Causes and risk factors
Constipation is the major cause of Encoperesis. Other causes may be due to lack of toilet training, premature toilet training, emotional stress due to disturbed or change in home environment such as due to divorce of parents or birth of sibling. Predisposing factors for Encoperesis are being male, history of constipation, low socioeconomic status.
Clinical presentation
Patient with Encoperesis is often having history of constipation. The stool is hard, dry, and impacted. The child passes only the liquid stool that passes around the hard stool. It is leaked during day or night. Signs and symptoms include difficulty in retaining faeces, soiling of clothes, constipation and hard stools, occasional passage of very large stool that almost blocks up the toilet, avoidance of bowel movement.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Digital per rectal examination and abdominal x-ray is done. Psychiatric evaluation to find out if there is any emotional cause is recommended.
Treatment
Treating the underlying constipation with laxative or stool softener or enemas is needed. Encouraging good bowel habits by schedule bowel movements especially after meal. Change of dietary habits, including high fibre diet will also help in managing Encoperesis. Psychotherapy, may be required if the child has guilt, shame of low self esteem due to Encoperesis.
Other Modes of treatment
The other modes of treatment can also be effective in treating Encoperesis. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Encoperesis.
