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          Treating Encopresis

          July 11, 2007

          Toilet training your toddlers is hard enough. But what happens when you still have to carry a diaper bag for kids approaching their teens?

          That’s the dilemma Beth and Doug face. Their 9- and 15-year-old sons suffer from encopresis, a complication of chronic constipation where the body pushes against the fecal material in a child’s colon, and they involuntarily leak stool.

          On an average day, the couple washes three to four loads of clothes. Their children have had accidents everywhere ” at church, while shopping, and while watching TV, and Beth dreads the thought of having company. “The first thing that they’re going to smell is dirty butt,” she says.

          Dr. Phil asks pediatrician Dr. Brown why encopresis is such a common disorder in children. Many believe that kids are lazy or misbehaving when they soil their clothes, but Dr. Brown says this is not the case. “These kids are not in denial that they have a problem. They actually have lost the urge [to go]. They don’t feel that sensation that they need to poop anymore,” she explains.

          Children with encopresis are often desensitized to odor. They experience nasal fatigue, which makes it difficult to detect the odor of their bowel movements. Further, kids with encopresis may have experienced hard stools when they were being potty trained, and they associate using the toilet with pain. “They don’t want to poop anymore, and it becomes a vicious cycle,” Dr. Brown says.

          She offers Doug and Beth several steps to treat their sons’ disorder. “We’re going to clean them out from below using laxatives. We’re going to clean them out from above by using stimulants. So laxatives and enemas, or a combination, to get things moved out,” she advises.

          Because encompresis takes a while to develop, Dr. Brown cautions the parents to exercise patience when treating the ailment. “You’re going to gradually go to a maintenance, where you’re decreasing those medications, so that the stool is nice and soft and happening regularly. The other really important piece is fiber. That’s going to be the long-term life solution ” for everybody. Then, the next thing is having them sit on the toilet regularly. After meals is the best time that your bowels are stimulated to go,” she suggests.

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