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A study of treatment resistance among children referred for encopresis
Insights
Children with persistent encopresis resistant to treatment had less initial stool retention and accidents throughout the day. Early treatment response did not predict long-term outcomes for encopresis in children.
Area of Science:
- Pediatric Gastroenterology
- Child Psychology
Background:
- Persistent encopresis is a common pediatric condition.
- Treatment resistance poses challenges in managing encopresis.
Purpose of the Study:
- Identify distinguishing characteristics of children with persistent encopresis resistant to intensive treatment.
- Explore factors predicting long-term treatment outcomes.
Main Methods:
- Longitudinal follow-up of children treated at a pediatric outpatient clinic.
- Comparison of characteristics between treatment-resistant and treatment-responsive encopresis groups.
Main Results:
- Children resistant to treatment showed less initial stool retention.
- Accidents in resistant children occurred throughout the day.
- Early treatment success/failure did not predict long-term resistance.
Conclusions:
- Less initial stool retention and continuous accident patterns are risk factors for treatment resistance in encopresis.
- Parental attributions may influence treatment outcomes.
- Identifying high-risk factors is crucial for intensive intervention in encopresis.
Abstract:
This study reports on some of the distinguishing characteristics of children with persistent encopresis who have proven, at long-term follow-up, to be resistant to intensive pediatric-based treatment at a referral outpatient clinic. Resistant children differed from responsive children primarily in two respects: they tended to have less stool retention at initial presentation, and their accidents occurred at all hours of the day. Additional information suggested that early success or failure did not presage long-term resistance and that parents' attributions of the cause of their child's soiling were related to outcome. Discussion centered on enumerating important high-risk factors that signal the need for more intensive intervention and follow-up.