Evaluation of a standard protocol for retentive encopresis: a replication

Area of Science:

• Pediatric Gastroenterology
• Child Psychology
• Behavioral Medicine

Background:

• Retentive encopresis is a common pediatric condition often resistant to standard medical management.
• Previous research suggests combined interventions may improve outcomes for encopresis.
• This study aimed to replicate the efficacy of a specific combined protocol.

Purpose of the Study:

• To replicate the effectiveness of a short-term, combined medical and behavioral intervention for retentive encopresis.
• To evaluate the protocol's impact on soiling incidents and bowel movement frequency.
• To assess the long-term need for further treatment post-intervention.

Main Methods:

• Fifty-nine children with treatment-resistant encopresis and their parents attended six 1-hour group sessions.
• The protocol integrated medical strategies (enema clean out, fiber increase, toilet sitting) with behavioral strategies (differential attention, contingency management, contracting).
• Data collected pre- and post-treatment included soiling incidents, bowel movement frequency, and dietary fiber intake.

Main Results:

• An 85% decrease in soiling incidents was observed.
• Weekly independent bowel movements increased by 15%, and parent-prompted movements by 9%.
• 86% of children achieved continence and required no further treatment.

Conclusions:

• The combined medical and behavioral intervention protocol is effective for retentive encopresis, even in cases resistant to standard care.
• This approach offers a viable and successful treatment option for children with encopresis.
• The findings support the utility of integrated medical and psychological treatments for pediatric encopresis.