movements during the treatment period. This record can be very helpful in determining whether the treatment is working.
Medical Treatment for Encopresis
Although many different regimens have been developed for the treatment of encopresis, most rely on the following principles:
- Empty the colon of stool
- Establish regular soft and painless bowel movements
- Maintain very regular bowel habits
While there is almost always a large behavioral component to chronic encopresis, behavioral therapy alone, such as offering rewards or reasoning with the child, usually is not effective. Rather, a combination of medical and behavioral therapy works best.
Medical professionals usually refer to emptying stool from the colon and rectum as evacuation or, in severe cases when the doctor needs to remove the stool manually, disimpaction. Evacuation can be accomplished in the following ways:
Give an enema or series of enemas: An enema pushes fluid into the rectum. This softens the stool in the rectum and creates pressure within the rectum. This pressure gives the child a powerful urge to pass a bowel movement, and the stool is usually expelled rapidly. The fluid in most enemas is water. Something is usually added to keep the water from being absorbed by the intestinal lining. Widely used enemas include commercial sodium phosphate preparations (such as Fleet saline or Pedia-Lax enemas), slightly soapy water, and milk and molasses mixtures. Daily enemas for several days may be needed to completely evacuate the colon.
Give a suppository or a series of suppositories: A suppository is a tablet or capsule that is inserted into the rectum. The suppository is made of a substance that may stimulate the rectum to contract and expel stool or it may soften the stool by drawing extra water from the body into the bowel. Popular stimulant suppositories include Dulcolax, Correctol, or Fleet Bisacodyl. Popular stool softening suppositories with glycerin are provided by Fleet or Pedia-Lax. Daily suppositories for several days may be needed to completely evacuate the colon.
Give strong laxatives: Most laxatives work by increasing the amount of water in the large intestine. Some laxatives cause the lower intestine to secrete water and others work by decreasing the amount of water absorbed in the lower intestine. In either case, the end result is much more water in the lower intestine when using laxatives than when not using them. This large amount of water softens formed or hard stool in the intestine and produces diarrhea. Laxatives used for this purpose include magnesium citrate, GoLYTELY, and COLYTE products. Treatment for several days may be needed to completely evacuate the colon.