Encopresis also called soiling, is the repeated and inappropriate passing of stool (usually involuntarily) into clothing at least once a month for at least 3 months. The mental or chronical age should be at least 4 years of age. It may be primary type in which person has never established fecal continence and a secondary type in which the disturbance develop after a period of established fecal continence.
Usually it is more common in boys (1.3%) than girls (0.3%). A child who suffers from encopresis may have a range of emotional difficulties like frustration, shame, embarrassment and anger by teasing or criticized or punished by friends and family, they alsohave low self-esteem and feel depressed. It can be successfully treated with the help of therapist.
How to recognize Encopresis
- Leakage of stool or liquid stool on underwear, rule out that should not be diarrhea
- Constipation with dry, hard stool
- Avoidance of bowel movements and long periods of time gap between stool
- Sometimes it is associated with daytime wetting or enuresis
Causes behind illness:
- Withholding stool due to fear of using the toilet when children remain away from home or because of painful stool.
- Do not want to interrupt game or other activities
- Too little fiber in meal
- Drinking less water or fluids
- Drinking too much cow's milk or an intolerance to cow's milk sometimes remain a cause.
2. Emotional issues: A child may experience stress from
- Premature, difficulty in toilet training.
- Changes in the child's life, such as dietary changes, toilet training, starting school or schedule changes.
- Emotional stress may trigger encopresis. Emotional stressors in family or home
3. Some times it is associated with other emotional difficulties like Attention-deficit/hyperactivity disorder (ADHD), Autism spectrum disorder, Anxiety or depression
- Physical exam, Digital rectal exam, Abdominal X-ray helps in diagnosis.
- Detailed Psychological evaluation also helps in diagnosis and treatment.
- Laxatives, Rectal suppositories, Enemas are helpful in clearing bowel.
- Dietary changes like fiber and drinking adequate fluids remain helpful.
- Psychotherapy helps to find out emotional issues and its causes.
- Psychotherapy helps child associated with shame, guilt, depression or low self-esteem.
- They discuss techniques for regular bowel movements without delay.