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PubMed2005

Daytime encopresis associated with gland mal epileptic seizures: case report.

Sphincteric incontinence of stool and urine are not unusual features of generalised epileptic seizures. Isolated secondary encopresis as a manifestation of an epileptic seizure is unusual. This report is of, a four year old boy, with daytime secondary non-retentive encopresis. The onset of encopresis was preceded by several episodes of nocturnal generalised tonic clonic epileptic seizures. An electroencephalogram showed features consistent with complex partial seizures. He was commenced on anti-epileptic treatment with phenytoin sodium, and by the third day of treatment, the patient had achieved stool control.

Child, Preschool↗
PubMed2003

Reflexology in the management of encopresis and chronic constipation.

Encopresis or faecal incontinence in children is an extremely distressing condition that is usually secondary to chronic constipation/stool withholding. Traditional management with enemas may add to the child's distress. This study investigated the efficacy of treating patients with encopresis and chronic constipation with reflexology. An observational study was carried out of 50 children between three and 14 years of age who had a diagnosis of encopresis/chronic constipation. The children received six sessions of 30-minutes of reflexology to their feet. With the help of their parents they completed questionnaires on bowel motions and soiling patterns before, during and after the treatment. A further questionnaire was completed by parents pre and post treatment on their attitude towards reflexology. Forty-eight of the children completed the sessions. The number of bowel motions increased and the incidence of soiling decreased. Parents were keen to try the reflexology and were satisfied with the effect of reflexology on their child's condition. It appears that reflexology has been an effective method of treating encopresis and constipation over a six-week period in this cohort of patients.

Adolescent↗
PubMed1975

Children with encopresis: A descriptive analysis.

During an 18-month period, 102 children with encopresis were seen in a general pediatric outpatient clinic. Through interviews and questionnaires, extensive historical information was obtained. Children were compared with respect to demographic characteristics, bowel-function histories, early training and management, and present manifestations of bowel dysfunction. A wide variety of historical backgrounds and manifestations was observed. It was found that many of the traditional generalizations about encopresis could not be substantiated. It is suggested that a very individualized approach to this problem be adopted and that children with encopresis be investigated carefully to uncover early developmental problems, critical life events, and the precise physiology and dynamics of present bowel dysfunction.

Adolescent↗
PubMed1991

Encopresis in children: a cyclical model of constipation and faecal retention.

Encopresis afflicts one in 100 children causing considerable stigma and parental concern. General practitioners are in a position to help in most cases but are often deterred by the psychoanalytical theories which have been developed to explain this problem. It is currently accepted that children with encopresis tend to retain stools. This leads to constipation, overstretching of sphincters and resultant faecal soiling. Physical and psychological perpetuating factors result in retention once again, thus completing a cycle of constipation and retention. Various precipitant and predisposing factors can maintain this cycle. Once physical causes have been excluded a simple behavioural approach can be adopted aimed at retraining the bowel. By using laxatives to prevent retention, gaining the child's confidence, cooperation and understanding and involving both the family and school, encopresis can be successfully managed in general practice.

Child, Preschool↗
PubMed1991

[Significance of electroencephalography in the physical examination of children with encopresis].

At an one time transversal examination 28 of 36 children with encopresis exhibited abnormal findings, increased incidence of sharp waves, a back ground that was too slow for their age and subcortical dysfunctions was striking. The abnormalities are approached as constitutional risks and maturational retardation with increased environmental propensity. Increased frequency of enuresis and encopresis in premature craniosynostosis was found. Electroencephalography should be used in paediatric and child psychiatric examination as a not burdening screening method for clarifying the aetiologic conditions of encopresis and getting hints of brain maturation, constitutional disorders and may be signs of brain damage.

Adolescent↗
PubMed1991

[Encopresis in children. Preliminary report of new therapeutic and diagnostic aspects].

There appears to be no strict boundary between encopresis, which is defined as a psychogenic disorder, and incontinence, in which there is an inability to retain faeces voluntarily. Our findings over an 8-year period suggest that unrecognized functional or organic retention disorders are present in encopresis more often than previously thought. Of 16 children with encopresis who were examined by perfusion manometry 14 were found to have disorders of anorectal functions. Of these, 7 showed pathologically low sphincteral pressure rates and 3 abnormally high rates with coordination disorders. Four had normal sphincteral pressure rates but considerably disturbed sensitivity. In the 3 children examined by MRI so far clear morphological changes were found. The question of whether the deviations found were the result of primary or secondary changes could not be clarified. However, of key importance is that these additional findings enable the use of a combined course of treatment (passive sphincter training by electrostimulation and active sphincter training with biofeedback) that seemed to bring improvement quickly and reliably.

Adolescent↗
PubMed1988

Behavioral ratings and outcome of medical treatment for encopresis.

The relationship between behavior problems and encopresis remains controversial. Recent research suggests that children with encopresis do have numerous behavior problems, but that these problems are generally not as severe as the behavior problems found in children referred for mental health services. This study explores the relationship between baseline behavior ratings of encopretic boys, ages 6-11, on a standardized rating form, the Child Behavior Checklist (CBCL), and outcome of medical treatment for their encopresis. A strong correlation between the product of the sum of the factors on the internalizing scales and the sum of the factors on the externalizing scales and their interaction on the CBCL was associated with outcome. Specifically, moderate elevations of this function predicted good outcome at 3, 6, and 12 months. Very high elevations and minimal or no elevation predicted poor outcome at 3, 6, and 12 months. Possible reasons for these somewhat surprising results are discussed.

Child↗
PubMed1979

Encopresis in adolescence: two case studies.

Encopresis is an underreported psychopathological symptom of adolescence, not necessarily defining a specific diagnostic entity. The two cases presented offer an opportunity to evaluate encopresis occurring in markedly different adolescent pathological entities and developmental backgrounds. The first patient presented a longitudinal life course wherein toilet training and fecal considerations were prominent throughout his development. Indeed, this young man had such areas of cohesive functioning, as to be appropriately considered within the range of characterological pathology, severe, though it may be. In marked contrast, the second patient's encopresis represented but a small part of a totally encompassing psychotic disintegration.

Adolescent↗
PubMed1995

Functional encopresis: symptom reduction and behavioral improvement.

This study assessed the relationship between functional encopresis and accompanying problems: emotional, behavioral, and social. Symptom resolution and changes in these concomitant problems were studied. Seventy-six children, 6 to 12 years of age, enrolled in this "self-selected," nonequivalent, control (contrast) group research design with 38 children in each group. Using the Child Behavior Checklist, children were tested before treatment and 6 months later. The results showed that children with encopresis had significantly more emotional/behavioral problems and poorer social competence before treatment than children in the contrast group; combined medical and psychotherapeutic intervention led to a significant reduction in soiling frequency, and children with encopresis experienced significantly fewer behavioral problems and significantly improved social competence after treatment. There was a small group of children for whom treatment was difficult. The data suggest that highly elevated behavior problem scores, especially in association with parental negativeness, may be related to poor treatment outcome.

Behavior Therapy↗
PubMed1993

[Diagnosis and therapy of functional encopresis].

Males clearly dominate within this diagnostic category with an overall prevalence rate between 1 and 2%. Functional encopresis is often connected with other emotional and behavioural problems. After excluding an organic incontinence the main aim of the diagnostic procedure is to search for stressors that may have caused the encopresis and now contribute to the stability of the disturbance. Usually indications of an early disturbed parent-child relation are found. Techniques of behavioural therapy are superior to psychoanalytical methods that do not surpass the rate of spontaneous remissions. The therapeutic approach by Wright and Walker is recommended, which comprises systematic rewards, glycerine suppositories and enemas. 78% of the such treated children showed a lasting remission. The connection of numerous other psychic disorders with encopresis is demonstrated by a case report.

Attention Deficit Disorder with Hyperactivity↗
PubMed1998

Encopresis in the school-aged child.

This paper defines encopresis, identifies associated characteristics and clinical presentation, and describes diagnosis and treatment plans. The use of a case study illustrates how encopresis may be encountered by the school nurse. Health promotion issues and prevention concepts are examined as possible means of facilitating prevention and management of encopresis in the school-aged child.

Child↗
PubMed1990

Encopresis: behavioral parameters associated with children who fail medical management.

The present study examined behavioral parameters such as parent management of encopresis and parental coping styles (active, cognitive, and avoidance) as predictors of success with medical management of encopresis. The results suggest that parents use a variety of management strategies and treatment success cannot be predicted using these variables. However, in line with previous research the presence of child behavior problems appeared to be a potential predictor variable.

Adolescent↗
PubMed1990

Combined medical and psychological treatment of hospitalized children with encopresis.

Sixteen children, all inpatients at a state psychiatric hospital, received combined medical and psychological treatment for encopresis. One-year follow-up showed significant improvement. The results suggest that encopresis can be treated in severely emotionally disturbed children with a multifaceted and multidisciplinary approach.

Behavior Therapy↗
PubMed1979

Chronic encopresis: a system based psychodynamic approach.

A successful method used in treating a series of five cases of chronic encopresis is reported. The method is a system based approach, taking into account the typically underlying hostile mother-child psychodynamics accompanying encopresis.

Child↗
PubMed1992

Chronic constipation with encopresis persisting beyond 15 years of age.

Childhood constipation with encopresis is a common malady. Previous reports suggest that essentially all patients either respond to standard treatments or have spontaneous recovery before 16 years of age. In this paper, we describe the results of anorectal function studies and treatment outcome in four patients in whom constipation and encopresis persisted beyond 15 years of age. Abnormalities in the ability to defecate water-filled balloons, in external sphincter relaxation with straining, in rectal sensation and development of the urge to defecate, and in maximum anal resting pressure were seen in some or all of these patients. In addition, two patients had impaired voluntary squeeze strength. Two patients responded to standard therapy; a colostomy was needed in one; and one failed therapy and has become a recluse.

Adolescent↗
PubMed1991

Randomised trial of laxatives in treatment of childhood encopresis.

Primary faecal incontinence (encopresis) in children is usually treated with laxative medication and a behaviour modification programme aimed at promoting regular toileting, but the effectiveness of laxatives has never been adequately investigated. 169 children with encopresis and evidence of stool on plain abdominal radiograph were randomly allocated to receive multimodal (MM) therapy (laxatives plus behaviour modification; n = 83) or behaviour modification alone (BM; n = 86). Mean (SD) follow-up was 55.1 (27.0) weeks and 56.7 (32.0) weeks, respectively. By 12 months' follow-up 42 (51%) of the MM group and 31 (36%) of the BM group (p = 0.079) had achieved remission (at least one 4 week period with no soiling episodes) and 52 (63%) vs 37 (43%) (p = 0.016) had achieved at least partial remission (soiling no more than once a week). MM subjects achieved remission significantly sooner than BM subjects, and the difference in the Kaplan-Meier remission curves was most striking in the first 30 weeks of follow-up (p = 0.012). The patterns of compliance with toileting in the treatment groups were almost identical, although about 1 in 8 children overall did not comply with the sitting programme. After exclusion of the 24 poor compliers, there was no significant difference between BM and MM groups. This study shows a clear advantage overall for the use of laxative medication, although the benefit may not be as great for children who are able to maintain regular toileting.

Adolescent↗
PubMed1993

Use of play with clay to treat children with intractable encopresis.

We used play with modeling clay to treat six children, aged 4 to 12 years, with a history of intractable constipation with encopresis for a mean of 5.4 (2 to 8) years, refractory to treatment; biofeedback therapy had not been tried. Clay was chosen because, as a brown, messy material, it was a metaphor for feces and could let the child express either his disgust or aggressivity, or let him build symbolic structures. No interpretation was made during treatment. Four children had no symptoms during 2 months of therapy and no relapse during 1 year of follow-up, one child improved significantly, and one child failed to respond but withdrew from treatment after only three sessions. Modeling clay may be a cheap and effective treatment modality for refractory constipation with encopresis.

Aluminum Silicates↗
PubMedDate not supplied

Management of encopresis in early adolescence in a medical-psychiatric unit.

The aim of this work is to present the role of a medical-psychiatric unit in the treatment of chronic resistant encopresis in adolescence as an effective alternative to the standard approach. Four case reports are presented. The integrative program is based on full patient cooperation and involves separating the patient from the family environment and the use of medical intervention combined with modified behavioral therapy and parental education and guidance. The patient is given full responsibility for the cure. The median full hospital stay for our patients was 2 weeks, and outcome in all cases was complete remission. This experience suggests that chronic resistant encopresis in adolescents requires a different approach from the standard because of the patient's developmental stage and the often hostile family dynamics. A medical-psychiatric setting provides an excellent management milieu and can lead to a dramatic improvement in this chronic disabling condition.

Adolescent↗