Encopresis is present when a child who has been toilet trained (typically over age 4), has bowel movements in inappropriate places. Generally this is seen within the child’s clothes which cause the clothes to become soiled. This act can be intentional or unintentional. In order for a true case of encopresis to be diagnosed, the above characteristics must occur at least once per month for three consecutive months.
Many times, but not always, the cause of encopresis is constipation which results in the stool becoming hard. Soft, liquid-like feces are then eliminated from the body around the hard stool. This causes leaking of stool into the child’s clothes. Your child may also complain of abdominal pain and avoid bowel movements. This is due to the hard stool becoming painful to pass.
As you can image, the child may feel embarrassed, have low self-esteem, become frustrated, feel shame, and become socially isolated.
The best thing for the child is to:
1. receive a patient, loving, caring approach from caregivers
2. medical intervention, and
3. mental health support and planning.
Treatment and tips
1. Consult with your child’s doctor. Common medical approaches include medical tests such as an abdominal x-ray and blood work. Medication to eliminate the presence of constipation is generally the medical intervention used if constipation is identified.
2. Promote a diet that is high in fiber. Great high fiber choices include broccoli, popcorn, wheat bread, and fruit. Many grocery stores also carry fiber supplements for kids. These are a great way to make sure your child is getting enough fiber. In addition to fiber, offer your child plenty of water throughout the day. Fiber intake and water seem to go hand-in-hand to keep things moving.
3. Provide your child with a mental health professional who can conduct an evaluation and provide counseling services, especially when the child’s encopresis is not due to constipation. Possible causes include, but are not limited to: parents separating, the birth of a sibling, or being toilet trained too early. Mental health counseling can assist with your child’s feelings, family functioning, positive reinforcement planning, and can address social concerns that are present due to this disorder.
4. Never punish or criticize your child for soiling.
5. Establish a routine for your child to void stool. Consistent toileting times will help to regulate your child’s bowel movements. This also helps to reduce the likelihood of your child avoiding passing stool. Consistent avoidance not only results in further constipation, but it stretches the colon and ultimately damages the nerve endings that are responsible for signaling your child’s brain that it is time to poop.
6. Be consistent, positive, and optimistic with the plan to help your child. Stick with it for at least several months and re-evaluate regularly with your chosen providers.
Further strategies are within reach!
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