Elimination Disorders in Children

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Can elimination disorders in children be prevented?

While there are no guarantees in this world (except death and taxes, as Benjamin Franklin reportedly said), there are several measures that can be taken to lessen the likelihood of constipation and/or encopresis. Breastfed infants have fewer stooling issues than their formula-fed counterparts. Careful monitoring of intestinal changes associated with the introduction of solid foods (between 4 to 6 months of age) is helpful. The process of toilet training should be viewed as the socially coordinated behavior of a purely biologic function. Forceful threats, intimidation, shaming, and extreme pressure should not be part of the toilet-training process. Many a toddler discovers that they, and not their parents, have ultimate control of when and where they will have a bowel movement. Forcing the issue will often only complicate matters. Frustrated parents should remember that very few high school seniors wear Depends to the senior prom. As noted above, a healthy diet emphasizing proper hydration, whole grains, fruits and vegetables, and an active lifestyle will promote normal stool production and elimination.

What is the prognosis for children with elimination disorders?

With parental education regarding risk factors and awareness of techniques maximizing their avoidance, the prognosis for children with elimination disorders is positive. Likewise, effective therapy has been demonstrated to be successful in both the short and long term, allowing reestablishment and maintenance of normal bowel function.

Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics

REFERENCES:

Abi-Hanna, Adel, and Alan Lake. "Constipation and Encopresis in Childhood." Pediatrics in Review 19 (1998): 23-31.

Ferry, George. "Definition, clinical manifestations and evaluation of functional fecal incontinence in infants and children." UpToDate.com. Apr. 29, 2013. <http://www.uptodate.com/contents/definition-clinical-manifestations-and-evaluation-of-functional-fecal-incontinence-in-infants-and-children>.

Ferry, George. "Treatment of chronic functional constipation and fecal incontinence in infants and children." UpToDate.com. July 23, 2013. <http://www.uptodate.com/contents/treatment-of-chronic-functional-constipation-and-fecal-incontinence-in-infants-and-children>.

Har, Aileen, and Joseph Croffie. "Encopresis." Pediatrics in Review 31 (2010): 368-374.

Medically Reviewed by a Doctor on 3/11/2016

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