Enhancing the management of secondary encopresis by assessing acceptability of treatment: a case study

This clinical case study utilized a behavioral treatment sequence to assist an 11-year-old encopretic male who had been refractory to prior treatments. The sequence included: (1) positive reinforcement of bowel movements and the non-occurrence of soiling accidents; (2) self-evaluation; (3) positive practice; (4) milk of magnesia; (5) diet modifications; and (6) a numbered underwear strategy. The treatment was initiated on a pediatric inpatient unit and then generalized to the child's home environment. Parental acceptability of treatment was assessed during a three-day home visit while the procedure was implemented by the parents. The combination of behavioral treatment with milk of magnesia eliminated soiling accidents and increased the frequency of appropriate bowel movements. Results were maintained throughout a one-year follow-up.