Encopresis in children is often directly related to constipation. Here is some more information about this problem.
Smita was worried about her seven-year-old son Vinay. Vinay would consistently pass stools in his pants even though he was toilet trained. Most of the time, the accidents would occur at home. Lately, they had started to happen even when he was outside the house. Smita was fed up. She had tried shouting at him, punishing him, and even spanking him. However, nothing seemed to work. In desperation, she took him to the family doctor and told him what the problem was. There, her doctor told her that Vinay could be suffering from 'Encopresis'. Hearing her doctor's explanation, Smita began to understand that Vinay was not dirtying himself on purpose. He just could not help it.
What is encopresis?
Encopresis is a medical term given to a condition in which a toilet-trained individual passes faecal matter in any other area except the toilet. This means that even if there is a toilet available, the person will still pass a stool in his underwear. A person suffering from encopresis will exhibit this behaviour on a regular basis, which is different from an individual who may have simply had one or two bathroom 'accidents'. Although encopresis is primarily a childhood occurrence, it may also be seen in adults and in elderly people suffering from extreme dementia.
A child can only suffer from encopresis if he is already toilet trained. Therefore, encopresis can only strike children who are beyond the age of about five years. It is not a common disorder with only around three percent of children being affected. However, boys are three times more likely to suffer from encopresis than girls. There is no known medical reason to explain this ratio. Along with enuresis, or bedwetting, encopresis is commonly classified as an elimination problem.
How is it related to constipation?
A child suffering from encopresis may not feel the normal urge to go to the bathroom to pass faeces. This is because his bowel movements go undetected until it is too late. Encopresis in most cases is a result of constipation. Constipation itself may be due to dietary reasons or deliberate withholding of the stool.
Faeces pass through the colon before they are excreted from the body. In the colon, excess water is removed from the stool and recycled for other biological functions. If a child does not consume adequate amount of fluids each day, the stool that reaches the colon is already lacking water. When the colon further removes water from it, it becomes harder. This hard stool is difficult to pass and causes great pain when the child excretes it. Consequently, the child begins to associate pain with the bowel movements.
Because the child is afraid to pass stools, he may start to deliberately hold in his faeces. This further increases the problem. The faeces remain in the colon for a longer period and more water is extracted from them. From the colon, the stool passes into the rectum, which is the anal passage, before it is excreted out through the anus. If the stool is extremely hard, it may get lodged in the rectum and cannot proceed further. Thus the child becomes constipated.
This hard stool in the rectum may stretch and damage the rectum such that it can no longer detect the presence of faeces in it. It also weakens the muscles of the anus, which govern excretion. When new faeces are formed and pass through the colon, they cannot exit the body due the hard stool blocking their path. Eventually, some of the softer stools may manage to squeeze around the hard stool and enter the rectum. However, since the rectum cannot feel their presence, they pass undetected. The weakened anal muscles too cannot hold them in nor can they stimulate the contractions associated with passing stools. As a result, the stool is passed without the child being aware of it.
In cases where encopresis is caused due to constipation, the condition can be treated by solving the constipation problem. Constipation itself can easily be treated with a combination of medication and dietary changes. Your child will be back to his healthy self in no time.
Have you heard about encopresis? Do you know someone who suffers from this problem? What do you think of the relationship between encopresis and constipation? To share your views, tips, and experiences, click here.
