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At least 19 recordsLinked to original sources
PubMed1975

Children with encopresis: A descriptive analysis.

During an 18-month period, 102 children with encopresis were seen in a general pediatric outpatient clinic. Through interviews and questionnaires, extensive historical information was obtained. Children were compared with respect to demographic characteristics, bowel-function histories, early training and management, and present manifestations of bowel dysfunction. A wide variety of historical backgrounds and manifestations was observed. It was found that many of the traditional generalizations about encopresis could not be substantiated. It is suggested that a very individualized approach to this problem be adopted and that children with encopresis be investigated carefully to uncover early developmental problems, critical life events, and the precise physiology and dynamics of present bowel dysfunction.

Adolescent↗
PubMed1991

Encopresis in children: a cyclical model of constipation and faecal retention.

Encopresis afflicts one in 100 children causing considerable stigma and parental concern. General practitioners are in a position to help in most cases but are often deterred by the psychoanalytical theories which have been developed to explain this problem. It is currently accepted that children with encopresis tend to retain stools. This leads to constipation, overstretching of sphincters and resultant faecal soiling. Physical and psychological perpetuating factors result in retention once again, thus completing a cycle of constipation and retention. Various precipitant and predisposing factors can maintain this cycle. Once physical causes have been excluded a simple behavioural approach can be adopted aimed at retraining the bowel. By using laxatives to prevent retention, gaining the child's confidence, cooperation and understanding and involving both the family and school, encopresis can be successfully managed in general practice.

Child, Preschool↗
PubMed1979

Encopresis in adolescence: two case studies.

Encopresis is an underreported psychopathological symptom of adolescence, not necessarily defining a specific diagnostic entity. The two cases presented offer an opportunity to evaluate encopresis occurring in markedly different adolescent pathological entities and developmental backgrounds. The first patient presented a longitudinal life course wherein toilet training and fecal considerations were prominent throughout his development. Indeed, this young man had such areas of cohesive functioning, as to be appropriately considered within the range of characterological pathology, severe, though it may be. In marked contrast, the second patient's encopresis represented but a small part of a totally encompassing psychotic disintegration.

Adolescent↗
PubMed1979

Chronic encopresis: a system based psychodynamic approach.

A successful method used in treating a series of five cases of chronic encopresis is reported. The method is a system based approach, taking into account the typically underlying hostile mother-child psychodynamics accompanying encopresis.

Child↗
PubMed1992

Chronic constipation with encopresis persisting beyond 15 years of age.

Childhood constipation with encopresis is a common malady. Previous reports suggest that essentially all patients either respond to standard treatments or have spontaneous recovery before 16 years of age. In this paper, we describe the results of anorectal function studies and treatment outcome in four patients in whom constipation and encopresis persisted beyond 15 years of age. Abnormalities in the ability to defecate water-filled balloons, in external sphincter relaxation with straining, in rectal sensation and development of the urge to defecate, and in maximum anal resting pressure were seen in some or all of these patients. In addition, two patients had impaired voluntary squeeze strength. Two patients responded to standard therapy; a colostomy was needed in one; and one failed therapy and has become a recluse.

Adolescent↗
PubMed1991

Randomised trial of laxatives in treatment of childhood encopresis.

Primary faecal incontinence (encopresis) in children is usually treated with laxative medication and a behaviour modification programme aimed at promoting regular toileting, but the effectiveness of laxatives has never been adequately investigated. 169 children with encopresis and evidence of stool on plain abdominal radiograph were randomly allocated to receive multimodal (MM) therapy (laxatives plus behaviour modification; n = 83) or behaviour modification alone (BM; n = 86). Mean (SD) follow-up was 55.1 (27.0) weeks and 56.7 (32.0) weeks, respectively. By 12 months' follow-up 42 (51%) of the MM group and 31 (36%) of the BM group (p = 0.079) had achieved remission (at least one 4 week period with no soiling episodes) and 52 (63%) vs 37 (43%) (p = 0.016) had achieved at least partial remission (soiling no more than once a week). MM subjects achieved remission significantly sooner than BM subjects, and the difference in the Kaplan-Meier remission curves was most striking in the first 30 weeks of follow-up (p = 0.012). The patterns of compliance with toileting in the treatment groups were almost identical, although about 1 in 8 children overall did not comply with the sitting programme. After exclusion of the 24 poor compliers, there was no significant difference between BM and MM groups. This study shows a clear advantage overall for the use of laxative medication, although the benefit may not be as great for children who are able to maintain regular toileting.

Adolescent↗
PubMed1991

No-enema therapy for idiopathic constipation and encopresis.

Idiopathic constipation and encopresis of childhood are thought to occur when children volitionally withhold stool. Withholding may be prompted by social pressures or by episodes of painful defecation. Repetitive withholding may result in colonic dilatation and colorectal dysfunction. Therapy involves removal of impacted stool, stool softening, and behavioral therapy. The use of enemas in this therapy is widespread but may be counterproductive. A retrospective review of patients treated without enemas revealed 45 patients whose course could be followed for six months. Ninety-eight percent of these had successful initial cleanouts without enemas; 94% had continued success at six months. These results, comparable with other treatment programs, demonstrate that therapy without enemas is a reasonable alternative in the treatment of childhood constipation and encopresis.

Child↗
PubMedDate not supplied

[The usefulness of biofeedback in children with encopresis. A preliminary report].

Children with encopresis (costiveness) have a social problem, and (BFB) offers them a valid therapeutic alternative. The present prospective study compares the advantages of this technique with conventional treatment in 21 patients, with average ages of 10.13 and 8.54 years in each group. The patients were studied by clinical, manometric and electromyographic parameters. Those treated with BFB showed clinical improvement, with manometric significant enhancement (p < 0.001) of the percentage of internal anal sphincter (IAE) relaxation, relaxation interval of the IAE and rectal sensation threshold (RST), on the other hand, patients treated by conventional therapy only improved the RST (p < 0.01). Biofeedback seems useful in the treatment of the child with encopresis.

Anal Canal↗
PubMed1992

Behavioral management of toilet training, enuresis, and encopresis.

Toileting problems are a matter of great concern to parents and are a frequent source of family discord, but proper handling of toilet training as well as enuresis and encopresis can ameliorate any untoward effects of these problems. Both the pediatrician and the pediatric psychologist can play a major role in this area.

Behavior Therapy↗
PubMed1978

Chronic neurotic encopresis as a paradigm of a multifactorial psychiatric disorder.

Chronic neurotic encopresis (CNE), a childhood psychiatric disorder characterized by inappropriate fecal soiling, necessitated the formation of the following specific etiological factors: a) a neurologically immature developmental musculature, an organic condition which may complicate toilet training; b) premature or harsh toilet training; c) a family constellation in which the father is frequently absent and the mother erratic, emotionally inappropriate, and distant; d) the child's formation of a noncommunicative, passive, dependent personality. All of these factors are helpful in explaining the occurrence of CNE, which is thus seen as the result of a synergistic interaction among them. The complexity of etiological agents dictates a multifactorial rather than unicausal model of mental illness. Future research and tactics of psychotherapeutic intervention should focus on the interplay among these factors rather than attempting to single out one primary predisposing factor.

Central Nervous System↗
PubMedDate not supplied

A behavioural programme for the modification of encopresis.

This paper describes a behaviour modification programme for the treatment of encopresis. The programme, which is carried out by the parents over a relatively short period of time in the home setting, aims to make the child aware of internal cues prior to elimination and to rearrange the contingencies for appropriate use of the toilet. To date, seven of eleven children, both continuous and discontinuous encopretics, have been treated successfully and have remained clean for up to 7 months regardless of other problems in the child and his family. From a relatively detailed analysis of those treated it can be concluded that a behavioural approach is effective with chronic encopretic children, many of whom had been previously treated unsuccessfully by both physical and psychotherapeutic procedures. The failures suggest, firstly that careful assessment of each child and the motivation of the parents is required, so that the standard programme can be modified to suit each individual case. Secondly a maintenance programme must follow the intensive treatment procedure to ensure that parents continue to handle the child consistently.

Behavior Therapy↗
PubMedDate not supplied

Treatment of childhood encopresis--a review.

Children with encopresis may present to a number of different professionals. The literature on different treatment methods is reviewed. The roles of verbal psychotherapy, physical treatment, behaviour therapy and mixed treatment programmes are discussed.

Administration, Rectal↗
PubMed1976

Physiopathology of megarectum: the association of megarectum with encopresis.

Studies of both rectosphincteric reflex threshold and conscious rectal sensitivity threshold were performed on 15 control subjects and 61 children with a radiological megarectum, 70% of whom were encopretics. In control subjects, the reflex threshold and the sensitivity threshold were obtained with a comparable volume of rectal distension. In the megarectum patients, sensitivity was often considerably reduced, the incidence of encopresis increasing proportionally with the decrease in conscious rectal sensitivity. Patients were segregated in three functional groups, according to measurements of the sensitivity threshold.

Adolescent↗
PubMedDate not supplied

Encopresis in Hirschsprung's disease: a report on two cases.

Two patients with persistent severe encopresis after surgery for Hirschsprung's disease were treated with a token economy type of behavior modification therapy. After eight weeks there was very marked improvement, which persisted after discharge home without relapse after four and eight months respectively.

Behavior Therapy↗
PubMed1992

[Correlation between inpatient and ambulatory psychotherapy exemplified by a case of secondary encopresis in preadolescence].

By comparing the in-patient and out-patient psychotherapeutic treatment of a patient with encopresis in early adolescence the authors develop a psychoanalytical understanding of the psychotherapeutic effects which the different settings have on the patient and his parents. In the authors' opinion both forms of therapy supplement each other and promote the patient's development during the course of treatment.

Ambulatory Care↗
PubMed1976

Children with encopresis: a study of treatment outcome.

A pediatric treatment program for encopresis was established in a large medical center. This consisted of counseling and education, initial bowel catharsis, a supportive maintenance program to potentiate optimum evacuation, retraining, and careful monitoring and follow-up. A group of 127 children received care for this problem. At the end of one year, outcome data were obtained on 110 patients. Of these, 51% had not had "accidents" for more than six months. Another 27% showed marked improvement and were having only rare episodes of incontinence. 14% of these children showed some improvement, but continued to have incontinence, while 8% showed no improvement whatsoever during the treatment year. These four outcome groups were compared with respect to a large number of demographic, developmental, psychosocial, and clinical variables.

Cathartics↗