What is encopresis? How can it be diagnosed and treated at home? Get the answers to these questions and more in our comprehensive guide.

Understanding Encopresis

Encopresis is a condition in which a child experiences involuntary bowel movements, often resulting in soiling of the child’s underwear. This can be a distressing and embarrassing issue for both the child and the family, but with the right approach, it can be effectively managed and treated.

Diagnosing Encopresis

To diagnose encopresis, your child’s doctor may perform a physical exam, conduct a digital rectal exam, recommend an abdominal X-ray, or suggest a psychological evaluation if emotional issues are contributing to the symptoms. The doctor’s goal is to rule out any physical causes for the constipation or soiling and determine the underlying factors driving the condition.

Physical Exam and Symptom Discussion

During the physical exam, the doctor will discuss your child’s symptoms, bowel movements, and eating habits to determine if there are any physical causes for the constipation or soiling.

Digital Rectal Exam

The doctor may perform a digital rectal exam, which involves inserting a lubricated, gloved finger into your child’s rectum while pressing on the abdomen with the other hand. This helps the doctor check for any impacted stool.

Abdominal X-ray

If necessary, the doctor may recommend an abdominal X-ray to confirm the presence of impacted stool.

Psychological Evaluation

If emotional issues are contributing to your child’s symptoms, the doctor may suggest a psychological evaluation to address any underlying factors.

Treating Encopresis at Home

The primary goal of encopresis treatment is to clear the colon of any retained, impacted stool and then encourage regular, healthy bowel movements. This often involves a combination of medical interventions and behavioral modifications.

Clearing the Colon

Your child’s doctor may recommend one or more of the following methods to clear the colon and relieve constipation:

• Certain laxatives
• Rectal suppositories
• Enemas

The doctor will likely closely monitor the progress of the colon clearing to ensure it is effective.

Encouraging Healthy Bowel Movements

Once the colon is cleared, the focus shifts to encouraging regular, healthy bowel movements. This may involve:

• Dietary changes, including increased fiber and fluid intake
• Gradual discontinuation of laxatives as the bowel function returns to normal
• Training the child to go to the toilet as soon as the urge to have a bowel movement occurs
• A short trial of eliminating cow’s milk, if indicated

Behavior Modification

Your child’s doctor or a mental health professional can discuss techniques for teaching your child to have regular bowel movements, a process often called behavior modification or bowel retraining. This can be especially helpful if emotional issues are contributing to the encopresis.

Psychotherapy

If your child is experiencing shame, guilt, depression, or low self-esteem related to the encopresis, the doctor may recommend psychotherapy with a mental health professional to address these emotional factors.

Self-Care Tips

In addition to the medical interventions and behavioral modifications, there are several self-care tips that can help manage encopresis at home:

• Focus on fiber-rich foods to help form soft stools
• Encourage your child to drink plenty of water
• Establish a regular toilet routine, with 5-10 minutes of sitting on the toilet after meals
• Use a footstool near the toilet to improve comfort and bowel positioning
• Be patient and use positive reinforcement, avoiding blame or punishment
• Limit cow’s milk if recommended by the doctor

Preparing for the Appointment

When you visit your child’s doctor to discuss encopresis, it’s a good idea to be well-prepared. Before the appointment, make a list of your child’s symptoms, any major stresses or life changes, and a detailed record of your child’s diet and any medications or supplements they are taking. This information will help the doctor provide a more accurate diagnosis and personalized treatment plan.

Conclusion

Encopresis can be a challenging condition, but with the right approach and a combination of medical interventions, behavioral modifications, and self-care strategies, it can be effectively managed and treated at home. By working closely with your child’s doctor and following the recommended treatment plan, you can help your child overcome encopresis and regain control of their bowel movements.