Enuresis and encopresis

Enuresis and encopresis must be seen as symptoms, not diseases, occurring in heterogeneous groups of children. A number of known factors are etiologically relevant to each symptom, and it is likely that others remain to be discovered. Both enuresis and encopresis are truly psychosomatic entities, in which psychosocial and physiologic elements act and react with one another in the development and maintenance of the problem. Further research, emphasizing concurrent psychological and biologic evaluation, is needed to answer the many still remaining questions about the etiology, natural course, and treatment of these common childhood symptoms. Psychiatrists should be available as consultants to colleagues in primary care during the evaluation of enuretic and encopretic children and should be ready to treat a subgroup of symptomatic children who have identifiable psychopathology.