Full Answer
What is the goal of encopresis treatment?
The goal of encopresis treatment is to prevent constipation and encourage good bowel habits. Educating the child and family about the disorder is another important part of treatment. Treatment often begins by clearing any feces that has become impacted in the colon, also called the large intestine.
How can I Help my Child with encopresis?
A psychotherapist may help a child with encopresis cope with its negative psychological effects, such as shame or decreased self-esteem. In the absence of constipation, a psychiatric evaluation may help identify an underlying cause for the behavior.
What are the types of encopresis?
Encopresis is categorized according to the subtype that characterizes the presentation—primary is with constipation and overflow incontinence; secondary is without constipation and overflow incontinence.
What are the DSM criteria for encopresis?
Elimination Disorders: Encopresis. DSM criteria for encopresis state that the behavior must occur once a month for at least 3 months duration before the diagnosis applies. In addition, the child must be at least 4 years old (or developmentally equivalent to a 4 year-old). Generally, encopresis is an involuntary condition.
How is psychological encopresis treated?
Treatment, which should be administered by a physician, may include measures such as providing laxatives, enemas, or stool softeners and introducing a high-fiber diet. If necessary, a pediatric gastroenterologist may employ additional techniques to help overcome encopresis.
Is encopresis a mental disorder?
Chronic neurotic encopresis (CNE), a childhood psychiatric disorder characterized by inappropriate fecal soiling, necessitated the formation of the following specific etiological factors: a) a neurologically immature developmental musculature, an organic condition which may complicate toilet training; b) premature or ...
Is encopresis an anxiety disorder?
Encopresis affects about 1.5 percent of young school children and can create tremendous anxiety and embarrassment for children and their families. Encopresis is not a disease but rather a symptom of a complex relationship between the body and psychological/environmental stresses.
How can I help my teenager with encopresis?
Encourage your child to drink lots of water, eat fiber rich foods such as fruits, vegetables and whole grains. Consider scheduling evidence based psychological intervention if your child feels shame, guilt, depression or low self esteem related to encopresis.
Can encopresis cause behavior problems?
A child with encopresis is at risk for emotional and social problems related to the condition. They may develop self-esteem problems, become depressed, do poorly in school, and refuse to socialize with other children, including not wanting to go to parties or to attend events requiring them to stay overnight.
How do schools deal with encopresis?
How Is Encopresis Treated?Emptying the rectum and colon of the hard poop. Depending on the child's age and other things, the doctor may recommend medicines, including a stool softener, laxatives, and/or enemas. ... Helping your child begin having regular BMs. ... Reducing use of the stool medicines.
How do I stop pooping anxiety?
A Gastroenterologist's Top 5 Ways To Stop Nervous PoopsDecrease Caffeine Intake.Be Aware Of What You're Eating.Destress With Exercise And Meditation.Make Sure You're Getting Enough Fiber.See A Doctor If You Need To.
What is the most common cause of encopresis?
Most cases of encopresis are the result of chronic constipation. In constipation, the child's stool is hard, dry and may be painful to pass. As a result, the child avoids going to the toilet — making the problem worse. The longer the stool remains in the colon, the more difficult it is for the child to push stool out.
What is retentive encopresis?
Liquid stool might leak out around harder stool, and parents might mistake this for diarrhea. Encopresis with constipation is called “retentive encopresis.”
Which dietary modification should be made for a child with encopresis?
Your child's doctor may recommend: Dietary changes that include more fiber and drinking adequate fluids. Laxatives, gradually discontinuing them once the bowel returns to normal function. Training your child to go to the toilet as soon as possible when the urge to have a bowel movement occurs.
What is non retentive encopresis?
Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency.
Why does my 12 year old poop his pants?
Encopresis is also known as fecal soiling. It occurs when a child (usually over the age of 4) has a bowel movement and soils their pants. This problem is most often linked to constipation. Constipation occurs when stool becomes backed up in the intestines.
Can stress cause encopresis?
Scientists have found a second or "backup brain" in the gut that can influence people’s moods and behavior. Known as the enteric nervous system...
What is the link between encopresis and depression?
Encopresis can be both a contributing factor and a symptom of depression in childhood and adolescence. Parents will want to keep an eye out for a...
What happens if encopresis is not treated?
Children whose encopresis goes unrecognized or untreated may not be able to resolve their symptoms on their own for many years. In some cases, they...
Can encopresis be intentional?
Sometimes, children may deliberately soil themselves. This occurs more frequently with children who have a co-occurring disorder, like conduct diso...
How can you treat encopresis at home?
In addition to following a physician’s treatment recommendations, parents can make some simple lifestyle changes at home to help their child deal w...
What is the treatment for encopresis?
Treatment, which should be administered by a physician, may include measures such as providing laxatives, enemas, or stool softeners and introducing a high-fiber diet. If necessary, a pediatric gastroenterologist may employ additional techniques to help overcome encopresis.
How to diagnose encopresis?
For a diagnosis of encopresis, according to the DSM-5: 1 A child passes feces—involuntarily or on purpose—into clothing, on the floor, or in other inappropriate places 2 This occurs at least once a month for three months 3 The child is at least 4 years old (or at an equivalent level of development) 4 This behavior must not be attributable to a substance's physiological effects or another medical condition, except through a mechanism involving constipation
Why do children with encopresis feel embarrassed?
It is often the result of chronic constipation, which over time results in the leakage of stool. Typically, this behavior is involuntary. Children with encopresis often feel ashamed and may seek to avoid entering situations where they could feel embarrassed.
How old is a child when they have encopresis?
The child is at least 4 years old (or at an equivalent level of development) This behavior must not be attributable to a substance's physiological effects or another medical condition, except through a mechanism involving constipation. Encopresis can be further classified according to two subtypes:
How long does encopresis last?
A maintenance phase that involves scheduled toilet times and regular laxative use may last a couple of months or longer , according to the American Academy of Pediatrics. A psychotherapist may help a child with encopresis cope with its negative psychological effects, such as shame or decreased self-esteem.
Leonardo Rocker
Encopresis (or faecal soiling) is one of the most frustrating difficulties of middle childhood, affecting approximately 1.5% of young school children (von Gontard, 2013). It is a debilitating condition to deal with as a parent, as it usually occurs at a stage when children are past the age of toilet training.
What causes encopresis?
Parents of children with encopresis often feel frustrated as they often believe that their children play an active role in controlling their bowel movements. While in some cases, soiling may be intentional, in other cases it may be involuntary and beyond the child’s control. It is important to be aware of the many possible causes of this disorder.
What are the potential risk factors for Encopresis?
In western cultures, bowel control is established in 95% of children by age 4 in 99 % of children aged 5 (von Gontard, 2013). Around primary school age (10-12 years old) 1.5% of children develop encopresis.
What is the impact of encopresis in school-aged children?
Encopresis can have a severe effect on the child, family and school environment. Encopresis is often a family preoccupation, as parents and siblings become increasingly frustrated as family activities may be disrupted due to the constant soiling.
What are the treatment options for encopresis in school aged children?
While encopresis is a chronic and complex problem amongst many families, it is treatable. As a parent, it is important to be aware that there is no quick fix for encopresis, the process might take months and relapse is very common. Sixty-five per cent of patients are almost completely cured in 6-months and 30% show improvement (Har & Coffle, 2010).
Other tips include
Never tease or embarrass your child and do not show anger. Supporting your child’s self-esteem is essential. Name-calling and teasing are frequent results when a child soils at school/and/or smells of feces so it is important that their self-esteem is not affected as a result.
View article references
American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Cox, D., Morris, J., Borowitz,S., Sutphen, J. (2002).
How to tell if a child has encopresis?
In addition to defecating in improper places, a child with encopresis may have other symptoms, including: Loss of appetite. Abdominal pain. Loose, watery stools ( bowel movements) Scratching or rubbing the anal area due to irritation from watery stools. Decreased interest in physical activity.
What are the risks of encopresis?
A child with encopresis is at risk for emotional and social problems related to the condition. They may develop self-esteem problems, become depressed, do poorly in school, and refuse to socialize with other children, including not wanting to go to parties or to attend events requiring them to stay overnight.
What is the difference between enuresis and encopresis?
There are two types of elimination disorders, encopresis and enuresis. Encopresis is the repeated passing of feces into places other than the toilet, such as in underwear or on the floor. This behavior may or may not be done on purpose. Enuresis is the repeated passing of urine in places other than the toilet.
What is the best treatment for constipation in children?
In more severe cases, the doctor may recommend using stool softeners or laxatives to help reduce constipation. Psychotherapy (a type of counseling) may be used to help the child cope with the shame, guilt, or loss of self-esteem associated with the disorder.
Does encopresis get better as a child gets older?
Encopresis tends to get better as the child gets older, although the problem can come and go for years. The best results occur when all educational, behavioral, and emotional issues are addressed. A child may still have an occasional accident until they regain muscle tone and control over their bowel movements.
Abstract
Encopresis or fecal incontinence is a common childhood concern in which a child over the developmental age of 4 years passes stool into an inappropriate place (e.g., underwear or onto the floor). Although this condition can be diagnosed in adulthood, it is often first diagnosed in childhood or early adolescence.
About this chapter
Low Kapalu C.M., Christophersen E.R. (2019) Cognitive Behavioral Therapy for Encopresis. In: Friedberg R., Paternostro J. (eds) Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-030-21683-2_16
Encopresis Psychology: What is Encopresis Disorder?
It is one of the most common eliminating disorders that occur in children. It is characterized with the kid having problem with going to the toilet. To be specific, it is described as the frequent passing of feces from one place to another instead of in the toilet. It can either be on the floor or in underwear.
Encopresis Psychology: The Symptoms
The disorder does not only involve defecating in appropriate places. It also involves several symptoms like appetite loss, abdominal pain, loose and watery stools and withdrawal from family and friends.
Encopresis Psychology: Causes
There is no clear cause why this disorder occurs. However, there are different explanations that were proposed why it is experienced by children. It can either be due to dietary, physiological, anatomical or psychological reasons. But the explanation that is most acceptable is that its cause of the disorder is multi-faceted.
The Psychological Explanation
The disorder is due to the physical abnormality that caused interference in their ability to control their bowel. However, if there is not a physical abnormality, it is likely that its cause is psychological related. That is the cause especially if the child is intentionally withholding it. It can be for several psychological reasons.
What is the DSM 5 for encopresis?
Encopresis is the inappropriate elimination of feces. The DSM 5 indicates the prevalence is approximately 1% of 5 year olds and is seen more in males.
How often should a child have enuresis?
Specifically, at least 1-3 times for 3 months and the child is older than 4 or 5. These behaviors can occur on their own or together. Enuresis is the inappropriate elimination of urine. The DSM 5 ( Diagnostic and Statistical Manual of Mental Disorders) indicates that the prevalence of enuresis is around 5%- 10% for children 5 years old ...
How to help with bowel movement?
Involve the pediatrician to rule out a medical condition. Obtain education about nutrition and how to have a healthy diet to help with digestion and sustain regular toileting / bowel movements. Consult with a psychologist. Keep positive and remain patient.
What is considered clinically significant when a child first learns to use the bathroom?
Often when children first learn to use the bathroom, accidents are expected to happen. Toileting behavior that is considered clinically significant is when instances of eliminating urine and/or feces are occurring outside of the bathroom, inappropriately and frequently.
What is the treatment for encopresis with constipation?
In the case of Encopresis with Constipation and Overflow Incontinence, the primary treatment approach may be medical or physical in nature. Bulk-forming laxatives and/or colonic irrigation may be prescribed, and parents may be urged to add a greater proportion of dietary fiber and water to the child's dieat.
What happens when a child has encopresis?
Due to constipation, only part of the total available stool is voided during each of these movements. Portions of the remaining stool then leak out of the bowel, often during the child's daily activities . When the child's underlying constipation problem is treated, this form of encopresis generally resolves.
How often does encopresis occur?
Andrea Barkoukis, M.A., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D. Encopresis occurs when children who are old enough to eliminate waste appropriately repeatedly defecate in inappropriate places such as inside clothing or on the floor. DSM criteria for encopresis state that the behavior must occur once a month for at least 3 months ...
How common is encopresis in children?
About 3% of all children treated for a mental disorders meet criteria for the condition. Encopresis is 3 to 6 times more common in males than in females. Diagnosis of Encopresis.
Why is it important to have a rectal exam for encopresis?
As the majority of encopresis cases involve constipation, it is quite important that symptomatic children receive a thorough medical examination including a rectal examination as part of their diagnostic workup so as to identify any physical or medical conditions that might be causing problems.
Is encopresis an involuntary condition?
Generally, encopresis is an involuntary condition. There are two different varieties of Encopresis: With Constipation and Overflow Incontinence, and Without Constipation and Overflow Incontinence. Children with the Constipation and Overflow Incontinence type produce less than three bowel movements per week.
Can encopresis cause constipation?
As the name suggests, children experiencing Encopresis without Constipation and Overflow Incontinence show no evidence of constipation. Instead, the child's feces are usually normal in form, and soiling is intermittent rather than regular.
How to explain enuresis and encopresis to families?
Explain enuresis and encopresis to families in a way that helps them see the accidents as the problem instead of placing the blame on the child. Provide behavioural treatment to encourage the child to use the toilet.
What is enuresis and encopresis?
What are enuresis and encopresis? Enuresis means urinating (peeing) where you shouldn’t (e.g., in bed or in clothing). Encopresis means defecating (pooping) where you shouldn’t (e.g., in clothes or on the floor). To have enuresis or encopresis:
How does enuresis help children?
Many children with enuresis and encopresis get better with time even without treatment. For these children, treatment simply helps it happen faster. Psychologists can: Help children become aware of the signs their body uses to tell them they need to go to the bathroom.
How often does enuresis occur?
That means at least twice a week for enuresis and once a month for encopresis. The wetting or soiling must also happen That means this problem must happen for at least 3 months. Some children with enuresis only have problems at night ( bedwetting ), referred to as nocturnal enuresis.
What does it feel like to be a parent with enuresis?
Parents of children with encopresis or enuresis may feel judged, alone, anxious, and helpless. Parents may also become frustrated with their child and the other parent, which can be hard on their relationships.
What is Enhanced Toilet Training for Encopresis?
It is also important to praise the child when they stay dry! Enhanced Toilet Training for encopresis. This approach combines the use of a toileting schedule, modeling how to properly poop to the child, rewards, education on which body parts are involved with pooping, and medication.
What are some examples of behavioral treatments for enuresis?
Examples of common treatment approaches include: Dry bed training with a urine alarm for treating bedwetting.