encopresis…

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soiling, incontinence, stool, encopresis, voluntary, involuntary passage of stools causing soiling of clothes by a child over 4 years of age, overflow incontinence, encopresis results from chronic constipation, bowel incontinence, encopresis, divided into two groups, physiologic basis, the encopresis, second, seems to be an emotional basis, encopresis frequently is associated, constipation, fecal impaction, hard fecal material is retained, in the colon, a passage of soft, semi-liquid stool around the impacted stool, problem is not under the conscious control, the child, leakage of stool, night, rarely physical causes, than constipation, infancy, related to a lack of toilet training, training at too early an age, an emotional disturbance oppositional defiant disorder, a conduct disorder, whatever the cause the child, develop associated shame, guilt, loss of self-esteem, child, try to hide the discovery, the problem, incidence is not well documented but is thought to be, 1 percent, risk factors include male gender, low socioeconomic status, chronic constipation, inability to retain feces, bowel incontinence, passage of stool in inappropriate places, generally, in the child's clothes, secretive behavior associated, bowel movements, evidence of constipation, hard stool, digital examination, the rectal vault, demonstrate a fecal impaction, an abdominal x-ray, confirm impacted stool, in the colon, goal, prevent constipation, encourage good bowel habits, laxatives, enemas, remove fecal impaction, a stool softener, a diet high in fiber, fruits, vegetables, whole grain products, adequate fluid intake, promote the passage of softer stools, minimize the discomfort associated, bowel movements, parents, supportive, refrain from criticism, discouragement, pediatric gastroenterologists often provide education, parents, child, use biofeedback, the child to treat the more difficult cases, psychotherapy, the child deal, associated shame, guilt, loss of self-esteem, encopresis, in the absence of constipation, psychiatric evaluation, help determine the underlying cause, most children respond to treatment, child, suffer from low self-esteem, peer disapproval related to this problem, routine bowel habits, not developed, child, suffer from chronic constipation, this behavior is noted, child over 4 years old, obscure prevention is difficult, a general rule, refrain from too early, too coercive toilet training.