Encopresis Diagnosis and Overview

Overview and Diagnosis:

Encopresis is simply defined behaviorally as fecal soiling in inappropriate places for children over five years of age. It occurs in two to three percent of the pediatric population and it could well be underreported.

Dr. Robert W. Collins, PhD, PC
Soiling Solutions®
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Physical causes for Encopresis should be “ruled out,” however, they are present in only approximately five percent
of cases. Thus, Encopresis is a “functional” disorder which frustrates physicians and parents alike. We are dealing
with a smelly, offensive, body product which can cause disease and urinary tract infections, especially in girls.

Encopresis in and of itself causes both psychological and physiological (in that order) consequences rather than
the reverse. This is very confusing for both parents and physicians because of the “medical model” assumptions.
Encopresis takes two basic forms. Functional Fecal Retention (FFR) is an extreme, over-learned, reflexive holding
which can result in an enlarged colon or even a “megacolon.” A megacolon can be confirmed by X-ray and digital
examination. Painful bowel movements and even hospitalization may result.

A vicious cycle frequently results leading to even more automatic “holding.” This can perpetuate the FFR of
Encopresis for months and even years.

The non-retentive form of Encopresis is much less common and is more typical of developmentally delayed
children or children who just do not appear to have been toilet trained in the first place.

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