No-enema therapy for idiopathic constipation and encopresis
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E E Gleghorn1, M B Heyman, C D Rudolph
1Children's Hospital Medical Center, Oakland, CA.
Insights
Idiopathic constipation and encopresis in children often stem from withholding stool. Successful treatment is achievable without enemas, offering a viable alternative for pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Dysfunction
Background:
- Idiopathic constipation and encopresis in children are often linked to volitional stool withholding.
- This withholding can be triggered by social pressures or painful defecation, potentially leading to colonic dilatation and dysfunction.
Purpose of the Study:
- To evaluate the efficacy of a treatment approach for childhood constipation and encopresis that excludes the use of enemas.
Main Methods:
- A retrospective review was conducted on 45 pediatric patients treated for constipation and encopresis without enemas.
- Patient outcomes were followed for a six-month period.
Main Results:
- Ninety-eight percent of patients achieved successful initial stool cleanout without enemas.
- Continued treatment success was observed in 94% of patients at the six-month follow-up.
Conclusions:
- Therapy for childhood constipation and encopresis without enemas demonstrates high success rates.
- This approach is a reasonable and effective alternative to traditional treatments involving enemas.
Abstract:
Idiopathic constipation and encopresis of childhood are thought to occur when children volitionally withhold stool. Withholding may be prompted by social pressures or by episodes of painful defecation. Repetitive withholding may result in colonic dilatation and colorectal dysfunction. Therapy involves removal of impacted stool, stool softening, and behavioral therapy. The use of enemas in this therapy is widespread but may be counterproductive. A retrospective review of patients treated without enemas revealed 45 patients whose course could be followed for six months. Ninety-eight percent of these had successful initial cleanouts without enemas; 94% had continued success at six months. These results, comparable with other treatment programs, demonstrate that therapy without enemas is a reasonable alternative in the treatment of childhood constipation and encopresis.