Encopresis is a disorder that affects children between the ages of 4 to 17 years of age. Although it is not very common, it is also not rare. This disorder can be frustrating for parents and especially stressful for children. This article will talk about what Encopresis is, symptoms and how to get help.
Encopresis is defined as “the repetitive, voluntary or involuntary, passage of stool in inappropriate places by children 4 years of age and older, at which time a child may be reasonably expected to have completed toilet training and to exercise bowel control.” In other words, Encopresis happens when a child becomes constipated for an extended amount of time. When the bowel backs up into the intestines, liquid leaks from the bowels and causes it to stain a child’s underwear.
Approximately 4% of children, between the ages of 4 and 17 years old, develop Encopresis due to chronic constipation. This disorder is diagnosed after the age of 4 and is rarely diagnosed in the absence of constipation.
Encopresis is caused by constipation. Constipation can be caused by a number of factors. Below are reasons why a child may be constipated for a lengthy amount of time:
Signs and symptoms of encopresis may include:
Common characteristics of Encopresis are chronic constipation. If you notice that your child is constipated far more often than not, you should consider taking them to the doctor to discuss options so that the condition doesn’t develop into something more serious.
According to DSM-5, there are 4 features that must be present to support a diagnosis of encopresis:
Encopresis is usually diagnosed by a medical doctor with the above being present.
Encopresis can be similar to other conditions on the surface but there is big difference in their symptoms and causes. The conditions below explain the differences.
Unlike Encopresis, Enuresis is the continued inability to control their urination. While Encopresis deals with the bowel movements, Enuresis deals with urination. Encopresis can also be voluntary, unlike Enuresis which is involuntary.
Fecal incontinence differs from Encopresis in that it is something that cannot be controlled. Fecal incontinence is often caused by a medical condition or some sort of muscle or nerve damage. Sometimes people can also have fecal incontinence after surgery. This is not something that someone knowingly does and is completely out of their control.
Encopresis should not be confused with any bowel incontinence or bowel excretion that is not caused by constipation. Encopresis is caused solely by constipation, although the reasons for constipation will vary.
In order for someone to be diagnosed with Encopresis, it must be present between the ages of 4 and 17 years old, therefore, Encopresis is a diagnosis specifically given to children.
The following is a case of Encopresis:
A 6-year-old boy, George who lives with his mom, is removed from his home and placed in foster care following abuse and neglect charges. The boy is sent to live with a foster family and deals with trauma from the move as well as some malnutrition from his biological family. After being in the foster family for two weeks, he develops stomach pains, loss of appetite and becomes lethargic. He is taken to the hospital and given an x-ray where is it determined that he is constipated and has probably been constipated since the being at the foster home. The foster family states that they have noticed that George has had bowel movements in his underwear but was afraid to tell his foster family that he is unable to use the bathroom. After talking with the family, a process of elimination, and further testing, it is determined that George has Encopresis. The doctor uses an enema to help to relieve George’s constipation and the family is referred to a nutritionist and mental health professional to talk about prevention, dietary changes, and coping skills for George.
Children with Encopresis are at risk for isolation, feelings of shame and guilt, and possible depression. It is important to seek medical treatment as early as possible as well as mental health treatment to assist with coping. With treatment, this condition can be resolved successfully and a child can have normal bowel movements.
Every child who develops Encopresis, develops it for different reasons, but it should be noted that the persons with the following conditions may be more likely to develop Encopresis:
Treatment for encopresis may include:
Punishing a child with Encopresis is never the answer as it will only cause a child to be more emotionally stressed and continue to complicate the situation.
Often, making changes in your child’s diet will help constipation. Consider the following suggestions:
Following good bowel habits and getting your child used to having regular bowel movements is key to overcoming this disorder. Here are some suggestions to lead to good bowel habits:
Until the rectum and intestines regain their muscles control, it is common for a child to have accidents. Young children can wear pull-ups to help them until they no longer need them. This can be a very difficult and stressful time for your child, so it is important to make it as normal as possible for them. For older kids, taking a change of underwear and clothes would be helpful.
Your doctor may prescribe an enema to assist in removing the bowel from the intestines. An enema is a liquid that is placed in the rectum to loosen the stool and make it come out. Never give your child an enema at home. An enema should only be given under doctor’s care and will most likely take place in a hospital. A stool softener may also be given to a child to soften the bowel movement. This should also not be given to a child unless they are under a doctor’s care and the doctor has recommended it.
Many treatments for Encopresis can be done with things at home, such as changing your child’s diet and exercising more. Some parents also turn to probiotics for help with digestive issues that can help with having regular bowel movements. There has been controversy surrounding using probiotics so you should research the possibility and discuss it with your primary care doctor.
Encopresis is a condition that will more likely cause a great deal of stress to the parents and child alike. Children run the risk of feeling embarrassed, succumb to teasing, and may even before isolated from friends. Parents may feel anger and stress due to not knowing what is causing the disorder and wanting their child to control themselves. It is important to seek support from family, friends and professionals to help with dealing with this disorder. Children need to feel safe so that they can get through this as well as parents need to feel understood as well.
Encopresis is a medical condition that requires medical attention and is covered by most insurances. Contact the number on the back of your insurance card of consult with your primary care doctor to find out the exact coverage by your insurance.
Seeking a therapist could be very beneficial in learning to cope with this disorder. You can find a therapist by going online to www.psychologytoday.com and searching for a therapist that will help with the stress of caring for a child with this disorder. You can also search for a child therapist that could assist your child with dealing with stress, shame, and coping skills.
When searching for a therapist, you want to find someone that has experience with treating children and/or experience in treating families that are caring for a child with a chronic illness. Finding the right fit may take some time but if you do your research and ask the right questions, you should find someone that you feel comfortable with rather quickly.
The following questions should be asked to a potential therapist:
There aren’t many resources for dealing with Encopresis, however, finding a good primary care doctor or pediatrician would be the first step in getting help for your child. Getting support from family and friends is important in helping your child to deal with this disorder.
While Encopresis is more common than most people know, it is something that isn’t talked about often. Its important to gather as much information on this disorder as possible and equip yourself with treatment that works for your child. Being patient and understanding with your child will be key in helping them to overcome this condition so that they can begin to have normal bowel movements and a healthier life.
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