Encopresis

Diagnosis  

The doctor treating your child might:  

• Inquire regarding the child’s diet, potty training, emotional health (stress), and medical history.  
• Perform physical assessment to rule out physical causes for constipation or soiling, talk about your symptoms, bowel motions, and food habits.  
• Conduct digital rectal exam to observe for impacted stools by pressing on your child’s belly with one hand while putting a greased, gloved finger into your child’s rectum.  
• Abdominal X–ray to verify stool impaction.  
• Psychological evaluation if your child’s symptoms are being exacerbated by emotional problems.  

Treatment  

Encopresis treatment involves several steps aimed at addressing the condition. These steps include clearing the colon of impacted stool, encouraging healthy bowel movements, and utilizing behavior modification techniques. In some cases, psychotherapy might be recommended if emotional factors are involved. 

• Clearing the Colon of Impacted Stool: The initial stage focuses on relieving constipation by clearing the colon of retained stool. Doctors may suggest using specific laxatives, rectal suppositories, or enemas to achieve this. Regular follow–up is important during this phase to monitor progress. 
• Encouraging Healthy Bowel Movements: After the colon is cleared, the emphasis shifts to promoting regular bowel movements. Recommendations might include dietary changes to increase fiber intake and proper fluid consumption. Gradual reduction of laxatives as bowel function improves is also part of this stage. Training your child to respond promptly to the urge for bowel movements is encouraged. 
• Behavior Modification: Behavior modification, also known as bowel retraining, can play a crucial role. Doctors and mental health professionals offer techniques to help your child establish consistent bowel habits. This approach helps in avoiding future episodes of encopresis.
• Psychotherapy: In situations where emotional factors might contribute to encopresis, psychotherapy with a mental health professional can be considered. This is especially relevant if your child experiences emotions like shame, guilt, depression, or low self–esteem related to the condition.