Encopresis is one of the most frustrating difficulties of childhood . This is so not only for the child, but also for the father and mother, who often do not know how to act. It can be traumatic for children to have difficulty controlling their stools.
Furthermore, these children are often teased by their peers and are shamed and blamed by adults for their difficulty. In this article we will talk about what is important for families to know about encopresis.
What is encopresis?
Encopresis is part of the disorders of urine and stool elimination , called enuresis and encopresis, respectively. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these types of disorders are called excretion disorders. Although, they were previously called elimination disorders.
According to DSM-5 To receive this diagnosis, the following four characteristics must be present:
The chronological age of the patients must be at least 4 years.
The child repeatedly passes his bowel movements in inappropriate places (such as clothing). This can happen involuntarily or voluntarily.
At least one of these episodes occurs every month for at least 3 months.
This behavior does not occur as a result of substances (for example, laxatives), nor is it due to some other medical problem.
Different types of encopresis
We can talk about 2 types of encopresis :
Retentive encopresis: This type of encopresis is associated with cases of constipation.
Non-retentive encopresis: This type of encopresis occurs when there is no relationship between incontinence and periods of constipation.
Most of the time the encopresis is of the retentive type . Children with this type of encopresis have an underlying medical reason for not controlling their bowels. Non-retentive encopresis, on the other hand, does not have any physical condition that prevents normal behaviors of going to the bathroom.
How to manage encopresis
Mothers and fathers often have difficulties in knowing how to handle this delicate situation. Therefore, I would like to give you some tips so that you know how to handle encopresis if your child is in this situation.
First, go to the pediatrician to be able to make a proper diagnosis and explore the possible medical causes of the problem your child is having. The doctor may detect various problems and ask you to make changes to your child’s diet and / or activity level. One of the most important points is to seek early treatment for this problem.
Parents often feel embarrassed when their child has encopresis, which makes it more difficult for them to ask for help. My advice is, don’t wait for this problem to go away on its own. If the problem persists, the child’s self-esteem and confidence may be further damaged than necessary .
On the other hand, if your son gets his underwear dirty, don’t be angry or punish him. Don’t embarrass him either. With these types of attitudes you will only make your child’s self-esteem worse. I am aware that it may seem like intentional behavior at times, but it may not be under your child’s control or your child may not do better. Likewise, don’t blame your child . You won’t make the problem better, but it will make it feel worse about itself.
It can also be interesting to show the child that there are other children with the same problem that he has. In fact, you can explain to him that other children are likely to go to his school and the same thing happens to him. Consider teaching your child how the gut works and that it is possible to strengthen the muscles and nerves that control bowel function.
Using logs and rewards as a strategy
For some children it may be helpful to keep a record of situations in which they have not been able to control their stools and have had an accident. In this way, you can try to discover if there is a pattern in accidents or any specific trigger , that is, if they always occur in the dining room, when you go to a friend’s house, late in the afternoon.
Keeping track of accidents can cause anxiety for some children, while for others it helps them feel they have more power and control over the problem. Only use these types of strategies if they benefit your child, and always with the advice of a professional.
We can also use a reward system or token economy . The child can receive a point or sticker on a graph or table for each day that passes without staining. When you get a certain number of points, you can receive a toy or prize. It is important to note that this approach does not work for all children. In fact, in certain cases it can be counterproductive. Therefore, consult a professional who can advise you according to the specific situation and needs of your child.