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Overflow encopresis and stool toileting refusal during toilet training: a prospective study on the effect of
1Department of Pediatrics, The Children's Hospital, University of Pennsylvania School of Medicine, Philadelphia, USA.
Insights
Many children with overflow encopresis struggle with stool toileting refusal during toilet training. Primary encopresis cases showed resistance to medical treatment, unlike secondary encopresis.
Area of Science:
- Pediatrics
- Gastroenterology
- Child Psychology
Background:
- Overflow encopresis is a common condition in children.
- Stool toileting refusal can complicate toilet training for bowel movements.
- Understanding factors influencing treatment outcomes is crucial.
Purpose of the Study:
- To determine the incidence of stool toileting refusal in children with overflow encopresis.
- To evaluate the impact of stool toileting refusal on treatment response.
- To compare treatment outcomes between primary and secondary encopresis.
Main Methods:
- Retrospective analysis of 53 children with overflow encopresis.
- Assessment of stool toileting refusal during toilet training.
- One-year follow-up data collection for 43 children.
- Comparison of treatment outcomes based on encopresis type and duration of soiling.
Main Results:
- 45% of children experienced difficulty with toilet training for bowel movements.
- Children with soiling for less than 1 year had higher success rates (91%) compared to those soiling longer (55%).
- Children with primary encopresis showed significantly poorer treatment outcomes (1/12) compared to secondary encopresis (21/37, p=0.003).
Conclusions:
- Stool toileting refusal is a significant issue in overflow encopresis.
- Duration of soiling and type of encopresis (primary vs. secondary) are key factors in treatment success.
- Children with primary encopresis and stool toileting refusal are resistant to medical treatment.
Abstract:
We determined the incidence of stool toileting refusal in 53 children with overflow encopresis; 24 (45%) experienced difficulty toilet training for bowel movements. One-year follow-up data were obtained for 43 children, 31 with secondary encopresis and 12 with primary encopresis. Among the children with secondary encopresis, no difference was observed in response to treatment between children with and without difficulty toilet training. Ninety-one percent (11 of 12) of the children who had been soiling for less than 1 year at the time of presentation were free of soiling and no longer required therapeutic medication, compared with 55% (10 of 18) of the children who had been soiling for a longer period. Only 1 of 12 children with primary encopresis was free of soiling and no longer receiving therapeutic medication at 1 year, compared with 21 of 37 with secondary encopresis (p = 0.003). We concluded that children with primary encopresis who demonstrated stool toileting refusal during toilet training were resistant to medical treatment.