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Encopresis
1Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Iowa, Iowa City, 52242-1083, USA. vera-loening-baucke@uiowa.edu
Insights
Encopresis treatment, involving education and behavioral changes, significantly improves symptoms in children. Recovery rates are high, with substantial improvement seen within five years.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Encopresis, or fecal incontinence, can be challenging to differentiate from other causes of fecal soiling.
- Functional constipation often underlies encopresis in children, necessitating a tailored treatment approach.
Purpose of the Study:
- To outline diagnostic and therapeutic strategies for managing encopresis in children.
- To emphasize the importance of a comprehensive treatment plan for successful outcomes.
Main Methods:
- Differentiating encopresis from organic causes through detailed history and physical examination.
- Employing a treatment regimen combining education, behavioral interventions, and medical therapy (laxatives when indicated).
Main Results:
- Most children with encopresis, with or without constipation, benefit from minimal laboratory workup.
- Successful management requires consistent adherence to the treatment plan by both child and parents.
- Dramatic improvement in encopresis symptoms is commonly observed.
Conclusions:
- Effective encopresis management relies on a multi-faceted approach, including behavioral modification and, when necessary, laxative therapy.
- High recovery rates are achievable, with significant long-term improvement reported within five years of treatment.
Abstract:
A careful history and physical examination will help to differentiate between encopresis with or without constipation and fecal incontinence caused by anatomic or organic disease. Most children with encopresis with or without functional constipation require no or minimal laboratory workup. Successful treatment of encopresis requires a combination of parent and child education, behavioral intervention, medical therapy, and long-term compliance with the treatment regimen. The conventional treatment approach consists of behavior modification and laxative for children with encopresis with constipation and behavior modification alone for the few children with encopresis without constipation. Almost every patient will experience dramatic improvement in encopresis. Recovery rates are 30% to 50% after 1 year and 48% to 75% after 5 years.