What is Encopresis?

Encopresis commonly known as fecal soiling is a common condition normally seen in children caused mainly due to prolonged constipation or refraining from going to the toilet when the need arises. This condition is seen in children between the age group of 3 and 7 years. It is quite common for children to have this problem of constipation and refraining from going to the toilet for quite some time before it is detected[1].

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There have been cases where encopresis has been associated with urinary tract symptoms or urinary incontinence as well. It is extremely important for the parents to have awareness of this condition so as to catch the symptoms early and go for treatment. Some parents might see their child soiling the clothes as a behavioral problem and not know that it is something which is beyond their control[1].

The frontline management of encopresis involves removal of the stool in its entirety from the rectum. This can be done with medication or stool softeners. Enemas are also sometimes used for clearing the rectum. The stool softeners should continue to make the stools soft so that the child can defecate without any pain or discomfort and prevent the stools to be accumulated again[3].

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Once encopresis has been treated, there is a thin chance of it recurring so parents should be weary of it as well. However, more than 50% of children with encopresis tend to have normal bowel movements without soiling their clothes with treatment within a span of a year. Can a child outgrow encopresis is what has been discussed in the article below[1]

Can My Child Outgrow Encopresis?

The answer to this question is, yes, many children outgrow this problem by the time they are 7 to 8 years of age. In the remaining cases, they respond positively towards treatment. Treatment for encopresis involves dietary modifications, medications, and plenty of motivation on the part of the parents[2].

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If a child has encopresis due to fear or stress then psychological counseling is of benefit although in such cases treatment takes a bit longer. Despite this, parents should not feel low as children respond favorably to all the treatments and end up having normal bowel movements[2].

The treatment for encopresis is done in three stages. The first stage involves use of medications to empty the rectum from all the accumulated stools. The choice of medication is made depending on the age of the child. Stool softeners and laxatives are prescribed to make the stools soft so that they can be passed easily. In some cases, the physician may also recommend giving enemas to clear the rectum[3].

For children who either refrain from going to the toilet due to fear of it causing pain, feeling embarrassed to go in public places like school, or not understanding the indications to go to the toilet require counseling and motivation. The children should be trained to understand the signs of the urge to defecate and not refrain from going to the restroom[3].

Timed voiding is the best way to inculcate this habit. Make the child go to the toilet after every meal while at home. This will allow him to pay attention to the signs of the urge to defecate. Psychological counseling will help to get rid of any embarrassment or anxiety of going to the toilet in schools or other public places if they have access to the toilet[3].

Stool softeners should be continued till the time the child starts having normal bowel movements and the incidences of “accidents” comes down to very minimal and then gradually weaned[3].

In conclusion, a child can definitely outgrow encopresis. In fact, almost 50% of children with this condition tend to outgrow them with age and maturity. The remaining kids require treatment in the form of counseling, medications, and stool softeners to which they positively respond[2].

Thus parents should not worry about their child having “accidents” while at school or in public places. They should in fact take a note of the number of bowel movements the child has in a week to see if they are constipated[2].

If the parents feel that their child is under some form of stress then motivation and counseling can help them. Medications are always there to help children with encopresis and constipation and help the child get rid of this condition completely[2, 3].

References:  

Sheetal DeCaria MD

Written, Edited or Reviewed By:

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Last Modified On: May 22, 2019

This article does not provide medical advice. See disclaimer

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