Encopresis is also known as stool soiling or holding, which occurs when a child refuses to have bowel movements, which causes the collection of the impacted stool in the rectum and colon. When the colon gets filled up with impacted stool, the liquid stool may be forced to leak from the anus, which in turn stains the child’s underwear.
Encopresis normally occurs after a child has attained the age of 4, after the child has already known how to use the toilet. In majority of the cases, the condition is a sign of unceasing constipation. In fewer instances, it might be caused by emotional or developmental issues.
Encopresis is categorized as secondary or primary encopresis. Primary encopresis occurs in children who have never been trained successfully. In secondary encopresis, children develop the problem after successful toilet training.
Encopresis symptoms and signs might include:
- Constipation with hard, dry stool
- Forestalling of bowel movements
- Passage of outsized stool that almost clogs or clogs the toilet
- Leakage of liquid stool or stool on the child’s underwear; in cases where the leaked stool is in large amounts, it’s usually mistaken for diarrhea
- Abdominal pain
- Loss of appetite
- Long periods between bowel movements; this can be for as long as a week or more
When Should Your Child See the Doctor?
You need to take the child to a doctor if the child has already been toilet trained and begins to display 1 or more of the above listed symptoms.
Encopresis is caused by several factors, the most common causes being:
Constipation; most encopresis cases are caused by chronic constipation. Constipation makes the stool of the child to be dry, hard and this can be quite painful when passing stool. This makes the child to avoid going to the toilet which worsens the problem. The longer the stool is retained in the colon, it gets harder for it to be pushed out. The colon gets stretched which affects the nerves that sends the signal that it’s time to visit the toilet. If the colon gets too full, liquid or soft stool tends to leak out.
Emotional issues; encopresis can also trigger encopresis. A child can get stress from certain life changes or premature toilet training.
Risk factors that can increase the chances of a child developing encopresis include:
- Chronic constipation; this may make the child to have the phobia of passing stool
- Gender; this condition is more prevalent in boys
- Failing to drink enough fluids; this makes the existing constipation to get worse
A child suffering from encopresis can experience varying emotions, including shame, anger, frustration and embarrassment. It the child gets reprimanded by adults or teased by other children, the child might get depressed or have self-esteem issues.
Tests & diagnosis
The doctor can perform a physical exam which includes a digitalized rectum exam with a view to checking for the impacted stool. The doctor may insert a gloved, lubricated finger into the rectum while putting pressure on the abdomen.
The doctor may also advise for an X-ray of the abdomen to authenticate that an impacted stool is actually present.
The doctor may want to carry out a physical evaluation to determine the emotional issues that are contributing to encopresis in your child.
Treatments & drugs
It’s advisable to get early treatment for encopresis. The colon is first cleared off the impacted stool that is retained. Afterwards, treatment geared towards facilitating proper bowel movements is administered. This can include teaching the child to visit the toilet as soon as the urge to pass stool occurs. This can be done by using the following:
- Colon lubricants
- Plenty of oral fluids
- Stool softeners i.e. lactulose
- Rectal suppositories