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Constipation in Childhood: Encopresis

The word encopresis was coined by Weissenberg in 1926, who considered this the equivalent of enuresis. Now encopresis is defined as the repetitive passage of formed, semi-formed or liquid stool into the clothing, with no demonstrable organic cause, in a child who should be toilet-trained.

Constipation can cause encopresis. Fecal impaction of the rectum leads to stretching of the rectal wall as well as to stretching and shortening of the anal canal. Normal sensations disappear, and normal function of rectum and sphincters is impaired. Involuntary passage of soft stool around the impaction results. The parents often think that the child has diarrhea. Medical treatment is often not sought for a long time.

Constipation_in_Childhood_Encopresis

Many parents have used punitive measures to control the problem without success.

In most instances, psychologic problems are the result of encopresis and not the cause. A psychiatric disorder is likely if the older child passes normal bowel movements regularly into the underclothes and careful evaluation shows no evidence of constipation.

Urinary tract problems are commonly associated with fecal impaction in both sexes and are most likely related to mechanical compression of the bladder. Ascending urinary tract infection develops frequently in girls with encopresis.

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