Encopresis is the leakage of feces in the child's underwear that, in most cases, happens involuntarily and without the child noticing.
This incontinence usually arises from a previous constipation, with accumulation of hard stools, usually due to psychological causes. Therefore, the main form of treatment is with psychotherapy with a child psychologist and monitoring by a pediatrician, who can indicate ways to improve the consistency of stools and treat constipation.
Despite being more common in boys after the age of 4, encopresis can occur at any age, affecting both men and women. In adults, fecal incontinence affects more the elderly, mainly due to changes in the functioning of the muscles that form the rectum and anus, caused by childbirth, surgery or deformities in the region. Check out more causes and how to treat this problem in the adult in fecal incontinence.
What are the causes
Although it may arise from changes in the child's digestive system, most of the time, encopresis is related to chronic constipation, causing hard and dry stools to accumulate in the final region of the intestine. In this way, the muscle tone and sensitivity of the region are impaired, and there is a leak of feces, without the child noticing or being able to control it.
The main causes of stool retention in children include:
- Fear or shame of using the toilet; Anxiety while learning to use the toilet; Being experiencing a period of stress; Difficulty in reaching or accessing the bathroom; Diet with little fiber and with excess fat and carbohydrates; Little fluid intake; Anal fissure, which causes pain during bowel movement. Diseases that slow down the functioning of the intestine, as in hypothyroidism. Mental problems, such as attention deficit hyperactivity disorder or schizophrenia.
Encopresis appears in children aged 4 years or older, because before this age, it is common to have greater difficulty in controlling the anal sphincter. In addition, it is common for encopresis to be accompanied by enuresis, which is urinary incontinence during the night. Know even when it is normal for the child to wet the bed.
How the treatment is done
Encopresis is curable, and to be treated it is necessary to resolve its cause, it is essential to be patient and help the child develop a habit of using the toilet regularly, in addition to making improvements in food, with fruits, vegetables and liquids, such as way to prevent constipation from persisting. Learn what to do to combat constipation in your child.
The pediatrician or gastroenterologist may recommend the use of laxatives, in syrup, pills or suppositories, such as Lactulose or Polyethylene glycol, for example
. Psychotherapy is also important for the child to be more comfortable with the use of the toilet and evacuation, and one of the techniques widely used by psychologists is play therapy, in which the child releases his feelings and problems through play.
If the encopresis is caused by a disease that affects the child's digestive tract, specific treatment of the disease and, in rarer situations, surgery may be necessary.
Consequences of encopresis
Encopresis can cause some negative consequences for the child, such as low self-esteem, irritation, social isolation. Therefore, it is very important that, during treatment, parents support the child, avoiding excessive criticism.
