Elimination Disorders and Encopresis in Children
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.
What Other Problems Are Associated With Encopresis?
A child with encopresis is at risk for emotional and social problems related to the condition. They may develop self-esteem problems, become depressed, do poorly in school, and refuse to socialize with other children, including not wanting to go to parties or to attend events requiring them to stay overnight. Teasing by friends and scolding by family members can add to the child's self-esteem problems and contribute to the child's social isolation. If the child does not develop good bowel habits, he or she may suffer from chronic constipation.
What Is the Outlook for Children With Encopresis?
Encopresis tends to get better as the child gets older, although the problem can come and go for years. The best results occur when all educational, behavioral, and emotional issues are addressed. A child may still have an occasional accident until he or she regains muscle tone and control over his or her bowel movements.
Can Encopresis Be Prevented?
Although it may not be possible to prevent encopresis, getting treatment as soon as symptoms appear may help reduce the frustration and distress, as well as the potential complications related to the disorder. In addition, being positive and patient with a child during toilet training may help prevent any fear or negative feelings about using the toilet.