Encopresis is the accidental or deliberate passing of stool into clothing rather than the toilet, occurring most often in toilet-trained children over four years old. Constipation is the primary cause of encopresis, but the underlying cause of the constipation can be eating habits, deliberately holding stool in because of past, physically painful toilet experiences, or as a result of emotional distress. The best encopresis treatment occurs in steps beginning first by clearing the impacted bowels, followed by producing regular soft stools, and finally by promoting healthy and regular bowel movements and use of the toilet. If psychological problems caused the encopresis, the child should see a therapist to help him deal with the underlying issues. Sometimes, it is helpful for a parent or the primary care-giver to speak with the therapist so the child is given consistent, positive support at home.
A child will often soil their clothing because his bowels have become severely impacted or blocked by constipation and only small amounts of loose stool are able to leak out. The first part of encopresis treatment is to clean the bowels of the impacted fecal matter. A doctor should be consulted to determine how severely the bowels are blocked and which course of encopresis treatment is best, but several methods are available. Suppositories, stool softeners, and enemas are often used to pass the impacted stool, although enemas are sometimes traumatic for a child, especially a child with bathroom issues.
Once the bowels have been cleared, the next step in encopresis treatment is to find a way to keep the child's stool soft so that he will routinely pass it with ease, preventing painful visits to the bathroom. The best way to keep the stool soft is to change the child's diet to one filled with fiber, fruits, vegetables, and stool-softening juices such as apple, pear, and prune juice. These changes can be difficult, and often take time. In the interim, many doctors will suggest a mild stool softener or laxative be taken daily. Gradually, as the diet begins to improve, the stool softeners or laxatives can be decreased and eventually stopped.
The final step in encopresis treatment is to establish regular bathroom use and success by encouraging the child to go to the bathroom around the same time every day. The experience should be kept stress-free and praise should be given for trying. Children will often need to sit for a while before they have success, so reading books, game books, or even toys may be used to pass the time and reduce anxiety. If the child has developed encopresis as a result of psychological trauma, a therapist should also be seen at this stage to discuss the problem. The therapist should also advise the child and parent on how to promote bathroom visits and stay positive.