Materiały źródłowe

• #1 Encopresis in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/encopresis

  Encopresis is the involuntary leaking of feces, most often caused by chronic constipation. An estimated 1 to 3 percent of children have this problem at one time or another in childhood. […] Treatment for encopresis depends on the root cause. If encopresis is caused by constipation, treatment may include: Laxatives to help the child pass the impacted stool, Medication to keep bowel movements soft so the stool will pass easily, 5 to 10 minutes sitting on the toilet at home after breakfast and dinner. […] In the case of toilet refusal, treatment includes a combination of the medical treatments described above and behavioral treatments to help the child become more comfortable using the toilet for bowel movements. […] The physicians and nurse practitioners in the Division of Gastroenterology, Hepatology and Nutrition at Boston Children’s Hospital are experts in helping children have regular bowel movements on the toilet. We start with a complete medical history, questions about toilet training, and a thorough physical exam.

• #2 Encopresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560560/

  Encopresis or fecal incontinence is defined as the involuntary passing of stool into inappropriate places such as the underwear in children older than four years of age. It represents severe psychological distress on children and their families. This activity reviews the evaluation and management of encopresis and highlights the role of the interprofessional team, including pediatricians, child psychiatrists, and pediatric gastroenterologists in approaching and treating children with this condition. […] The treatment for encopresis relies on treating the root cause, which is chronic constipation. Management of constipation is covered in a different section in Statpearls, Pediatric Functional Constipation. The recently published NASPGHAN guidelines include four important phases in the treatment of chronic constipation: (1) education, (2) disimpaction, (3) prevention of reaccumulation of feces, and (4) follow-up.

• #3 Constipation in Kids: Your Family’s Guide to Getting „Unstuck” | Children’s Mercy Kansas City

  https://www.childrensmercy.org/departments-and-clinics/gastroenterology/constipation-and-encopresis/family-guide-to-childhood-constipation/

  If your child is having trouble pooping, it could be constipation. […] Encopresis, or unintentionally pooping, can be a symptom of constipation, too. Long-term constipation can make it harder to control bowel movements (BMs). These messy accidents arent usually voluntary. Ninety percent of encopresis cases are caused by chronic constipation. […] For toilet-trained kids, 1 or more poop accidents per week (encopresis). […] Your doctor may recommend whats called a cleanout to unblock the bowel and give those tired colon muscles a fresh start. […] Treating functional constipation is a process. A cleanout helps remove as much waste as possible from the colon. After the cleanout, doctors will often suggest a daily laxative to prevent stool from building up again. […] The Childrens Mercy BRICK (Bowel Retraining in Constipated Kids) Clinic was created to provide comprehensive treatment for children with severe, chronic constipation. […] BRICK Clinic takes a combined approach to care that addresses the physical, mental, emotional and social aspects of functional constipation.

• #4 Functional constipation, incontinence and encopresis – ROC Clinic

  https://rocclinic.com/en/pediatric-urology/functional-stress-incontinence-and-encopresis/

  Stool impaction causes fluid reabsorption, which makes the stool harder, larger, and more painful to pass. […] Over time, as the rectum distends to accommodate the retained fecal mass, rectal sensation decreases and fecal incontinence secondary to impaction by fecalomas (encopresis) may develop. […] Depending on the results of the tests mentioned above, the following treatments may be indicated: […] This type of laxative activates colonic motility, especially useful in patients with megarectum or long-standing constipation with encopresis and lack of response to osmotic laxatives. […] This treatment is indicated in patients presenting with pelvic dyssynergia or obstructive defecation (incoordination during defecation). […] The purpose of biofeedback is to restore a normal defecation pattern using visual and verbal feedback techniques.

• #5 Encopresis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/encopresis/symptoms-causes/syc-20354494

  Encopresis can be frustrating for parents and embarrassing for the child. However, with patience and positive reinforcement, treatment for encopresis is usually successful. […] Early treatment, including guidance from your child’s doctor or mental health professional, can help prevent the social and emotional impact of encopresis. Regular follow-up visits with your doctor can help identify ongoing or recurring problems so that adjustments in treatment can be made as needed.

• #6 Encopresis: A Four-Pronged Treatment Approach – Get Help Israel

  https://gethelpisrael.com/blog/Encopresis:-A-Four-Pronged-Treatment-Approach

  Encopresis, more commonly called soiling or fecal incontinence, refers to the involuntary passage of feces. […] While encopresis is often very distressing to both the child and the family, it is treatable. The earlier treatment begins, the better the outcome. […] The first step is to consult with the child’s pediatrician followed by an evaluation with a pediatric gastroenterologist to address any physiological factors. […] I begin treatment by working with parents to implement a schedule that has the child sit on the toilet for 5-10 minutes starting 20 minutes after every meal. […] All children, even those as young as four, can be taught how their bodies work. […] There are many emotional interventions that I incorporate into the therapeutic process, tailored to each child’s underlying issues. […] Children will take time to heal and may experience periodic setbacks, but with consistency, successful outcomes are achievable. With a combination of medical intervention and therapeutic approaches, it is possible to overcome the challenges of encopresis.

• #7 Soiling (Encopresis) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/encopresis.html

  Encopresis is not a behavioral issue or a simple lack of self-control. Punishing or humiliating a child with encopresis will only make matters worse. […] Instead, talk to your doctor for help to get through this challenging but treatable problem. The doctor also might recommend that your child see a gastroenterologist. […] Treatment happens in three phases: […] Emptying the rectum and colon of the hard poop. Depending on the child’s age and other things, the doctor may recommend medicines, including a stool softener, laxatives, and/or enemas. […] Helping your child begin having regular BMs. This is done with the aid of stool-softening agents. […] Reducing use of the stool medicines. As regular BMs happen, the doctor will decrease a child’s use of stool softeners and/or laxatives.

• #8 Encopresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560560/

  Disimpaction, or removal of the fecal impaction, is recommended before maintenance therapy. Fecal disimpaction can be accomplished with oral, or rectal agents. Oral administration of laxatives is less invasive and is more cost-effective than enemas or manual disimpaction. The use of orally administered polyethylene glycol (PEG) for fecal disimpaction is effective and safe. […] The next step of treatment focuses on the prevention of recurrence, which can be achieved through a combination of dietary changes, behavioral interventions, and medication. […] Although conventional therapy usually successfully treats children with constipation induced encopresis, a small group continues to have intractable symptoms. Surgical interventions may benefit this minority, including intrasphincteric injection of botulinum toxin (Botox), antegrade enemas, and rectosigmoid resection.

• #9 Encopresis Treatment & Management: Approach Considerations, Behavioral Therapy and Biofeedback, Pharmacologic Therapy

  https://emedicine.medscape.com/article/928795-treatment

  Although controversy remains and conflicting data have been reported, many authors advocate behavioral strategies, with or without long-term laxative therapy, to encourage bowel movements in patients with chronic encopresis. The addition of an intensive behavioral program to conventional medical therapy can be of substantial therapeutic benefit for most children with chronic encopresis. […] Because most children with encopresis have retentive encopresis as a consequence of chronic constipation with resulting overflow incontinence, medical therapy is initially focused on disimpaction of the distal colon, which is followed by prolonged use of laxatives to ensure that the child passes soft stools frequently without any associated pain. Disimpaction can be accomplished with aggressive use of oral cathartics or a series of enemas. After the colon is disimpacted, long-term laxative therapy is generally started. Virtually any laxative can be used, provided that it is administered in sufficient quantity to produce 1-2 soft stools daily.

• #10 Encropresis – Conditions – Gastroenterology, Hepatology & Nutrition – Golisano Children’s Hospital – University of Rochester Medical Center

  https://www.urmc.rochester.edu/childrens-hospital/gastroenterology/conditions/encopresis.aspx

  Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. […] Treatment for encopresis may include: […] Removing the impacted stool […] Keeping bowel movements soft so the stool will pass easily […] Retraining the intestine and rectum to gain control over bowel movements. […] Your child’s healthcare provider may prescribe an enema to help remove the impacted stool. An enema is a liquid that is placed in your child’s rectum. It helps loosen the hard, dry stool. Never give your child an enema without the approval of your child’s healthcare provider. […] Your child’s healthcare provider will likely prescribe medicines to help keep your child’s bowel movements soft for several months. This will help stop stool from getting impacted again. Never give your child stool softeners without the approval of your child’s healthcare provider.

• #11 What Is Encopresis? – Child Mind Institute

  https://childmind.org/article/what-is-encopresis/

  When a child is over the age of four and has consistent bowel movements anywhere other than the toilet, they may have encopresis. […] A doctor can diagnose a child with encopresis by conducting a physical exam and a rectal exam to check for hardened stool. They may also recommend an x-ray of their abdomen. For treatment, they could prescribe stool softeners, laxatives, and enemas. […] To diagnose a child with encopresis, a doctor may conduct both a routine physical exam and a rectal exam to check for hardened, impacted stool. They may also recommend an x-ray of the child’s abdomen. And to treat symptoms, typically the doctor will: […] This can be done with medications such as laxatives or rectal suppositories. The doctor may also recommend an enema, a procedure that involves inserting liquid into the rectum through the anus to flush out the contents of the colon.

• #12 Encopresis

  https://www.massgeneral.org/condition/encopresis

  Encopresis is when your child leaks stool into their underwear. It is also called stool soiling. It is most often because of long-term (chronic) constipation. Encopresis happens to children ages 4 and older who have already been toilet trained. […] Treatment for encopresis may include: Removing the impacted stool […] Keeping bowel movements soft so the stool will pass easily […] Retraining the intestine and rectum to gain control over bowel movements. […] Your child’s healthcare provider may prescribe an enema to help remove the impacted stool. […] Your child’s healthcare provider will likely prescribe medicines to help keep your child’s bowel movements soft for several months. This will help stop stool from getting impacted again. […] Treatment may also include diet and lifestyle changes.

• #13 Encopresis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001570.htm

  If a child over 4 years of age has been toilet trained, and still passes stool and soils clothes, it is called encopresis. The goal of treatment is to: […] Prevent constipation […] Keep good bowel habits […] It is best for parents to support, rather than criticize or discourage the child. Treatments may include any of the following: […] Giving the child laxatives or enemas to remove dry, hard stool. […] Giving the child stool softeners, such as magnesium hydroxide, lactulose, or polyethylene glycol powder, as recommended by your provider. […] Having the child eat a diet high in fiber (fruits, vegetables, whole grains) and drink plenty of fluids to keep the stools soft and comfortable. […] Seeing a pediatric gastroenterologist when these treatments are not enough. Your gastroenterologist may use biofeedback, or teach the parents and child how to manage encopresis.

• #14 Soiling (Encopresis) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/encopresis.html

  A good way to track your child’s progress is by keeping a daily poop calendar. […] Patience is the key to treating encopresis. It can take several months to a year for the stretched-out colon to return to its normal size and for the nerves in the colon to become effective again. […] Successful treatment of encopresis depends on the support a child gets. Some parents find that positive reinforcement helps to encourage the child throughout treatment. […] With lots of love, support, and reassurance that they’re not the only one in the world with this problem, your child can overcome encopresis.

• #15 Encopresis

  https://www.massgeneral.org/condition/encopresis

  Making changes in your child’s diet and activity level may help prevent constipation and stool soiling. […] If your child’s encopresis is caused by another health problem, treating that condition may help. […] You can also help your child have regular bowel movements by making some diet and lifestyle changes. Give your child high-fiber foods and limit high-fat and high-sugar foods. […] Your child’s healthcare provider can also give helpful suggestions and medicines as needed.

• #16 Encopresis – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/constipation/encopresis/

  Encopresis is a problem that children age four or older can develop due to long-term constipation. […] Specific treatment for encopresis will be determined by your child’s doctor based on the following: […] Treatment for encopresis may include: […] Removing the impacted stool […] Keeping bowel movements soft so the stool will pass easily […] Retraining the intestine and rectum to gain control over bowel movements. […] An enema may be prescribed by your child’s doctor to help remove the impacted stool. […] Your child’s doctor will often prescribe medications to help keep your child’s bowel movements soft for several months. […] Changes in your child’s diet will help constipation, and may include: […] Increasing the amount of fiber in your child’s diet by adding more fruits and vegetables or adding more whole grain cereals and breads.

• #17 Encopresis (Fecal Soiling) in Children | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/encopresis/

  Encourage your child to drink more fluids, especially water. […] Limit fast foods and junk foods that are usually high in fats and sugars, and offer more well-balanced meals and snacks. […] Increase exercise. Exercise aids digestion by helping the normal movements the intestines make to push food forward as it is digested. […] Proper bowel habits. […] If these methods do not help, or if your physician notices other problems, they may recommend laxatives, stool softeners or an enema. […] Until the intestine and rectum regain their muscle tone, children may still have „accidents” and soil their underwear on occasion.

• #18 Encropresis – Conditions – Gastroenterology, Hepatology & Nutrition – Golisano Children’s Hospital – University of Rochester Medical Center

  https://www.urmc.rochester.edu/childrens-hospital/gastroenterology/conditions/encopresis.aspx

  Treatment may also include diet and lifestyle changes. Help your child to eat more fiber by: […] Other diet changes that may help include: […] It’s also a good idea to have your child eat meals on a regular schedule. Eating a meal will often cause a bowel movement within 30 to 60 minutes. […] In some cases these changes may not help. Or your child’s healthcare provider may find another problem. If so, the provider may recommend using laxatives, stool softeners, or an enema. These products should only be used if recommended by your child’s provider. […] Your child may still have accidents and soil underwear from time to time. This will happen until the intestine and rectum get their muscle tone back again. […] Have your child bring a change of underwear or pants to school. This can help your child feel less embarrassed. It may help improve your child’s self-esteem.

• #19 Encopresis Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17849-encopresis-soiling

  Encopresis is a condition where a toilet-trained child has bowel movements when they are not on the toilet. […] Treatment is unique to each child diagnosed with encopresis and could include: […] Parents should encourage and offer support to their child by creating a potty routine to keep up with good bowel habits including: […] Based on the severity of your child’s diagnosis, your provider might recommend taking your child to see: […] It’s important that your child’s diet doesn’t contain foods high in fat and sugar. […] Treatment is long-term with the goal of creating regular bowel movements for your child. […] You can prevent encopresis by avoiding constipation and creating positive toileting experiences for your child. […] While you might see some progress early in treatment, it usually takes months for your child to overcome encopresis. […] If you notice your child has symptoms of encopresis, visit their healthcare provider. […] When toilet training your child, accidents will happen. […] It may be challenging as your child’s caretaker to deal with encopresis and frequently soiled clothes.

• #20 Encopresis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/encopresis

  Encopresis treatment will be determined by your child’s doctor based on the following: […] Treatment for encopresis may include: […] Removing the impacted stool […] Keeping bowel movements soft so the stool will pass more easily […] Retraining the intestine and rectum to gain control over bowel movements. […] An enema may be prescribed by your child’s doctor to help remove the impacted stool. […] Your child’s doctor will often prescribe medications to help keep your child’s bowel movements soft for several months. […] If dietary and behavioral changes do not help, or if your child’s doctor notices other problems, they may recommend laxatives, stool softeners, or an enema. […] Proper bowel habits. Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal.

• #21 Encopresis – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/constipation/encopresis/

  Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal. […] If these methods do not help, or if your doctor notices other problems, he or she may recommend laxatives, stool softeners or an enema. […] Until the intestine and rectum regain their muscle tone, children may still have “accidents” and soil their underwear on occasion.

• #22 About encopresis | Children’s Wisconsin

  https://childrenswi.org/medical-care/gastroenterology-liver-and-nutrition-program/conditions/encopresis

  Increase exercise. Increasing the amount of exercise your child gets can also help with constipation. […] Develop proper bowel habits. Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal. […] If these methods do not help, or if your physician notices other problems, he/she may recommend laxatives, stool softeners, or an enema. […] You may be referred to a pediatric GI specialist and/or pediatric behavioral health specialist who can assist with management of your child’s encopresis.

• #23 What Is Encopresis? – Child Mind Institute

  https://childmind.org/article/what-is-encopresis/

  A pediatrician will often prescribe stool softeners such as lactulose or mineral oil to make the passing of bowel movements more manageable. […] If your doctor suspects this might be the case, they’ll suggest that your child see a mental health professional. This can also help the child cope with the emotional and social distress that often comes along with having encopresis. […] Once a child has been diagnosed with encopresis, parents or caregivers need to work with the doctor to regulate bowel movements. Part of this involves changes in diet and exercise. […] To keep kids motivated, have a reward system for when they use the bathroom. They can get coupons, or “poop-ons,” as a reward for engaging in healthy pooping habits. […] Having encopresis can take a toll on a child’s social, emotional, and mental health. […] So, if you start to notice that your child is withdrawing from you and/or their peers, it can be helpful to seek further mental health support.

• #24 Encopresis in Children – The Drop Therapy Site

  https://thedroptherapy.com/encopresis-in-children/

  Probiotics, flax seed, chia seeds can be helpful for constipation. […] Magnesium and Vitamin C supplements can also help with constipation. […] Sitting after meals for at least 10-15 minutes can help with a routine of passing adequate volumes of poop at the right time. […] Rewarding your child for the hard work and good days. No shaming or punishing for the soiling. It is not their fault. […] Let the school and teachers know about the treatment plan and that the soiling can sometimes get worse before it gets better.

• #25 Encopresis in Children | Causes, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/e/encopresis

  Treatment of Encopresis includes: […] Cleaning the hard stool out of the lower colon […] Keeping bowel movements soft so the stool will pass easily […] Toilet sitting at least twice a day (if age appropriate) […] Retraining the intestine and rectum to gain control over bowel movements. […] It is very important that you develop a routine and stick to it. Long-term success depends on how well you can follow the care plan. This treatment will take many months of hard work for you and your child. There is no quick fix for this. […] Your child’s doctor or nurse practitioner will often order medications to help keep your child’s bowel movements soft. This will help your child not hold in the poop and over time will allow the colon to return to its normal shape and function. Please do not give your child stool softeners without the approval of a doctor or nurse practitioner.

• #26 Advanced Treatment Guidelines for Enuresis and Encopresis: The Latest in Evidence-Based Practice – Kids Bowel Bladder

  https://kidsbowelbladder.com/advanced-treatment-guidelines-enuresis-and-encopresis/

  Enuresis and Encopresis are two conditions that truly plague those who suffer from them. […] Good information available for parents regarding enuresis and encopresis treatment can be hard to come by. […] Common treatment approaches to encopresis include: Addressing underlying constipation: Encopresis is often caused by chronic constipation. Therefore, the first step in treatment is usually to address the constipation, either through medication, changes in diet, and bowel habits. […] Medications: Various medications can be used to help treat encopresis, including laxatives, stool softeners, and enemas. […] Pelvic Floor Therapy: This may include postural training, abdominal muscle coordination, pelvic floor muscle intervention, biofeedback, and more. […] Behavioral therapies, such as positive reinforcement, toilet training, and scheduled toilet sitting, are often used in conjunction with other therapies to help treat encopresis.

• #27 Encopresis: Symptoms, Mental Health, and Treatment

  https://psychcentral.com/disorders/encopresis-symptoms

  A combination of medication and behavioral therapy is often the most successful treatment for encopresis. […] Treatment for constipation may include oral or rectal medications, such as stool softeners to flush out the bowels. Your child’s pediatrician may prescribe polyethylene glycol (PEG) for this. […] Behavioral treatment helps encourage healthy bowel movements. This might include: regularly encouraging your child to sit on the toilet; rewarding your child for appropriate toilet-related behavior. […] It’s important for parents and caregivers not to punish children for soiling themselves. This can backfire and make the problem worse. […] Behavioral training usually involves being clear with the child that the situation isn’t their fault. It may also include educating the family and child about typical defecation and what causes constipation. […] It can also involve physical therapy to improve pelvic floor muscle awareness and help the child better control their bowel movements. […] In rare cases, medication or behavioral interventions may not help with encopresis. Surgery may be necessary to ease the symptoms and help your child.

• #28 Encopresis in Children and Adolescents – Society of Pediatric Psychology

  https://pedpsych.org/fact_sheets/encopresis/

  Encopresis is the voluntary or involuntary passage of stool in places other than toilets. […] Assessment and treatment of encopresis is based on a biobehavioral model. […] The treatment approach with the best outcome data is usually referred to as Medical-Behavioral. Typically, this consists of the use of medication to address the child’s constipation (either oral medications and/or rectal) and implementation of behavioral modification strategies to promote and maintain appropriate defecation. […] During behavioral treatment, a regular toilet sit schedule is established and children are rewarded for appropriate defecation behaviors (e.g., sitting on the toilet, stooling in the toilet, cleaning up if soiled). […] One empirically supported treatment of encopresis is Enhanced Toilet Training (ETT; Borowitz, Cox, Sutphen, Kovatchev, 2002), which has been delivered in both in person and online formats.

• #29 Encopresis in Children and Adolescents – Society of Pediatric Psychology

  https://pedpsych.org/fact_sheets/encopresis/

  Nonpharmacological interventions for constipation management may include increasing dietary fiber, increasing fluid intake, decreasing dairy consumption, increasing physical activity, and the use probiotics. […] There is emerging evidence for the efficacy of pelvic floor biofeedback in the management of constipation and encopresis. […] Regardless of the treatment approach, there seems to be general agreement that treatment that prevents or quickly addresses the reappearance of constipation is necessary. […] There is no empirical evidence to support the use of punishment in the treatment of encopresis.

• #30 Encopresis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/encopresis/diagnosis-treatment/drc-20354500

  Generally, the earlier that treatment begins for encopresis, the better. The first step involves clearing the colon of retained, impacted stool. After that, treatment focuses on encouraging healthy bowel movements. In some cases, psychotherapy may be a helpful addition to treatment. […] Your child’s doctor may recommend psychotherapy with a mental health professional if the encopresis may be related to emotional issues. Psychotherapy may also be helpful if your child feels shame, guilt, depression or low self-esteem related to encopresis.

• #31 Encopresis – Causes & Treatment | Atrium Health Wake Forest Baptist

  https://www.wakehealth.edu/condition/e/encopresis

  The goal of treatment is to: […] Treatments may include any of the following: […] Giving the child laxatives or enemas to remove dry, hard stool. […] Giving the child stool softeners. […] Having the child eat a diet high in fiber (fruits, vegetables, whole grains) and drink plenty of fluids to keep the stools soft and comfortable. […] Seeing a pediatric gastroenterologist when these treatments aren’t enough. The doctor may use biofeedback, or teach the parents and child how to manage encopresis. […] Seeing a psychotherapist to help the child deal with associated shame, guilt, or loss of self-esteem. […] For encopresis without constipation, the child may need a psychiatric evaluation to find the cause.

• #32 Advanced Treatment Guidelines for Enuresis and Encopresis: The Latest in Evidence-Based Practice – Kids Bowel Bladder

  https://kidsbowelbladder.com/advanced-treatment-guidelines-enuresis-and-encopresis/

  Psychological therapies: In some cases, psychological therapies such as cognitive-behavioral therapy (CBT) or family therapy may be recommended to help address any emotional or psychological factors that may be contributing to the condition. […] Education and support for the child and their family can be a key component of treatment. […] It’s important to stay up-to-date with the most recent evidence. What we know about treating encopresis points to success with using some combination of the above treatments. […] Overall, treating enuresis and encopresis requires a patient-centered approach that addresses the unique challenges faced by each individual, and meets them where they’re at in terms of treatment approaches. […] By recognizing these challenges and working collaboratively with patients and their families, as well as staying up-to-date on the most recent guidelines, medical professionals can develop effective treatment plans that improve patient outcomes and quality of life.

• #33 Kevin William Grant—Registered Psychotherapist – Understanding and Managing Encopresis: A Clinical Perspective

  https://www.kevinwgrant.com/blog/item/understanding-and-managing-encopresis-a-clinical-perspective

  Evidence-based treatments and interventions for Encopresis include laxative therapy, dietary modification, behavioral therapy, psychological support, family involvement, and school support. These approaches, often combined, aim to address Encopresis’s physical and psychological aspects, leading to improved outcomes and a better quality of life for affected children. […] Untreated Encopresis can result in a range of adverse consequences, including physical complications, psychological distress, social isolation, academic challenges, and the potential for long-term issues. As supported by research studies, early diagnosis, and comprehensive treatment are essential to mitigate these implications and improve the overall quality of life for children with Encopresis.

• #34 Encopresis and Autism: Interventions, Coping Strategies, and Bowel HealthAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontReset

  https://www.specialstrong.com/encopresis-and-autism-interventions-coping-strategies-and-bowel-health/

  Regular check-ups allow healthcare providers to track the child’s bowel health and catch any signs of constipation or encopresis early. Early detection ensures timely intervention and better treatment outcomes. […] […] The psychological aspect plays a significant role in encopresis. Providing mental health support can aid in reducing anxiety related to bowel movements and manage the emotional consequences of the condition. […] […] Coping with encopresis and autism can be challenging, both for the child and the family. Encopresis can lead to embarrassing situations and cause significant anxiety in children. For parents, it’s essential to provide emotional support and understand that the child is not having these accidents on purpose. […] […] If bowel accidents persist despite implementing home interventions, it is crucial to seek professional help. A healthcare provider or a specialized therapist can offer targeted interventions, ensuring that both encopresis and autism-related challenges are adequately addressed.

• #35 Functional constipation, incontinence and encopresis – ROC Clinic

  https://rocclinic.com/en/pediatric-urology/functional-stress-incontinence-and-encopresis/

  Stool impaction causes fluid reabsorption, which makes the stool harder, larger, and more painful to pass. […] Over time, as the rectum distends to accommodate the retained fecal mass, rectal sensation decreases and fecal incontinence secondary to impaction by fecalomas (encopresis) may develop. […] Depending on the results of the tests mentioned above, the following treatments may be indicated: […] This type of laxative activates colonic motility, especially useful in patients with megarectum or long-standing constipation with encopresis and lack of response to osmotic laxatives. […] This treatment is indicated in patients presenting with pelvic dyssynergia or obstructive defecation (incoordination during defecation). […] The purpose of biofeedback is to restore a normal defecation pattern using visual and verbal feedback techniques.

• #36 Encopresis: Meaning, Symptoms, Treatment, Causes

  https://www.medicinenet.com/encopresis/article.htm

  Most kids with encopresis also have constipation. […] Successful treatment of elimination disorders includes reestablishing an appropriate bowel evacuation regimen and development of a program to ensure maintenance of such a stool elimination pattern. A program that may include the use of laxatives, changes in diet, toileting behavior adjustments, and close follow-up has been shown to provide the highest rate of success. […] The use of probiotics has received scientific study in the last few years. Pediatric studies are less convincing than those utilizing adult patients and many studies present conflicting results. […] With parental education regarding risk factors and awareness of techniques maximizing their avoidance, the prognosis for children with elimination disorders is positive. Likewise, effective therapy has been demonstrated to be successful in both the short and long term, allowing reestablishment and maintenance of normal bowel function.

• #37 Fecal Incontinence (Soiling): Causes, Treatment and Prognosis | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/fecal-incontinence

  Fecal incontinence (accidentally having bowel movements) is a very common problem. With treatment, most children can develop bowel control and live normal lives. […] The good news is that with patience, encouragement and the right treatment, most children can develop good bowel control and live normal lives. […] Treatment is focused on preventing constipation and can be done through: Diet, Medications. […] There is also a promising new therapeutic modality for pediatric urinary and fecal incontinence, and chronic constipation in children when all other treatments have been unsuccessful. Sacral nerve stimulation (SNS) technology can be compared to a pacemaker for the heart, but provides stimulation to the anal canal area and lower part of the colon and the bladder. […] Treatment for these patients with slow motility can involve: Diet changes, Medication, Treatments, Bowel management programs.

• #38 Encopresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560560/

  The treatment of non-retentive encopresis has not been well defined. The treatment consists of education, keeping a bowel diary, and toilet training four times a day following meals and immediately after arriving home from school. […] Behavioral therapy of toilet training, in combination with a reward system, is the most critical step in the management of non-retentive encopresis. Currently, surgical interventions have no place in the treatment of children with non-retentive encopresis. […] Successful treatment of encopresis requires a team approach; family members, health care providers, and the patient work as a team for better treatment outcomes.

• #39 2023 Autism Highlight – A Multidisciplinary Intervention for Encopresis in Children With ASD, Autism Research Program, Congressionally Directed Medical Research Programs

  https://cdmrp.health.mil/arp/research_highlights/23Nathan_Call_highlight.aspx

  Given that 59% of children with ASD have toileting deficits (Tsai et al., 1981), the results of this study will impact a large number of individuals in the ASD population. Results from this project may have an impact on policies related to coverage for treatment of encopresis in children and adolescents with ASD and encopresis by payors and in practices related to the same. By promoting treatment methods for encopresis, children with ASD and their families will benefit through decreased parental stress, increased inclusion in the community, and removal of a potential barriers to developing social and other adaptive skills.

• #40 Encopresis and Autism: Interventions, Coping Strategies, and Bowel HealthAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontReset

  https://www.specialstrong.com/encopresis-and-autism-interventions-coping-strategies-and-bowel-health/

  Encopresis Treatment for Autism […] Managing encopresis in individuals with autism requires a multifaceted approach that includes medical, behavioral, and holistic interventions. The exact treatment protocol would depend on the severity and specifics of the child’s symptoms, but it generally involves the following: […] […] Doctors often prescribe medical interventions to directly target the underlying constipation and promote regular bowel movements. This could include the use of laxatives, stool softeners, and dietary changes. The primary aim is to counteract constipation and promote regular, easy bowel movements. […] […] Behavioral therapy is critical for managing encopresis and autism. This involves developing a toilet routine or training schedule, encouraging positive attitudes towards bowel movements, and using rewards as an incentive for making progress. It’s a teamwork between the child, family, and therapists. […]

• #41 2023 Autism Highlight – A Multidisciplinary Intervention for Encopresis in Children With ASD, Autism Research Program, Congressionally Directed Medical Research Programs

  https://cdmrp.health.mil/arp/research_highlights/23Nathan_Call_highlight.aspx

  Incontinence is a common concern among individuals with autism spectrum disorder (ASD). Existing treatments have generally utilized lengthy and invasive procedures and/or lacked methodological rigor. Furthermore, no treatment approach has incorporated medical approaches to address constipation, which is a significant contributor to encopresis in this population. […] To address this problem, with support from a fiscal year 2016 Autism Research Program Clinical Trial Award, Dr. Nathan Call developed a 2-week multidisciplinary intervention for encopresis (MIE) that combined medical and behavioral approaches. This intervention involved assessment by a gastroenterologist and outpatient behavioral treatments that included structured sitting on a toilet and use of a suppository, if needed, to promote independent bowel movements. The overall goal of this work was to demonstrate the efficacy of MIE by improving rates of continence (defined as no more than one incontinent bowel movement and at least six continent bowel movements over 14 days) and toileting independence (defined as continent bowel movements without the use of medication for 80% of bowel movements over 14 days).

• #42 Functional constipation, incontinence and encopresis – ROC Clinic

  https://rocclinic.com/en/pediatric-urology/functional-stress-incontinence-and-encopresis/

  In situations where there is an increase in basal pressure in the anal sphincter, the injection of this toxin is indicated, which „blocks” the sphincter and can help defecation. […] When the patient presents a marked dilatation of the colon and encopresis, treatment with laxatives may no longer be effective.

• #43 Fecal Incontinence (Soiling): Causes, Treatment and Prognosis | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/fecal-incontinence

  Bowel management programs are tailored for each individual child and often require trial and error to determine which combination of interventions, diets and medications will work best. […] The typical approach is to use an enema to empty the colon and to train the bowel to stay quiet in between enemas. […] If the child soils after eating a newly introduced food, that food should be excluded from the diet. […] Loperamide may be given to help slow down the colon. […] For some children who have had surgery to correct an anorectal malformation, a repeat procedure may help improve their potential for bowel control. […] Whether the prognosis for bowel control is considered good or poor, its important to note that most children who have undergone surgery to correct anorectal malformations or Hirshsprung disease will need some type of consistent dietary or medical intervention to prevent constipation or true fecal incontinence.

• #44 Encopresis – GI for Kids

  https://www.giforkids.com/encopresis/

  In children 4 years old and older, encopresis can be an embarrassing problem where stool leaks into the childs underwear. […] Encopresis can be very embarrassing for your child. The soiling is not something your child can control. You can help by being patient and understanding with your child as you follow the treatment steps. […] The first step in treating encopresis is to remove the impaction. There are several methods for clearing the colon and removing the impacted stool. The doctor may recommend one or more of the following: […] Once the colon is clear, the next step is to keep the bowel movements soft and easy to pass, and should include changing the childs diet and encouraging regular trips to the bathroom. […] Successful treatment of encopresis depends on the support the child receives. Positive reinforcement helps to encourage the child throughout treatment. If your child feels shame, guilt, depression, or low self-esteem related to encopresis, psychotherapy can be helpful.

• #45 Managing Encopresis in Schools | Show Me School Health

  https://showmeschoolhealth.org/resources/managing-encopresis-in-schools/

  Encopresis is a medical condition which must be diagnosed by a health care provider. It is usually related to underlying constipation and the treatment depends on whether there is underlying constipation. […] The management of encopresis depends on the type of fecal incontinence. For students with constipation-associated (retentive) functional fecal incontinence, management focuses on treating the underlying constipation using both behavioral modification and laxatives. For children with non-retentive fecal incontinence, management involves similar behavioral interventions, with particular attention to identifying the trigger for the episodes of incontinence but without laxative therapy. The treatment of encopresis can take months to years, so patience and understanding are vital. It may be helpful for the student to be referred to a physician who specializes in managing encopresis.

• #46 Encopresis

  https://phoenixchildrens.staywellsolutionsonline.com/Search/90,P01992

  Treatment for encopresis may include: […] Retraining the intestine and rectum to gain control over bowel movements. […] Your child’s healthcare provider may prescribe an enema to help remove the impacted stool. […] Your child’s healthcare provider will likely prescribe medicines to help keep your child’s bowel movements soft for several months. […] Treatment may also include diet and lifestyle changes. […] It’s also a good idea to have your child eat meals on a regular schedule. […] Try to get your child into a regular toilet habit. […] In some cases, these changes may not help. […] If so, the provider may recommend using laxatives, stool softeners, or an enema. […] Your child’s healthcare provider can also give helpful suggestions and medicines as needed. […] It can be helped with diet and lifestyle changes, and medicines. […] Coordinating care among professionals in the school and medical community is important for recovery.

• #47 Encopresis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/encopresis

  The goal of treatment is to: […] Treatments may include any of the following: […] Giving the child laxatives or enemas to remove dry, hard stool. […] Giving the child stool softeners, such as magnesium hydroxide, lactulose, or polyethylene glycol powder, as recommended by your provider. […] Having the child eat a diet high in fiber (fruits, vegetables, whole grains) and drink plenty of fluids to keep the stools soft and comfortable. […] Seeing a pediatric gastroenterologist when these treatments are not enough. Your gastroenterologist may use biofeedback, or teach the parents and child how to manage encopresis. […] Seeing a psychotherapist to help the child deal with associated shame, guilt, or loss of self-esteem. […] For encopresis without constipation, the child may need a psychiatric evaluation to find the cause. […] Most children respond well to treatment. Encopresis often recurs, so some children need ongoing treatment.

• #48 Stool Incontinence in Children – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/stool-incontinence-in-children/stool-incontinence-in-children

  Encopresis is a condition that requires attention and intervention, not simply reassurance and observation. […] Treatment is through education, relief of stool impaction, maintenance of proper stooling, and slow withdrawal of laxatives with continued behavioral and dietary intervention. […] Initial treatment involves educating the caregivers and child about the physiology of encopresis, removing blame from the child, and diffusing the emotional reactions of those involved. […] After stool impaction is relieved, the mainstay of treatment is family education, increased consumption of water and dietary fiber, bowel maintenance, and ongoing behavioral strategies and support. […] Behavioral strategies include structured toilet-sitting times; many children benefit from direct behavioral therapy. […] Regular follow-up visits are necessary for ongoing guidance and support. […] Encopresis can recur in times of stress or transition, so family members must be prepared for this possibility.

• #49 Encopresis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001570.htm

  Seeing a psychotherapist to help the child deal with associated shame, guilt, or loss of self-esteem. […] For encopresis without constipation, the child may need a psychiatric evaluation to find the cause. […] Most children respond well to treatment. Encopresis often recurs, so some children need ongoing treatment. […] Contact your provider for an appointment if a child is over 4 years old and has encopresis. […] Encopresis can be prevented by: […] Toilet training your child at the right age and in a positive way. […] Talking to your provider about things you can do to help your child if your child shows signs of constipation, such as dry, hard, or infrequent stools.

• #50 Encopresis – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/constipation/encopresis/

  Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal. […] If these methods do not help, or if your doctor notices other problems, he or she may recommend laxatives, stool softeners or an enema. […] Until the intestine and rectum regain their muscle tone, children may still have “accidents” and soil their underwear on occasion.

• #51

  https://www.shrinerschildrens.org/en/pediatric-care/encopresis

  Shriners Children’s provides specialty care for children with encopresis. […] Treatment is focused on preventing constipation and can be done through diet and medications. In some cases a bowel management program can be used to identify the correct medication dosage, and rarely, in very severe cases, surgery may be needed to help normalize bowel function and help prevent soiling. […] The good news is that with patience, encouragement and the right treatment, most children can develop good bowel control and live normal lives. […] Our goal is for your child to empty their bowel daily with no accidents and to live with as few limitations as possible. Success depends on your child’s condition and following your plan closely. […] Our team provides individualized diets, laxatives and psychosocial therapy to provide relief for children with constipation.

• #52 Treatment for Child Encopresis | Sydney Clinical Psychologists

  https://mindboxpsychology.com.au/child-psychology/treatment-for-child-encopresis/

  Co-existing emotional and behavioural disorders should be treated separately according to evidence-based recommendations. If your child also has anxiety, depression, or oppositional defiant disorder (ODD), these conditions should be treated concurrently. […] We use evidence-based approaches, including Cognitive Behaviour Therapy (CBT) and Behavioural Interventions, to provide tailored support for children struggling with encopresis (soiling), helping them build healthy toileting habits and reduce distress.

• #53 Encopresis Treatment & Management: Approach Considerations, Behavioral Therapy and Biofeedback, Pharmacologic Therapy

  https://emedicine.medscape.com/article/928795-treatment

  Despite the frequency with which childhood encopresis occurs, no large, randomized, controlled therapeutic trials have been conducted. As a result, treatment remains largely experiential rather than evidence based. Conventional medical therapy is commonly the first therapy attempted, generally consisting of the following: Demystification and education, Colonic disimpaction followed by routine laxative therapy, „Toilet training,” which is composed of regularly scheduled toileting, maintenance of a symptom diary, and an age-appropriate incentive scheme. The aim of this multimodal approach to therapy is to decrease the physical and emotional distress associated with defecation, to develop or restore normal bowel habits with positive reinforcement, and to encourage the child and parents to take an active role during the treatment. Conventional medical therapy proves successful in approximately one half of children with chronic constipation, encopresis, or both. If a child has not experienced significant clinical improvement after 2-4 months of therapy, a different therapy program may be indicated. Accordingly, it is appropriate to assess progress after 2-4 months of treatment. If the child remains symptomatic, consider enrolling him or her in an intensive behavior program that supplements conventional medical therapy. No evidence suggests that dietary interventions are beneficial in the management of encopresis. Although many people advocate high-fiber diets, the authors know of no studies conducted to systematically evaluate the effectiveness of dietary therapy in childhood encopresis. Although no surgical intervention has a proven role in the management of childhood encopresis, performing an appendicostomy or cecostomy to perform antegrade enemas in children who have proven refractory to medical therapy may improve their quality of life. In most cases of encopresis, consultation with a subspecialist is not absolutely necessary. Affected children are often referred to a pediatric gastroenterologist, a behavioral psychologist, or both.

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