Medications for Encopresis continued...
Emollient laxatives: These products decrease the absorption of water from the colon, and thus soften the stool, making it easier to pass.
- Mineral Oil, Milkinol -- This laxative is largely tasteless and has an oily consistency. It may be more palatable if cold or mixed into a fluid such as orange juice. It may cause seepage of orange oil from the anus, which can cause itching and stain the underwear. This laxative should generally not be given with food.
Stimulant laxatives: These agents have direct actions on the lining of the intestinal wall. They increase water and salt secretion into the colon and irritate the intestinal lining to produce contractions.
- Sennosides (Aloe Vera, Ex-Lax, Fletcher’s Castoria, Senokot) -- This laxative is derived from a plant, stimulates salt and water secretion into the colon, and promotes movement of stool through the colon. It may cause abdominal cramping at higher doses.
- Bisacodyl (Dulcolax or Fleet Bisacodyl) -- This colorless and odorless compound increases muscle contractions in the colon and stimulates salt and water secretion. It can be given by mouth or as a suppository and may cause abdominal cramping at higher doses.
- Dioctyl sodium sulphosuccinate (Colace, Dulcolax stool softener, Fleet Sof-Lax) -- This is a detergent that simulates salt and water secretion into the colon and promotes movement of stool through the colon. It may cause abdominal cramping at higher doses.
Other Treatments for Encopresis
For encopresis, fiber supplements and certain foods, such as fruit juices and prunes, can have a laxative effect. These foods and juices function as osmotic laxatives. They all contain various sugars that are not efficiently absorbed by the intestinal lining, thus increasing the amount of water in the colon. Given in large enough doses, all of these foods and juices are very effective laxatives. For weight management and prevention of constipation, vegetables and fruit should be encouraged for all children. However, most children are not willing to take in enough of these items every day for many months to serve as primary treatment for encopresis. Eaten in large enough quantities to ensure two soft bowel movements a day, these foods and juices may cause bloating and gas.
Drinking plenty of fluid helps keep stools soft and may help prevent constipation in the first place.
Children with encopresis rarely need surgery. However, surgery may be used in extremely chronic and cases that don't respond to treatment.
Follow-up Care for Encopresis
The extent of follow-up needed for encopresis varies by situation. Your child’s health care provider will probably want to see him at least once after treatment is well under way to ensure that the treatment is working or to alter treatment if necessary.
The best way to prevent encopresis is to prevent constipation in the first place. Make sure the child gets a varied diet with plenty of fruits and vegetables and whole grain breads and cereals. The child should drink water and other fluids frequently and be physically active every day. Finally, make sure the child has a regular time every day when he or she sits on the toilet. After a meal is the best time for this.