It is defined as the repetitive, voluntary or involuntary, passage of stool in inappropriate places by children of 4 years age and older and to exercise the bowel control. Approximately 4% of all the children 4-17 years of age will experience encopresis.Causes of Encopresis
Many children with encopresis have underlying constipation. Stool accumulates in the rectum and become desiccated, more difficult and painful to pass.
Children who develop encopresis may develop abnormal stretching and enlargement of the rectal area that reduces the reflux urge to stool.
The impacted stool mass allow upstream semisolid stool to leak around the downstream stool obstruction causing soiling in clothes .Occasional chunks of stool is passed without child desire.
Children with encopresis may successfully stool every day and evacuation of their bowel is incomplete.
Encopretic children commonly defecate in places inappropriate to the social context.
Children with encopresis seems oblivious to either stool staining of their clothes or heavy clothes odor they produce.
A complete evaluation of a child with constipation or encopresis involve thorough history, a detailed physical examination and laboratory testing.
An abdominal X-ray may be helpful to measure the child’s stool burden.
A pediatric gastro enterologist may perform a study of anal and rectal muscle tone to assess the anal /rectal response to inflation with air in children who do not respond to routine therapy.
There should be reestablishing of the bowel evacuation regimen and development of a program to ensure maintenance of stool elimination pattern.
Breastfeed infants have stooling problems when compared with formula fed peers.
Diluted juice will promote a softer and increased volume stool.
An adequate intake of water as well as activity will promote colonic health.
Establishment of a daily routine of toilet time has been shown to be very helpful.
Monitoring of intestinal changes associated with the introduction of solid foods is helpful.
Healthy diet emphasizing proper hydration, whole grains, fruits and vegetables promote normal stool production and elimination.
With parental education regarding risk factors and awareness of techniques maximizing their avoidance .
The prognosis for children with elimination disorders is positive. Effective therapy has been demonstrated to be successful in both the short and long term allowing reestablishment and maintenance of normal bowel function.
Child suffering from encopresis may experience certain mental ailments such as embarrassment, frustration, shame and even anger. If suffering child is teased by his co-mates they feel depressed and will have low self esteem.