Name of Symptom/Sign:
Encopresis | [[Image:{{{Image}}}|190px|center|]] | | {{{Caption}}} | | ICD-10 | R15 | | ICD-9 | 307.7, 787.6 | | ICD-O: | {{{ICDO}}} | | OMIM | {{{OMIM}}} | | DiseasesDB | {{{DiseasesDB}}} | | MedlinePlus | {{{MedlinePlus}}} | | eMedicine | {{{eMedicineSubj}}}/{{{eMedicineTopic}}} | Encopresis is involuntary "fecal soiling" in children who have usually already been toilet trained. Children with encopresis often leak stool into their underwear. The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: A symptom may loosely be said to be a physical condition which shows that one has a particular illness or disorder (see...
In medicine, a sign is a feature of disease as detected by the doctor during physical examination of a patient. ...
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Rabbit feces are usually 8-10 mm in diameter and dry to the touch. ...
Prevalence
The estimated prevalence of encopresis in 5-year-olds is ~1%. The disorder is thought to be more common in males. In epidemiology, the prevalence of a disease in a statistical population is defined as the ratio of the number of cases of a disease present in a statistical population at a specified time and the number of individuals in the population at that specified time. ...
Causes Encopresis is commonly caused by constipation, various physiological, psychological, or neurological disorders, or from surgery. Constipation or Irregularity, is a condition of the digestive system where a person (or other animal) experiences hard feces that are difficult to eliminate; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ...
Physiology (in Greek physis = nature and logos = word) is the study of the mechanical, physical, and biochemical functions of living organisms. ...
Neurology is a branch of medicine dealing with disorders of the central and peripheral nervous systems. ...
Typically, a child with encopresis has a long-standing history of constipation. The pain of moving his/her bowels leads to the child avoiding moving his/her bowels, which leads to hard stools which are even more difficult to pass. Eventually, the bowel is so full of stool, it starts to leak out. The child typically has no control over these accidents.
Encopresis may also be due to psychological problems, such as oppositional defiant disorder or conduct disorder. However, it is typically thought of as mainly a physical problem with a psychological component (but not cause). Oppositonal Defiant Disorder (ODD) When a child cannot seem to control his anger or frustration, even over what seems to be trivial or simple to others. ...
In psychiatry, conduct disorder is a pattern of repetitive behavior where the rights of others or the social norms are violated. ...
Diagnosis The psychiatric (DSM-IV) diagnostic criteria for encopresis are: The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and other countries. ...
- Repeated passage of feces into inappropriate places (e.g., clothing or floor) whether voluntary or intentional
- At least one such event a month for at least 3 months
- Chronological age of at least 4 years (or equivalent developmental level)
- The behavior is not exclusively due to a physiological effect of a substance (e.g., laxatives) or a general medical condition, except through a mechanism involving constipation.
The DSM-IV recognizes two subtypes: with constipation and overflow incontinence, and without constipation and overflow incontinence. In the subtype with constipation, the feces are usually poorly formed and leakage is continuous, and occurs both during sleep and waking hours. In the type without constipation, the feces are usually well-formed, soiling is intermittent, and feces are usually deposited in a prominent location. This form may be associated with oppositional defiant disorder or conduct disorder, or may be the consequence of anal masturbation. Oppositonal Defiant Disorder (ODD) When a child cannot seem to control his anger or frustration, even over what seems to be trivial or simple to others. ...
In psychiatry, conduct disorder is a pattern of repetitive behavior where the rights of others or the social norms are violated. ...
The male sexual organs Anal masturbation is autoeroticism focusing on the anal area. ...
Treatment There is a 3-pronged approach to the treatment of encopresis associated with constipation: - cleaning out
- using laxatives to soften the stool
- scheduled sitting times, typically after meals
The initial clean-out is achieved with laxatives, enemas, or both. Following that, laxatives are used daily to keep the stools soft.
Next, the child must try to use the toilet regularly to retrain his/her body. It is recommended that a child be required to sit on the toilet and 'try' to go for 10-15 minutes immediately after eating. Children are more likely to go to the bathroom immediately after eating. Creating a regular schedule of bathroom time will allow the child to achieve a proper elimination pattern.
See also Fecal incontinence is the inability to control ones bowels. ...
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References - The Diagnostic and Statistical Manual of Mental Disorders
External links - Aboutencopresis Links
- Aboutencopresis Forum
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