It is defined as the voluntary or involuntary incontinence of stool in children over 4 years of age.
Mechanism: Contamination begins around the hardened stool in the form of leakage. Rectal tension and decreased rectal sensitivity result in loss of the urge to defecate. This condition is known as encopresis. (It usually occurs after toilet training is completed.)
Incidence: It is between 1 – 3% in the male population. Boy / Girl: 6/1. It constitutes 10-20% of those who apply to the Pediatric Gastroenterology Polyclinic.
Major Causes of Encopresis:
1. Organic Causes
Constipation
Medications
Dehydration
Neuromuscular Diseases
Anal Anomalies
Meningomyelocele
Abdominal Wall Anomalies
Cystic Fibrosis
Rectal Abscess, Anal Fissure
Electrolyte Irregularity
Hypothyroidism
Motor mental retardation
2. Psychological Causes
Association with Bedwetting :
It is associated with 29% daytime, 34% nocturnal enuresis and 11% urinary tract infection. Enuresis, which occurs 89% during the day and 63% at night, is cured with the treatment of encopresis.
Symptoms
*Stool incontinence and incontinence
*Abdominal pain, loss of appetite
*Anorexia
*Tenesmus
*Diarrhea
*Decreased physical activity
*Enuresis
Purpose of Treatment: Prevention of costipation and encopresis is to ensure regular bowel movement and toilet habits. Family support should be provided and it is important that criticism is reduced and not discouraged. Parents and children should be considered together. In difficult cases, the child should be consulted to gastroenterology and psychiatry. In cases without constipation, psychiatry is important in determining the underlying cause.
Dietary Treatment: Water and fiber should be increased, milk, cheese and starch should be reduced.
Fiber needs change with age.
2-6 years old; 10 –20 gr/day fiber
6-12 years old: 20-30 gr/day fiber
Over 12 years old :30-45 gr/day fiber
Foods with High Fiber Content:
* Bran bread, mixed grain bread, corn bread
* Fig, apricot and dried plum, orange, almond
* Green vegetable and fruit types
· Psychological Support
· Bowel Habit Training: Positive reward system can be used.
·Medicines:(Consult your doctor.)
Phase 1:
Drainers are used to go back to the past.
Phase 2:
Stool solidification is prevented. Treatment lasts 6-12 months. The child is encouraged to sit on the toilet. It is provided to make stool twice a day. At this stage, teachers have a job. You should be sensitive, if necessary, school can be interrupted. It is ensured that the child uses the bathroom frequently.
Phase 3:
Medications are gradually reduced. If there is a relapse, the family is told that it is not the family’s fault. Treatment is complete without significant relapse in 75%. Relapse is observed in 10-20% of cases. The dose that responds to the treatment is increased again.
Encopresis is a chronic medical condition that requires patience and experience.
Mechanism: Contamination begins around the hardened stool in the form of leakage. Rectal tension and decreased rectal sensitivity result in loss of the urge to defecate. This condition is known as encopresis. (It usually occurs after toilet training is completed.)
Incidence: It is between 1 – 3% in the male population. Boy / Girl: 6/1. It constitutes 10-20% of those who apply to the Pediatric Gastroenterology Polyclinic.
Major Causes of Encopresis:
1. Organic Causes
Constipation
Medications
Dehydration
Neuromuscular Diseases
Anal Anomalies
Meningomyelocele
Abdominal Wall Anomalies
Cystic Fibrosis
Rectal Abscess, Anal Fissure
Electrolyte Irregularity
Hypothyroidism
Motor mental retardation
2. Psychological Causes
Association with Bedwetting :
It is associated with 29% daytime, 34% nocturnal enuresis and 11% urinary tract infection. Enuresis, which occurs 89% during the day and 63% at night, is cured with the treatment of encopresis.
Symptoms
*Stool incontinence and incontinence
*Abdominal pain, loss of appetite
*Anorexia
*Tenesmus
*Diarrhea
*Decreased physical activity
*Enuresis
Purpose of Treatment: Prevention of costipation and encopresis is to ensure regular bowel movement and toilet habits. Family support should be provided and it is important that criticism is reduced and not discouraged. Parents and children should be considered together. In difficult cases, the child should be consulted to gastroenterology and psychiatry. In cases without constipation, psychiatry is important in determining the underlying cause.
Dietary Treatment: Water and fiber should be increased, milk, cheese and starch should be reduced.
Fiber needs change with age.
2-6 years old; 10 –20 gr/day fiber
6-12 years old: 20-30 gr/day fiber
Over 12 years old :30-45 gr/day fiber
Foods with High Fiber Content:
* Bran bread, mixed grain bread, corn bread
* Fig, apricot and dried plum, orange, almond
* Green vegetable and fruit types
· Psychological Support
· Bowel Habit Training: Positive reward system can be used.
·Medicines:(Consult your doctor.)
Phase 1:
Drainers are used to go back to the past.
Phase 2:
Stool solidification is prevented. Treatment lasts 6-12 months. The child is encouraged to sit on the toilet. It is provided to make stool twice a day. At this stage, teachers have a job. You should be sensitive, if necessary, school can be interrupted. It is ensured that the child uses the bathroom frequently.
Phase 3:
Medications are gradually reduced. If there is a relapse, the family is told that it is not the family’s fault. Treatment is complete without significant relapse in 75%. Relapse is observed in 10-20% of cases. The dose that responds to the treatment is increased again.
Encopresis is a chronic medical condition that requires patience and experience.
