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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:

1. Constipation

  • 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


Treatment

  • 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.

Behavior modification:

  • 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.
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