What is Encopresis And How Does It Effect Toddlers
Encopresis is when a child involuntarily soils themselves. They will accidentally have fecal soiling of their underpants. The child will leak poop and this is completely involuntarily. It usually happens to children that have already been potty trained and can occur for a few different reasons. When this happens it can typically because of constipation, but there are other less common reasons such as: physical disorders, neurological disorders, the withholding of going poop or physiological disorders. Occasionally it can happen when a child has had surgery, though this is very rare.
A cycle begins where the child has been constipated or has with held a bowel movement, but now the stool has become very hard and difficult to pass, becoming painful to go to the bathroom. The child than continues to hold the bowel movement since it has become so painful to go to the bathroom. When this happens where a child is holding their bowel movements, over time the natural cycle or voluntary bowel movements is replaced with involuntary bowel movements. This is due to the fact that the stool will continue to build in the child's body. The stool continues to stretch and colon and rectum area and all sensation in this area is lost. The child will no longer feel that they have to have a bowel movement at all, even when they do need to go. This creates a blockage in the system, however the newer stool that is in the child's body that is soft, will leak around the hardened stool that is in the colon. The rectum can not hold the leaking stool, since there is no feeling in the area and the child will have an accident without even realizing it until after it has happened.
Due to the nature of the problem, trying to enforce sitting longer on the toilet to go, using stool softeners and other types of behavioral strategies, can actually make the problem worse. As the child has accidents they are embarrassed, however they are also still holding the stool too. When they do finally go, it is so painful, since the stool has become so large and it takes so long, that the cycle starts over again.
Typically, the approach to correct the problem is three pronged. The child's body needs to be cleaned out, stool softeners are used after the cleaning to ensure that it does not happen again and sitting on the toilet more often at scheduled times is used also. The cleaning out is usually done by giving an enema or using laxatives. However, many times both need to be used. After that the child will need to take stool softeners so that it is easier for them to go and no longer painful so that they do not want to hold a bowel movement. Along with this, the child will need to sit on the toilet at scheduled times to go. This does not mean for extensively long periods of time, but at certain times, similar to when they were being potty trained, to try and help make sure that they go.