Materiały źródłowe

• #1 Encopresis – StatPearls – NCBI Bookshelf

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

  The prevalence of encopresis worldwide is estimated between 0.8% and 7.8%. […] In the United States, a prevalence rate of 4% for functional encopresis was found in a retrospective review in four hundred and eighty-two children, 4 to 17 years of age, attending a primary care clinic. Encopresis was related to constipation in 95% of the children in this study. […] Fecal incontinence is more common in boys, having a male-to-female ratio of 3:1 to 6:1. […] Functional encopresis is more common in younger children (prevalence 4.1% in children ranging from 5 to 6 years of age and 1.6% in 11- to 12-year-olds), and the majority of children seek medical care at the age of 7 to 8 years. […] Encopresis can also be seen during the young adulthood period. […] Encopresis usually happens during the day time, and organic causes should be considered if the provider encounters the patient who presents with only nocturnal encopresis.

• #2 Encopresis – Wikipedia

  https://en.wikipedia.org/wiki/Encopresis

  Encopresis is voluntary or involuntary passage of feces outside of toilet-trained contexts (fecal soiling) in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into their undergarments. […] The estimated prevalence of encopresis in four-year-olds is between one and three percent. The disorder is thought to be more common in males than females, by a factor of 6 to 1.

• #3

  https://confidenceclub.co.uk/blogs/news/soiling-in-children-why-it-occurs-what-to-do

  If your child is experiencing poo accidents after the age of four years old, this is why it may be occurring and what you can do as a parent or carer to help them manage and prevent it. […] If your child is toilet trained and is experiencing soiling after the age of four, its important that they are medically assessed. As for how common it is, studies have shown that soiling (also known as encopresis or faecal incontinence) affects 3% of 4-year-olds and 1.6% of 10-year-old children. Its also estimated that 0.75% of kids between the ages of 10 and 12 also experience soiling. […] Other causes of soiling or faecal incontinence in children can include neurological disorders, developmental delays, abnormalities of or nerve damage to the anus/rectum, and rectal surgery. […] Your first port of call, if you notice your child is experiencing soiling, is to visit their GP. Ensuring your child receives a professional medical assessment means they’ll receive the appropriate treatment and avoid the condition worsening.

• #4 Encopresis Causes, Symptoms & Treatment

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

  Encopresis, also known as functional fecal incontinence or soiling, is when children pass stool (poop) into their underwear, in most cases accidentally. It occurs in children 4 years of age and older who have been toilet trained. The condition is more common in boys than girls. It affects 1% to 4% of children who are 4 years old, and the frequency of this condition decreases with older age. […] The most common cause of encopresis is constipation. When a child experiences constipation, its difficult to have a bowel movement because their stool is dry and hard inside their colon and it can be painful to pass. […] Encopresis could be a symptom of an underlying medical condition. Possible conditions that have encopresis as a symptom include: Colonic inertia: The colon doesnt move stool as it should.

• #5 Encopresis: Practice Essentials, Background, Pathophysiology

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

  Nearly all of the few published population-based studies examining the prevalence of encopresis have been conducted in North America and Europe. In one such study conducted in the Netherlands, 4.1% of children aged 5-6 years and 1.6% of children aged 11-12 years experienced fecal soiling at least once per month. […] In nearly all published series, boys are much more commonly affected than girls. In most series, approximately 80% of affected children are boys.

• #6 What are Elimination Disorders? – Telepsychiatry in Florida

  https://hupcfl.com/health-library/what-are-elimination-disorders/

  The prevalence of enuresis ranges from 5 to 10 percent in 5-year-olds, 1.4 to 5 percent in 9- to 10-year-olds, and about 1 percent in adolescents 15 years and older. […] Encopresis has been estimated to affect 3 percent of 4-year-old and 1.6 percent of 10-year-old children. […] Males are found to have encopresis three to six times more frequently than females.

• #7

  https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Fecal-Soiling.aspx

  Fecal soiling, referred to medically as encopresis in children over four years of age, affects about 1.5 percent of young school children, with boys outnumbering girls by a ratio of six to one. […] In most cases, however, fecal soiling is not voluntary, but occurs when emotional stress, resistance to toilet training, or physical pain during bowel movements causes a child to resist having bowel movements. […] If the problem continues beyond one or two accidents, however, be sure to make an appointment with your child’s pediatrician. […] If these physical causes have also been eliminated, emotional or psychological causes should be considered. […] Fecal soiling can occur when a child is anxious or emotionally distraught over some aspect of his life over which he has little control, such as family conflicts, academic difficulties, or problems with social relationships.

• #8 Encopresis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/encopresis

  Encopresis is also known as fecal soiling. It occurs when a child (usually over the age of 4) has a bowel movement and soils their pants. This problem is most often linked to constipation. […] Just because encopresis is associated with psychological causes doesnt mean that the symptoms are under your childs control. Theyre most likely not soiling themselves on purpose. The problem may begin because of controllable situations, such as fear of using a public toilet or not wanting to be toilet trained, but it becomes involuntary over time. […] Certain common risk factors increase your childs likelihood of developing encopresis. These include: repeated bouts of constipation, changing your childs toileting routine, poor toilet training. […] According to Stanford Childrens Health, boys are six times more likely to develop encopresis than girls. The reason for this difference is unknown.

• #8 Encopresis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/encopresis

  Encopresis is typically diagnosed based on the reported symptoms, a medical history, and a physical exam. […] If emotional distress or an underlying behavioral problem is present, your child may need psychological counseling. A counselor can help address related issues. They can help children develop coping skills and build self-esteem. […] Adopt a healthy approach to toilet training your child. Don’t start toilet training until your child is ready. Typically, children aren’t ready for training until after they turn 2 years old.

• #9 Encopresis in Children – A Quick Guide – Child Mind Institute

  https://childmind.org/guide/quick-guide-to-encopresis/

  Other times, encopresis happens when a child has a bad experience with toilet training or when they start school and have to use a public or shared bathroom for the first time. […] Other upsetting things in a child’s life — like moving or parents getting a divorce — can cause constipation that leads to encopresis. […] Encopresis sometimes goes along with developmental disorders. In those cases, the child might never have been toilet trained. When kids who have already been toilet trained develop encopresis, the cause is usually some kind of stressful experience. […] A child must be at least the age of four and poop in places like their underwear or the floor. It must happen at least once a month for at least three months. Before making a diagnosis of encopresis, a doctor will rule out things like food allergies or medicines that act as laxatives.

• #9 Encopresis in Children – A Quick Guide – Child Mind Institute

  https://childmind.org/guide/quick-guide-to-encopresis/

  Encopresis (or soiling) is a disorder in which a child over the age of four repeatedly poops in places other than the toilet, like their underwear or the floor. Some children with encopresis have problems with normal pooping, like constipation. Some children are afraid or anxious about pooping, so they try to hold it. In either case, not pooping for a long time makes it so the child can’t control it when they do finally poop. In some cases, when the encopresis is not because of constipation or holding it on purpose, it may be a sign of another psychiatric disorder. […] Encopresis is diagnosed when a child is over the age of four and often poops in places other than the toilet, like in their clothes or on the floor. […] Constipation is the most likely cause of encopresis. When a child becomes constipated then pooping can be painful and so the child tries not to poop at all. This causes the poop to get hard and then it’s even more painful for the child to defecate. This pattern causes the child to hold it to avoid the pain. After a while, the softer poop behind the hard poop leaks out at times and places the child can’t control.

• #9 Encopresis in Children – A Quick Guide – Child Mind Institute

  https://childmind.org/guide/quick-guide-to-encopresis/

  There are a few steps to treating encopresis: First, a doctor will give the child something like a laxative to help get out built-up poop. Then, the child will take a smaller daily dose of a medicine to keep their poop soft so that it doesn’t hurt when they go. The third part of treatment is teaching the child to poop normally. This usually means having them sit on the toilet for 10–15 minutes at the same time every day (usually after eating), to get them used to pooping in a regular way that doesn’t hurt. The doctor might also recommend changes in the child’s diet. If the child has feelings of shame or guilt about their encopresis, a therapist can help them deal with those feelings and learn ways of pooping normally. […] Kids with encopresis are often teased by siblings and classmates. Parents should watch out for low self-esteem and depression in children with encopresis.

• #10 Faecal incontinence, soiling or encopresis | Raising Children Network

  https://raisingchildren.net.au/school-age/health-daily-care/toileting/faecal-incontinence

  Faecal incontinence is when children who are 4 years old or older cant control when and where they do a poo. This means that they regularly do poos in places other than the toilet, most often in their underwear. […] Faecal incontinence is also called encopresis or soiling. […] Constipation and faecal incontinence are more common in children with attention deficit hyperactivity disorder (ADHD) and autistic children. […] The main symptom of faecal incontinence is pooing in places other than the toilet, usually in underwear. This can range from skid marks to larger bits of poo. […] You should see your GP for advice about treatment and management if you think your child is constipated or if your child: is 4 years old and cant yet control when or where they poo. […] The treatment for faecal incontinence depends on its cause.

• #11 Early childhood risk factors for constipation and soiling at school age: an observational cohort study | BMJ Paediatrics Open

  https://bmjpaedsopen.bmj.com/content/2/1/e000230

  Objective Constipation and soiling are common in childhood. This study examines the comorbidity between childhood constipation and soiling and early childhood risk factors for these problems. […] We extracted four latent classes: normative (74.5%: very low probability of constipation or soiling), constipation alone (13.2%), soiling alone (7.5%) and constipation with soiling (4.8%). […] Constipation alone was the most prevalent pattern in this cohort. Treatment for hard stools in early childhood is needed to prevent chronic constipation at school age. […] This study finds evidence that risk factors in early childhood are differentially associated with different trajectories of childhood constipation and soiling. […] Experiencing hard stools in early childhood is a risk factor for constipation; developmental delay is a risk factor for soiling alone and constipation with soiling.

• #11 Early childhood risk factors for constipation and soiling at school age: an observational cohort study | BMJ Paediatrics Open

  https://bmjpaedsopen.bmj.com/content/2/1/e000230

  We found that hard stools in early childhood were associated with an increased odds of constipation alone at school age, as well as a reduced risk for soiling alone. […] We found little evidence that socioeconomic factors are associated with childhood constipation and soiling. Developmental delay was associated with any soiling but not with constipation alone. […] This study finds evidence that experiencing hard stools in early childhood is a risk factor for later problems with constipation at school age.

• #12

  https://link.springer.com/article/10.1007/s00787-018-1162-8

  We found evidence that sleep problems at 3 years were associated with constipation and soiling at school age. […] In agreement with earlier studies, stressful events were associated with constipation with and without soiling, but stressful events were not associated with soiling alone. […] The strong association between constipation/soiling and psychological problems has implications for clinicians treating these children since these co-morbidities can adversely affect treatment outcomes.

• #13 Treatment Guidelines for Primary Nonretentive Encopresis and Stool Toileting Refusal | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0415/p2171.html

  Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency. An organic cause for nonretentive encopresis is rarely identified. The medical assessment is usually normal, and signs of constipation are noticeably absent. […] Encopresis affects 1 to 3 percent of children, with higher rates in boys than in girls. However, encopresis may go undetected unless health professionals directly inquire about toileting habits. […] From 80 to 95 percent of encopresis cases involve fecal constipation and retention. Although several excellent reviews cover retentive encopresis, encopresis in which fecal retention is not a primary etiologic component is under-represented in the literature.

• #13 Treatment Guidelines for Primary Nonretentive Encopresis and Stool Toileting Refusal | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0415/p2171.html

  While the treatment of retentive encopresis has progressed substantially in the past 20 years, less attention has been paid to the 5 to 20 percent of cases in which constipation is not contributory, or where a child refuses the toilet-training process. […] Many children with fecal soiling have a history of painful defecation, toilet phobia or toilet refusal behavior. […] It is critical to ensure that the child is having relatively frequent, soft and well-formed bowel movements before engaging in any intervention for soiling. […] Although ensuring frequent, soft and well-formed bowel movements should reduce the likelihood of a child withholding fecal material, a back-up plan is necessary. […] The following illustrative case demonstrates the efficacy of these treatment guidelines in a child with nonretentive encopresis and toileting refusal.

• #14 Encopresis – Help For Your ChildVisit our FacebookVisit our YouTube channelsearchcrosslinkedinfacebookpinterestyoutubersstwitterinstagramfacebook-blankrss-blanklinkedin-blankpinterestyoutubetwitterinstagram

  https://helpforyourchild.com/encopresis/

  Encopresis affects 1 to 3 percent of children, with higher rates in boys than in girls. However, encopresis may go undetected unless health professionals directly inquire about toileting habits. […] From 80 to 95 percent of encopresis cases involve fecal constipation and retention. Although several excellent reviews cover retentive encopresis, encopresis in which fecal retention is not a primary etiologic component is under-represented in the literature. Typically, children with the latter condition soil on a daily basis, with bowel movements of normal size and consistency. […] Various terms have been used to describe this problem, including functional encopresis, primary nonretentive encopresis and stool toileting refusal. These children may be further divided into at least four subgroups: (1) those who fail to obtain initial bowel training, (2) those who exhibit toilet „phobia,” (3) those who use soiling to „manipulate” their environment and (4) those who have irritable bowel syndrome.

• #14 Encopresis – Help For Your ChildVisit our FacebookVisit our YouTube channelsearchcrosslinkedinfacebookpinterestyoutubersstwitterinstagramfacebook-blankrss-blanklinkedin-blankpinterestyoutubetwitterinstagram

  https://helpforyourchild.com/encopresis/

  While the treatment of retentive encopresis has progressed substantially in the past 20 years, less attention has been paid to the 5 to 20 percent of cases in which constipation is not contributory, or where a child „refuses” the toilet-training process. […] Once the reason for a child’s resistance is identified, specific interventions can be initiated. […] It is critical to ensure that the child is having relatively frequent, soft and well-formed bowel movements before engaging in any intervention for soiling. […] Although ensuring frequent, soft and well-formed bowel movements should reduce the likelihood of a child withholding fecal material, a back-up plan is necessary.

• #15

  https://journals.lww.com/jrnldbp/Fulltext/2006/02000/The_Relevance_of_Fecal_Soiling_as_an_Indicator_of.4.aspx?generateEpub=Article%7Cjrnldbp:2006:02000:00004%7C%7C

  Encopresis is typically characterized as resulting from chronic constipation with overflow soiling but has been portrayed as an indicator of sexual abuse. The predictive utility of fecal soiling as an indicator of sexual abuse status was examined. Reported soiling rates were 10.3% (abuse), 10.5% (psychiatric), and 2% (normative), respectively. The soiling rate in the abused group differed significantly from that of the normative group, but not from the psychiatric group. The predictive utility of fecal soiling as an indicator of sexual abuse in children is not supported. Soiling seems to represent one of many stress-induced dysregulated behaviors. […] Clinicians should assume the symptom of soiling is most likely related to the typical pathology and treat accordingly.

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

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

  If your child has bowel movements (BMs) in places other than the toilet, you know how frustrating it can be. […] But many kids beyond the age of toilet teaching (generally older than 4 years) who soil their underwear have a condition known as encopresis (en-kah-PREE-sis). […] Encopresis is not a behavioral issue or a simple lack of self-control. […] Soiling and constipation are a top reason that kids go to see pediatric gastroenterologists (doctors who diagnose and treat disorders of the stomach and intestines). […] Kids can’t prevent this soiling and sometimes don’t know it’s happening because the nerves aren’t sending the signals that regulate pooping. […] Supporting kids and finding and treating the cause of the soiling will help it get better. […] 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.

• #17 Soiling (Encopresis) | Dayton Children’s Hospital

  https://www.childrensdayton.org/kidshealth/a/encopresis

  If your child has bowel movements (BMs) in places other than the toilet, you know how frustrating it can be. […] But many kids beyond the age of toilet teaching (generally older than 4 years) who soil their underwear have a condition known as encopresis (en-kah-PREE-sis). […] Soiling and constipation are a top reason that kids go to see pediatric gastroenterologists (doctors who diagnose and treat disorders of the stomach and intestines). […] Kids can’t prevent this soiling and sometimes dont know it’s happening because the nerves aren’t sending the signals that regulate pooping. […] Supporting kids and finding and treating the cause of the soiling will help it get better. […] 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. […] 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.

• #18 Soiling (child pooing their pants)

  https://www.nhs.uk/conditions/soiling-child-pooing-their-pants/

  Soiling is when a child regularly poos their pants. If they’re already potty-trained, the soiling is usually because they are badly constipated. Treatment from a GP can help. […] Soiling usually happens when a child is so constipated that a large, hard piece of poo becomes stuck at the end of their gut (rectum). […] Non-urgent advice: See a GP if: your child is regularly pooing their pants (soiling). […] Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if: your child is pooing their pants (soiling), has a swollen tummy and is being sick. […] If your child is pooing their pants (soiling) because they’re constipated, a GP can prescribe laxatives to clear out the hard poo and get your child pooing regularly and comfortably again. […] A GP may refer your child to a specialist for treatment if they think soiling could be caused by another medical condition.

• #19 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=90&contentid=P01992

  Encopresis is when your child leaks stool into his or her underwear. It is also called stool soiling. It is most often because of long-term (chronic) constipation. Encopresis happens to children (generally 4 or older) who have already been toilet trained. […] In most cases, stool soiling happens by accident. Encopresis can be very embarrassing for your child. […] In most cases encopresis happens because a child has long-term (chronic) constipation. […] Over time, liquid stool can start to leak around the hard, dry, impacted stool. This soils your child’s clothing. […] Any child who has long-term (chronic) constipation may develop encopresis. […] Encopresis affects boys more than girls. Experts don’t know why. […] Your child’s healthcare provider will give your child an exam and take a health history.

• #19 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=90&contentid=P01992

  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 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. […] Encopresis can cause both physical and emotional problems. […] Children with encopresis often feel upset by the accidents they have when they soil their clothes. […] You may help prevent stool soiling if you avoid any emotional upsets while your child is toilet training. […] Making changes in your child’s diet and activity level may help prevent constipation and stool soiling.

• #20 Pediatrics and Pelvic Health: Skid marks, Poop Accidents, Constipation

  https://fusionwellnesspt.com/blog/pediatrics-and-pelvic-health-encoporesis-skid-marks-poop-accidents-and-constipation

  Encopresis is fecal soiling associated with functional constipation in a child. The soiling often happens in the underwear, where the child loses whole pieces of formed bowel, liquid bowel, or has fecal staining on the underwear due to the inability to get clean when wiping. Constipation and encopresis are common problems in children. Encopresis is most common between ages 3 and 7 years. […] According to Olaru et al. (2016), up to about 84% of children with chronic functional constipation experience fecal accidents in the form of skid marks, difficulty getting clean while wiping, and fecal accidents. […] If your child is suffering from encoporesis, skid marks, poop accidents, and/or constipation, give the therapists at Fusion Wellness and Physical Therapy a call today!

• #21 Encopresis | Children’s Hospital of Philadelphia

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

  Encopresis is a problem that children age 4 or older can develop due to chronic (long-term) constipation. […] The rectum and intestine become enlarged due to the hard, impacted stool. Eventually, the rectum and intestine have problems sensing the presence of stool, and the anal sphincter (the muscle at the end of the digestive tract that helps hold stool in) loses its strength. Liquid stool can start to leak around the hard, dry, impacted stool, soiling a child’s clothing. […] For unknown reasons, boys develop encopresis six times more than girls. […] Children with encopresis may feel emotionally upset by the „accidents” they have when they soil their clothes. […] Until the intestine and rectum regain their muscle tone, children may still have „accidents” and soil their underwear on occasion.

• #22 Soiling In Children | KidsHealth New Zealand’s Trusted Voice On Children’s Health

  https://www.hauoratairawhiti.org.nz/your-health/child-health/soiling-ecopresis/

  The treatment of constipation and soiling takes time – most tamariki need to take medicine for many months and often years to manage the problem. […] If your child is soiling, you should take them to a health professional. […] Your health professional may suggest your child sees a specialist nurse or doctor if your child’s soiling is proving difficult to treat after standard treatments or if the health professional thinks there may be another condition causing your child’s constipation and soiling. […] Treatment for soiling focuses on unblocking and emptying the bowel – usually with a bowel washout, taking laxatives to help your child do a soft poo at least once a day, and establishing a regular routine of sitting on the toilet. […] Soiling problems can be frustrating and upsetting for parents and tamariki. It’s important to understand the cause and not to blame your child for soiling. […] Remember the poo is the problem, not your child. Don’t blame them.

• #22 Soiling In Children | KidsHealth New Zealand’s Trusted Voice On Children’s Health

  https://www.hauoratairawhiti.org.nz/your-health/child-health/soiling-ecopresis/

  Soiling is when your child does poo in their pants after the age when you would expect them to be toilet-trained. Soiling is usually caused by long-lasting constipation and an overloaded bowel. […] Soiling (encopresis) is when your child does poo in their pants after the age when you would expect them to be toilet trained. Soiling is a common problem affecting many tamariki. It can happen in any child, toddler or teenager. […] Soiling is usually caused by long-lasting constipation and an overloaded bowel. […] Soiling problems can be frustrating and upsetting for parents and tamariki (children). […] You are not alone – there are many tamariki with this problem. […] Soiling occurs without your child knowing – it is not deliberate and your child did not develop this problem to upset you or be manipulative.

• #23 Wetting and Soiling – The Child Psychology Service

  https://thechildpsychologyservice.co.uk/advice-strategy/wetting-and-soiling/

  Go to town on minimising the shame of soiling and wetting. Your child is likely to feel enormous fear and shame about the problem. […] If it is possible that your child may be wetting and/or soiling with either the unconscious or conscious intention of making themselves or their bed inhospitable to their feared abuser then work with them to create more safety.

• #24 About Encopresis – Department of Pediatrics

  https://med.virginia.edu/pediatrics/clinical-and-patient-services/patient-tutorials/chronic-constipation-encopresis/about-encopresis/

  When somebody suffers from encopresis it means that he or she cant control their bowel movements and pass bowel movements in their underwear. Soiling and fecal incontinence mean the same thing. […] In most cases, encopresis develops as a result of long-standing constipation. […] The vast majority of children suffering from encopresis have a history of constipation or a history of passing large and/or painful bowel movements. […] In many cases, the child or the parents do not recall the constipation since it was so long ago. […] Children dont usually feel these accidents happening they just seem to happen. […] Accidents tend to occur more often during the daytime when the child is active and moving around, and only rarely do they occur at night while the child is asleep. […] In most cases, encopresis is not primarily a behavioral problem.

• #25

  http://hospitals.aku.edu/nairobi/AboutUs/News/Pages/Monitor-your-child’s-bowel-movements.aspx

  To diagnose encopresis, your healthcare provider will carry out several tests including asking some questions about your child#39;s medical history, symptoms, emotional wellbeing (stress), toilet training and diet. […] Treatment of encopresis is unique to each child. […] Because most children with the condition have retentive encopresis as a consequence of chronic constipation, therapy is initially focused on evacuating the distal colon. […] However, with patience and positive reinforcement, treatment for encopresis is usually successful. […] Early treatment, including guidance from your child#39;s doctor or mental health professional, can help prevent the social and emotional impact of encopresis.

Zobacz więcej