|Other encyclopedia topics:||A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9|
|Contents of this page:|
Alternative NamesSoiling; Incontinence - stool
Definition Return to top
Encopresis is the voluntary or involuntary passage of stools in a child over age 4, which causes the soiling of clothes.
See also: Bowel incontinence
Causes Return to top
Encopresis is frequently is associated with constipation and fecal impaction. Often, hard fecal material remains in the colon and the child only passes a soft or semi-liquid stool around the impacted stool. Leakage of stool may occur during the day or night. There are rarely physical causes other than constipation (sometimes present since infancy).
Other causes may be related to:
Whatever the cause the child may develop associated shame, guilt, or loss of self-esteem. The child may try to hide the discovery of the problem.
The following may increase the risk for encopresis:
Symptoms Return to top
Exams and Tests Return to top
Digital examination of the rectal area may show a fecal impaction. An abdominal x-ray may confirm impacted stool in the colon.
Treatment Return to top
The goal is to prevent constipation and encourage good bowel habits. Laxatives, and sometimes enemas, are used to remove fecal impaction. A stool softener is often prescribed.
A diet high in fiber, including fruits, vegetables, whole grain products, and adequate fluid intake will promote the passage of softer stools and minimize the discomfort associated with bowel movements. Another way to treat this problem is to give flavored mineral oil to the child in sufficient quantity for the oil to leak from the rectum. This is an excellent short-term treatment, but it must be avoided long-term because of interference with calcium and vitamin D absorption.
Parents should be supportive and refrain from criticism or discouragement. Pediatric gastroenterologists often provide education to the parents and child and use biofeedback for the child to treat the more difficult cases. Psychotherapy can help the child deal with associated shame, guilt, or loss of self-esteem. For encopresis in the absence of constipation, psychiatric evaluation may help determine the underlying cause.
Outlook (Prognosis) Return to top
Most children respond to treatment.
Possible Complications Return to top
The child may suffer from low self-esteem and peer disapproval related to this problem. If routine bowel habits are not developed, the child may suffer from chronic constipation.
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if this behavior is noted in a child over 4 years old.
Prevention Return to top
Because the causes often are obscure, prevention is difficult. As a general rule, refrain from too early and too coercive toilet training.
References Return to top
Behrman RE. Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: WB Saunders; 2004.
Ferri FF. Ferri’s Clinical Advisor 2007: Instant Diagnosis and Treatment. 9th ed. St. Louis, Mo: Mosby; 2007.Update Date: 7/26/2007 Updated by: Daniel Rauch, M.D., FAAP., Director, Pediatric Hospitalist Program, New York University School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.