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[Psychosomatic approach to encopresis].
N Boige1, S Missonnier, M Bellaïche
1Service de pédiatrie, hôpital Andre-Mignot, Le Chesnay, France.
Summary
Encopresis, often linked to constipation and behavioral issues, requires a combined medical and psychological approach for effective treatment. Early intervention addressing both physical and emotional factors improves outcomes for affected children.
Area of Science:
- Pediatrics
- Child Psychology
- Gastroenterology
Background:
- Encopresis frequently stems from functional constipation and behavioral disorders involving fecal retention.
- It can signify challenges in sphincter control education, sometimes linked to autoeroticism over relational development.
- A depressive component is often observed in children with encopresis.
Purpose of the Study:
- To advocate for a bidisciplinary approach in evaluating and treating encopresis.
- To emphasize the importance of addressing both somatic and psychological aspects from the initial assessment.
- To outline a comprehensive therapeutic strategy for encopretic children.
Main Methods:
- Initiating a bidisciplinary evaluation including somatic and psychological assessments.
- Conducting a physical examination to identify constipation and stercoral stasis.
- Screening for associated psychopathological symptoms and pathogenic psychosocial situations.
Main Results:
- The physical exam helps diagnose constipation and stercoral stasis.
- Identifying psychological and psychosocial factors is crucial for understanding the dysfunction.
- Treatment requires addressing the diverse etiologic features of encopresis.
Conclusions:
- A bidisciplinary approach is essential for encopretic children, integrating physical and psychological care.
- Medical treatment for constipation is generally indicated, alongside psychotherapy tailored to individual needs.
- Educating the child and parents about the condition's origins is a vital first step in therapy.