Encopresis

Introduction
Encopresis takes place when a child resists having bowel movements, causing impacted stool to accumulate in the colon and rectum. The process is also called stool holding or soiling. When the child’s colon is full of stool, it can leak out of the anus, leading to stains on underwear.

Encopresis occurs after age 4, when the child has learned to use a toilet. Usually, encopresis is a symptom of chronic constipation. Sometimes, it may be the result of developmental or emotional issues.

Encopresis can be categorized as primary or secondary. Primary encopresis occurs in a child who has not been successfully toilet trained. In secondary encopresis, a child develops the condition after getting successfully toilet trained.

Symptoms
Encopresis may be determined through the following:

  • Leakage of stool or liquid stool on your child’s underwear.
  • Constipation with dry, hard stool.
  • Recurring urinary tract infections.
  • Passage of stool that clogs the toilet.
  • Avoidance of bowel movements.
  • Lack of appetite accompanied by abdominal pain.

Causes
Some of the most common causes of encopresis are constipation and emotional fear.

Most cases of encopresis arise from chronic constipation. During constipation, the child passes hard and dry stool. The child avoids visiting the toilet. As the stool remains in the colon longer, it is more difficult to push stool out. When the colon expands it affects the nerves to signal the time to visit the toilet.

Common causes of constipation include controlling passing of stools due to fear of using the toilet or unwillingness to interrupt play, eating little fiber or not drinking enough fluids. An allergy to cow’s milk or drinking too much cow’s milk can also cause constipation or even diarrhea.

Emotional stress arising from family pressure or circumstances also may trigger encopresis.

Diagnosis
The doctor may do a quick inventory of the child’s health by asking questions.

A physical exam comprising of a digital rectal exam is done to find status of impacted stool. During this exam, the doctor inserts a lubricated, gloved finger into your child’s rectum while pressing on his or her abdomen with the other hand. An abdominal X-ray is done to confirm the presence of impacted stool.

A psychological evaluation can help determine contributing factors for symptoms.

Treatment
Timely treatment can help in healing the disease. It is essential to clear the colon of accumulated stool. Later, patient can take up treatment that encourages healthy bowel movements such as visiting toilet timely.

An abdominal X-rays can reveal status of the colon.

For clearing the colon and curing constipation, measures such as stool softeners, colon lubricants, rectal suppositories, enemas and oral fluids are recommended by the doctor.

Stool softeners are used for six months or more. A psychologist can help the child with any awkward feelings towards the process of elimination and may also impart techniques to the child to not to hold stool.

Home Remedies
Inducing regular bowel movements is an important step to eliminate encopresis.

  • Fibrous food consisting of fruits and vegetables can help to form soft stools. Whole grains are healthier carbohydrates for consumption as they contain fibre in them.
  • Adequate hydration of body is essential to combat this disease.Warm water and other non-dairy fluids help in combating bowel problems. It is wise to limit dairy intake as it reduces bowel movements.
  • Create toilet routine daily to make elimination a habit. Encourage children to pass stools regularly. Make the child’s toilet habit a bit easier by putting a footstool near the toilet.

Regularly following these remedies can prevent relapse of this disease.

Homeopathic Remedies
Bryonia is useful for patients who experience severe pain while passing stools.

Calcarea carbonica is used for people facing slight discomfort and fatigue while passing bowels. This remedy suits those affected by chills, sweats, and weakness due to Encopresis.

Causticum is used for people facing strain and discomfort when trying to pass a bowel in a sitting position.

Graphites may have a positive effect on encopresis patients who get pain after passing bowel.

Lycopodium is useful for those experiencing frequent indigestion along with encopresis. It helps in relieving gas and bloating.

Nux Vomica is used for treating constipation.

Sepia is effective in relieving heavy feeling in the rectum.

Silicea relieves the fatigue, chills, and stress associated with the condition.

Sulfur is used for patients with encopresis that experience inflammation around the anus and extreme gas. This herb can cure constipation which causes extreme tiredness.

Consult a homeopath to know the exact dose of every drug for treating this ailment.

References
1. Di Lorenzo C, Benninga MA. Pathophysiology of pediatric fecal incontinence. Gastroenterology. 2004. 126(1 Suppl 1):S33-40.

2. Partin JC, Hamill SK, Fischel JE, Partin JS. Painful defecation and fecal soiling in children. Pediatrics. 1992. 89(6 Pt 1):1007-9.

3. Rockney RM, McQuade WH, Days AL, et al. Encopresis treatment outcome: long-term follow-up of 45 cases. J Dev Behav Pediatr. 1996. 17(6):380-5.

4. Thapar A, Davies G, Jones T, Rivett M. Treatment of childhood encopresis–a review. Child Care Health Dev. Nov-Dec 1992.18(6):343-53.

5. Dobson P, Rogers J. Assessing and treating faecal incontinence in children. Nurs Stand. Sep 16-22 2009. 24(2):49-56; quiz 58, 60.

6. Reid H, Bahar RJ. Treatment of encopresis and chronic constipation in young children: clinical results from interactive parent-child guidance. Clin Pediatr (Phila). 2006. 45(2):157-64.

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