Encopresis (cont.)
How Common Is Encopresis?
Encopresis is fairly common, even though many cases are not reported due to
the child's and/or the parents' embarrassment. It is estimated that anywhere
from 1.5% to 10% of children have encopresis. It is more common in boys than in
girls.
How Is Encopresis Diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a
complete medical history and physical examination. The doctor may use certain
tests—such as X-rays—to rule out other possible causes for the
constipation, such as a disorder of the intestines. If no physical disorder is
found, the doctor will base his or her diagnosis on the child's symptoms and
current bowel habits.
How Is Encopresis Treated?
The goal of 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. The next step is to try
to keep the child's bowel movements soft and easy to pass. In most cases, this
can be accomplished by changing the child's diet, using scheduled trips to the
bathroom and encouraging or rewarding positive changes in the child's bathroom
habits. 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.
What Other Problems Are Associated with 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.
Teasing by friends and scolding by family members can add to the child's
self-esteem problems and contribute to the child's social isolation. If the
child does not develop good bowel habits, he or she may suffer from chronic
constipation.
What Is the Outlook for Children with Encopresis?
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 he or she regains muscle tone and control over his or
her bowel movements.
Can Encopresis Be Prevented?
Although it may not be possible to prevent encopresis, getting
treatment as soon as symptoms appear may help reduce the frustration and
distress, as well as the potential complications related to the disorder. In
addition, being positive and patient with a child during toilet training may
help prevent any fear or negative feelings about using the toilet.
Reviewed by the doctors at The Cleveland Clinic Department of
Psychiatry and Psychology.
Edited by Cynthia Dennison Haines, MD,
on July 1, 2005.
Portions of this page copyright © The Cleveland Clinic
2000-2005
Last Editorial Review: 2/27/2008
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