Elimination Disorders and Encopresis in Children
What Causes Encopresis? continued...
Factors that may contribute to constipation include:
- A diet low in fiber
- Lack of exercise
- Fear or reluctance to use unfamiliar bathrooms, such as public restrooms
- Not taking the time to use the bathroom
- Changes in bathroom routines; for example, scheduled bathroom breaks at school or camp
Another possible cause of encopresis is a physical problem related to the intestine's ability to move stool. The child also may develop encopresis because of fear or frustration related to toilet training. Stressful events in the child's life, such as a family illness or the arrival of a new sibling, may contribute to the disorder. In some cases, the child simply refuses to use the toilet.
How Common Is Encopresis?
Encopresis is fairly common, although many cases are not reported due to the child's and/or the parents' embarrassment. It is estimated that anywhere from 1.5% to 10% of children have encopresis. It is more common in boys than in girls.
How Is Encopresis Diagnosed?
If symptoms of encopresis are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. The doctor may use certain tests -- such as X-rays -- to rule out other possible causes for the constipation, such as a disorder of the intestines. If no physical disorder is found, the doctor will base a diagnosis on the child's symptoms and current bowel habits.
How Is Encopresis Treated?
The goal of encopresis treatment is to prevent constipation and encourage good bowel habits. Educating the child and family about the disorder is another important part of treatment.
Treatment often begins by clearing any feces that has become impacted in the colon, also called the large intestine. The next step is to try to keep the child's bowel movements soft and easy to pass. In most cases, this can be accomplished by changing the child's diet, using scheduled trips to the bathroom, and encouraging or rewarding positive changes in the child's bathroom habits. In more severe cases, the doctor may recommend using stool softeners or laxatives to help reduce constipation. Psychotherapy (a type of counseling) may be used to help the child cope with the shame, guilt, or loss of self-esteem associated with the disorder.