Encopresis

Encopresis is a medical term for a toilet-trained child aged four or older who soils his/her clothes either voluntarily or involuntarily. Encopresis isn't a disease, but rather a symptom that may have different causes to it. Majority of the children who soil their pants are constipated.

It happens when your child resists having bowel movements, causing impacted stool to collect in the colon and rectum. When your child's colon is full of impacted stool, liquid stool can leak around the impacted stool and out of the anus, staining your child's pants.

What causes Encopresis?

Emotional issues may trigger Encopresis. A child may experience stress from premature toilet training or an important life event or change such as the divorce of a parent or the birth of a sibling.

Chronic constipation is another cause for Encopresis. If your child's stool is hard, dry and maybe painful to pass, your child may refuse or avoid going to the toilet, making the problem worse. Common causes of constipation include eating too little fibre, not drinking enough fluids or consuming excess of dairy products.

Signs & Symptoms of Encopresis

In addition to defecating in inappropriate places, a child with Encopresis may have other symptoms such as:

• Constipation with dry, hard stool
• Repeated urinary tract infections
• Passage of large stools that almost clogs the toilet
• Avoidance of bowel movements and long period of time between bowel movements, possibly as long as a week.
• Lack of appetite and abdominal pain
• Withdrawal from friends and family as well as decreased physical activity
• Leakage of stool on your child's underwear. If the amount of leakage is large, you may misinterpret it as diarrhoea.

Children with Encopresis are at a risk of emotional and social problems. They may become depressed, develop self-esteem problems, refuse to socialize with other kids and perform poorly in school. Punishing and humiliating children with Encopresis can only make it worse.

Exasperated parents usually get frustrated by the fact that their child seems unfazed by these accidents, which occur mostly during waking hours. Children face guilt and shame associated with the condition and some even try to hide their soiled pants from their parents. Another reason may be more scientific, because the brain eventually gets conditioned to the smell of faeces, and the child may no longer notice the odour.

Treatment

Encopresis is a complex and chronic but solvable problem. The child should be taught how the bowel works and that he can strengthen the nerves and muscles that control the bowel function. It's important that you don't blame your child and make him or her feel guilty because it will only contribute to lower self-esteem and incompetency to solve the problem. Behaviour modification or reward system can help inculcate proper toilet habits in the child. Psychological counselling may be essential for children who have significant behavioural and emotional difficulties.

If you notice that your child may have Encopresis, don't panic! Get in touch with your doctor and help your child overcome Encopresis. It's important for you to be patient and use positive reinforcement.