Famous Last Words about Encopresis: “He will grow out of it!”

“He will grow out of it!”

Most parents and physicians take a rational approach to children who are having trouble with bowel control.  They will try to reason with the child and encourage regular toilet sits after a meal.  They may turn the bathroom into a kind of entertainment center to hold the child’s interest in remaining there in hopes of a normal bowel movement.  The physician may prescribe a stool softener such as Miralax to ease stool passage without accompanying pain and to avoid a weakened and enlarged colon. This will suffice for many children, but there is a hard core of children who do not respond and are characterized by bathroom avoidance and constant leaks of stool which may be even be encouraged by stool softeners.  At this stage attempts to reason or lecture continue and all parties begin to have major conflicts with one another and even within themselves.  The physician may refer the family out to a psychologist because of the emotional consequences and hopes that a behavioral approach will succeed. The long-term damage caused by encopresis and the consequences of not treating the issue go beyond even further.

At some point, when it becomes obvious that there is a chronic, persistent issue, the family becomes increasingly distressed and the physician is pressured to prescribe a different approach.  However he/she is trained in “First, do no harm.” and will often default to assurances that “He will grow out of it!”  This is an ethical stance, however, not solving the problem has continuing long term harmful effects causing more emotional problems and even physical damage that can prolong the problem such as an enlarged and weakened colon.  It can delay adequate treatment for months and years hardening the holding habit and contributing to constipation.  Worse, all parties may not be aware that the child may have now lost control of the necessary coordinated muscle actions and voiding urge recognition required for successful bowel movements.

End Encopresis Damage:

End Encopresis Damage | Clean Kid ManualThe Soiling Solutions® (SS) approach using suppositories and enemas (S&E) would appear to be barbaric given all the sensitivity, anger, and fear that surround this area of the body.  It is a counter-intuitive program that can be done in the privacy of the home with monitoring by the physician if he can be convinced to give SS a try. Bottom medicine can be seen as very foreign by physicians who are so used to the oral or top down prescriptions for treating many conditions.  Also, they do not typically have the time to persuade, assure, and train parents that this is an appropriate intervention. Confronting the issue head on reduces fear and promotes eventual independent and self-initiated bowel movements.  The conditioning principles that are employed are desensitization (fear reduction with success and relief), urge stimulus recognition (immediate urges induced by the S&E), coordinated muscle action releasing the stool, and the immediate reinforcements of relief and success!  This is spelled out in the Clean Kid Manual© (CKM) and reinforced by participation in the SS Parent Forums available to CKM purchasers.  Physicians who have adopted SS have been very pleased and even offered pro bono advice on the SS parent forums. I will be happy to discuss SS with any physician and even mail his practice a free Exam Copy of the CKM for his reference if he/she is genuinely open and interested.

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