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What is Encopresis?An estimated 2 million children in the United States have encopresis. When children have encopresis, this means that they cannot control their bowel movements and have poop accidents in their underwear. Sometimes people use the words “soiling” or “fecal incontinence” to mean encopresis. Encopresis is a frustrating and difficult disorder for children and their families, and it can be hard to treat. In almost all cases, encopresis develops as a result of long-standing constipation. Most children suffering from encopresis have a history of constipation or passing very large, painful poops. In some cases, neither the child nor the parents recall the constipation since it was so long ago. In most cases, children with encopresis do not have their accidents out of spite or because they are lazy. Rather, many secondary behavioral problems develop as a result of the encopresis. Once the encopresis is treated, many of the behavioral problems can get better. However, behavior therapy alone is usually not sufficient to cure the problem.
Possible CausesChronic constipation in children often leads to large, hard difficult to pass bowel movements. The child may “hold back”, not completely emptying their colon when they poop to avoid pain. Or a child may “hold back” during times of stress or limited access to a toilet, such as a new school or vacation. Regardless of why, as the child holds back, they slowly fill up their colon with stool, stretching it out bigger and bigger. Doctors often call this “megacolon”, meaning the colon is larger than normal. This is why children with chronic constipation or encopresis can pass bowel movements that are extremely large, sometimes large enough to clog the toilet. Since children with chronic constipation often hold back, they don’t regularly empty the very bottom part of their colon (rectum), allowing their colon to continue removing water from waste and creating hard stools. This also means their rectum is often full. Normally, when we pass a bowel movement, we completely empty the colon. This means that most of the time, the rectum is empty. Once a day, twice a day, or every other day, some stool moves into the empty rectum and stretches it. It is this stretching that…
Tips for Parents[catlist id=”9″ content=”yes” template=”encopresis-research” numberposts=”-1″]
FAQ
Find a Pediatric GILocate a pediatric Gastroenterologist. http://members.naspghan.org/Members/MemberCenter/Find_a_Pediatric/Members/Member_Center/Find_a_Pediatric.aspx Special Thanks to NASPGHAN
Resources WebMD (Cleveland Clinic): http://www.webmd.com/mental-health/elimination-disorders-encopresis American Academy of Pediatrics: http://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Soiling-Encopresis.aspx Mayo Clinic: http://www.medicinenet.com/encopresis/article.htm Familydoctor.org: http://familydoctor.org/online/famdocen/home/children/parents/toilet/166.html Nemours Foundation: http://kidshealth.org/parent/general/sick/encopresis.html Columbia University: http://www.childrensnyp.org/mschony/P01992.html

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Har, J., Croffie, A. (2010).Encopresis. Pediatrics in Review Vol. 31 No. 9 September 1, 2010
pp. 368 -374 (doi: 10.1542/pir.31-9-368)

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