Encopresis

Encopresis is defined as leakage of stool into the clothing, also called "soiling". The child is not aware of this soiling until it has already occurred. He/she is not doing this on purpose and does not have control over the soiling. Illness or physical defects do not cause this. Stool "accidents" are often commonly mistaken for diarrhea.

Encopresis is most commonly caused by longstanding, often unrecognized constipation. A hard stool develops in the rectum and subsequent stool leaks out around it causing the soiling. The child begins to lose normal sensation in the rectum as the area is "stretched out" from the constipation; this contributes to further soiling.

Treatment for encopresis has four steps:

1. The first is a "clean out." This means that existing stool in the rectum and colon must be removed. Your doctor or nurse will discuss with you ways this stool can be evacuated.
   
   
2. The next step is institution of stool softeners. This will ensure that subsequent stools are easily passed. These are not laxatives and can safely be used on a daily basis for prolonged periods of time.. The common stool softeners are Lactulose, Sorbitol and polyethylene glycol (PEG) 3350 (Miralax, Glycolax, etc).
   
   
3. The next step is bowel retraining. This is the most important step. This is the time when your child will learn the normal sensations of having a regular bowel movement. You child will be given a schedule for toileting and positive reinforcement.
   
   
4. The child will be placed on a high fiber diet. This is important to ensure normal bowel function. You will be given a booklet regarding high fiber food choices.