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Treatments and drugs
By Mayo Clinic staffTreatment of encopresis focuses on clearing the colon of retained, impacted stool and encouraging healthy bowel movements. This includes training your child to go to the toilet as soon as reasonably able when the urge to defecate occurs.
There are several methods for clearing the colon and relieving constipation. Your child's doctor will likely recommend one or more of the following:
- Stool softeners, such as lactulose
- Colon lubricants, such as mineral oil
- Rectal suppositories
- Enemas
- More fluids
Your child's doctor may recommend abdominal X-rays to check the progress of the colon clearing.
Once the colon has been cleared, it's important to encourage your child to have regular bowel movements. In addition to recommending self-care measures such as a high-fiber diet, your child's doctor may recommend the use of stool softeners for six to 12 months.
Psychotherapy
If your child feels shame, guilt, depression or low self-esteem related to encopresis, psychotherapy can be helpful. A psychologist can help your child deal with these feelings and may also give you techniques for teaching your child not to hold stool. Ask your child's doctor for a recommendation.
- Parenting Corner Q&A: My child is way past toilet training, but he still soils his underwear. What should I do? American Academy of Pediatrics. http://www.aap.org/publiced/BK5_Soiling.htm. Accessed Sept. 10, 2008.
- Stool soiling and constipation in children. American Academy of Family Physicians. http://familydoctor.org/online/famcoden/home/children/parents/toilet/166.printerview.html. Accessed Sept. 10, 2008.
- Berkowitz CD. Encopresis. In: Berkowitz CD. Berkowitz's Pediatrics: A Primary Care Approach. 3rd ed. Washington D.C.: American Academy of Pediatrics; 2008:223-236.
- Stafford B, et al. Child & Adolescent Psychiatric Disorders & Psychosocial Aspects of Pediatrics. In: Hay Jr. WW, et al. CURRENT Diagnosis & Treatment: Pediatrics. 19th edition. The McGraw-Hill Companies Inc.; 2009. http://www.accessmedicine.com/content.aspx?aID=3398994&searchStr=encopresis. Accessed Nov. 28, 2008.
- Nurcombe B. Developmental Disorders of Attachment, Feeding, Elimination, & Sleeping. In: Ebert MH, et al. CURRENT Diagnosis & Treatment: Psychiatry. 2nd edition. The McGraw-Hill Companies Inc.; 2008. http://www.accessmedicine.com/content.aspx?aID=3291880&searchStr=encopresis. Accessed Nov. 28, 2008.
- Vegetative Disorders: Elimination Disorders: Encopresis. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th edition. Philadelphia, Pa.: Saunders Elsevier; 2007.
- Ferry GD, et al. Definition, clinical manifestations, and evaluation of functional fecal incontinence in children. http://www.uptodate.com/online/content/topic.do?topicKey=pedigast/10533&selectedTitle=1~14&source=search_result. Accessed Nov. 28, 2008.
