psychology

Encopresis

A child who is toilet trained may sometimes pass a stool and dirty himself. This can happen even if he is close to a toilet. If a child frequently experiences such episodes, he is said to be suffering from encopresis. Encopresis is not a disease. It is a disorder, which results in an individual's inability to defecate in an appropriate location, such as the toilet. This is in spite of a toilet being easily accessible. Often, the child may not even realise that he has passed a stool. Causes of Encopresis Since encopresis refers to involuntary defecation in spite of being toilet trained, it is said to strike only those children who have crossed around five years of age. Boys are at least three times more likely to suffer from this disorder. For a child to be diagnosed with encopresis, he should have an involuntary bowel movement at least two times or more, in a three-month period. In addition, the child should not have been suffering from any illness at that time, which may hamper his control over his bowels. Encopresis may be caused due to a variety of reasons but they are broadly classified into the following three categories. Regression from toilet training Children who have just been toilet trained sometimes regress from their training, which results in encopresis. At other times, a child may wilfully dirty himself. This may be a form of tantrum throwing or he may be feeling neglected and is looking for a way to grab attention. Other factors may also play a role such as a parent going back to work after being on leave, a new baby in the family, etc. Psychological difficulties Encopresis in adults is usually caused to due psychological or behavioural issues. In elderly people, encopresis may be seen as a result of the dementia associated with diseases such as Alzheimer's or Parkinson's. Encopresis can also be due to extreme anxiety. Many children and adults are very afraid to use public toilets. When such an individual is in a setting where he needs to use a public toilet, he will force himself to try to halt his bowel movements. Occasionally he may fail in his efforts. Some children experience encopresis because of a phobia associated with defecating. A child might be afraid of the toilet itself or fear the sound of a flushing toilet. However, psychological difficulties are considered only a partial cause of encopresis. Medical reasons Medical encopresis is the most common form of encopresis. Among medical reasons, constipation is the number one cause of encopresis, especially in children. A hard stool blocks the rectum and does not get excreted. Consequently, the new, softer faeces formed are pushed around it and they trickle out, without the person being aware of it. In rare cases, encopresis may be caused due to a serious condition such as nerve damage to parts of the intestine such as the colon. This is the part of the body responsible for the formation of the stool. A child who experiences encopresis due to a medical condition may display additional symptoms like: Abdominal pain Loss of appetite Nausea Dehydration Weight gain Occasionally, encopresis may be mistaken for diarrhoea. This is because the parent notices small amounts of faecal matter and assumes that the child is ill. Treatments Available The first step to treating encopresis is to identify the cause behind the condition. For encopresis caused due to regression, the parent must understand what is making the child want to go back to his baby years. Encopresis cannot be treated by scolding a child or punishing him. This will only worsen the situation. Instead, a parent must reassure the child so that he feels emotionally secure. This will encourage the child to let go of his fears and help him to master control over his bowels. Similarly, a person who suffers due to a psychological difficulty can be treated using psychiatric help as well as medication to control anxiety. Medical causes of encopresis such as constipation require a three pronged treatment plan. Initially, a doctor may prescribe a laxative in order to ease the passage of the hardened stool through the rectum. Once the stool has passed out of the body, the next step is to prescribe a stool softener. This will ensure that further stools passed remain soft. The third step is to induce the child to have regular bowel movements. The child develops a set time each day when his bowel is naturally stimulated to pass a stool. No matter what the cause, remember that encopresis is treatable. The process may take a while but with your encouragement, your child will fully overcome this problem. <<<< BACK