Some youngsters are predisposed from birth to early colonic inertia - that is, a tendency toward constipation because their intestinal tracts lack full mobility. At other times, semiformed or partial bowel movements may pass into the underwear, and because of the decreased sensation, the child may not be aware of it. Large, hard feces may be retained in the colon (large intestine) and rectum, but liquid stool can begin to seep around this impacted mass, passing through the anus and staining the underwear. Bowel movements then can be painful, which further discourages these children from passing the stools.Įventually, the sphincters (the muscular valves that normally keep stools inside the rectum) are no longer able to hold back all the stool. With time, these retained stools become harder, larger and much more difficult to pass. Most of these children are chronically constipated. Therefore, these children find it increasingly difficult to have a normal bowel movement. Also, the intestines progressively lose their ability to contract and squeeze the stools out of the body. As the intestinal walls and the nerves within them stretch, nerve sensations in the area diminish. Many of these youngsters simply may not respond to the urge to defecate and thus withhold their stools. When encopresis occurs, it begins with stool retention in the colon. While this may not be the case, children can play an active role in managing the processes involved in this disorder. Adults sometimes assume that the child is soiling himself on purpose. A frustrating conditionĬhildren, parents, grandparents, teachers and friends alike are often baffled by this problem. By contrast, children with the secondary form may develop this condition after they have been toilet trained, such as upon entering school or encountering other experiences that might be stressful. Children with the primary disorder have had continuous soiling throughout their lives, without any period in which they were successfully toilet trained. Two typesĭoctors divide cases of encopresis into two categories: primary and secondary. The condition is not related to social class, family size, the child's position in the family or the age of the parents. Boys with encopresis outnumber girls by a ratio of six to one, although the reasons for this greater prevalence among males is not known. Encopresis affects about 1.5 percent of young school children and can create tremendous anxiety and embarrassment for children and their families.Įncopresis is not a disease but rather a symptom of a complex relationship between the body and psychological/environmental stresses. It is the passing of stools into the underwear or pajamas, far past the time of normal toilet training. ![]() What should I do?Įncopresis is one of the more frustrating disorders of middle childhood. My child is way past toilet training, but he still soils his underwear.
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