Nurse and Teacher Coaches for Encopresis in Schools

The usual approach to children with encopresis in schools is to provide more ready access to a bathroom. Another is to provide clothes for changing at the school in case of accidents. By contrast my Soiling Solutions® (SS) protocol emphasizes quickly ending day-time encopresis accidents in school altogether by parent intervention.  This requires parental measures to be taken at home. The medical point person to implement the SS protocol is the school or medical office nurse. The child has a “fecal load” caused by “holding” and fear of accidents which leads to more holding in a “vicious” escalating cycle. This vicious cycle has to be interrupted on a daily basis using suppositories and enemas (S&E) emptying him sufficiently for a 24-hour period to be accident free until the next Power Hour of the SS protocol. The delayed and confusing effects of oral stool softeners and laxatives cannot accomplish a 24-hour accident free period.

My experience is that this expectation of daily S&E creates anxiety for everyone, even medical professionals. This has to be confronted because encopresis itself is a prolonged, corroding trauma with both physical and emotional consequences. I am a clinical psychologist with considerable expertise in treating anxiety disorders. The early relief experienced by the child and adults with the cessation of encopresis accidents is profound and leads to a “virtuous” cycle. Maintaining the status quo of encopresis with mere post-accident measures has to be confronted. This is where nurses and teachers can shine as coaches encouraging my protocol with parents.

You can read a summary of my SS protocol which was published by the International Foundation of Functional Gastrointestinal Disorders ( and my Power Hour schematic by clicking here. You can help the parents to take a more active role in ending encopresis. They will have to order my Clean Kid Manual© and listen to fellow SS parents on my email forum making everyone’s job much easier.