Encopresis and enuresis, while both referring to types of incontinence, are very different. Encopresis refers to soiling of the pants by feces, usually due to an impacted stool in a child who resists having bowel movements. Enuresis is urinary incontinence, most often seen in small children at night and referred to more commonly as bed-wetting.
While symptoms of both encopresis and enuresis may be seen during toilet training, and enuresis may be a normal developmental stage in children, both may become problematic if they are prolonged, or found in adults. Incontinence is common in the elderly, due to a loss of bowel and bladder control. Some medications may also cause encopresis and enuresis, and removing causative factors such as these are the first step in treatment.
Encopresis usually occurs in children who refuse to defecate. It is only diagnosed after the age of four, as before this, fecal soiling is normally just part of toilet training. Encopresis occurs because the feces become impacted and cause small amounts of liquid stool to soil the pants. This is called paradoxical diarrhea. It may be caused by chronic constipation, and there is sometimes a psychological component to the problem, which may require treatment.
Enuresis is urinary incontinence. In young children it is often just a stage, most commonly occurring at night, but may be a sign of psychological disturbance, which should be fully investigated. In adults, enuresis may occur in old age, or may be a sign of an underlying disorder such as a urinary tract infection, physiological urinary tract problems, or bladder cancer. Enuresis in adults requires thorough medical investigation to establish the cause.
Treatment for encopresis and enuresis differs due to their different mechanisms. Encopresis caused by chronic constipation is treated using laxatives where necessary and bowel training. Enuresis in children is treated firstly with non-drug measures such as moisture alarms and routine changing or cognitive therapy. In severe, non-responsive cases, anti-diuretic hormones such as desmopressin or DDAVP, anti-cholinergic drugs such as oxybutynin, or tricyclic antidepressants such as imipramine may be prescribed.
The first step in the treatment of encopresis and enuresis is removal of the causative factor, be it constipation, a urinary tract infection, or a psychological condition. While the conditions differ, both may cause extreme distress in children and adults, often resulting in a vicious cycle of anxiety and worsening of the problem. Patience is key in treating either condition.