Sunday, June 14, 2009

Encopresis



Encopresis is actually a term attributed to any passing of feces in a "non-designated" location (namely the toilet, in locations where plumbing is available). It is, however, also used to describe a medical inability to restrict defecation to the appropriate places, as well as psychologically-rooted difficulty in the same regard. It is restricted to individuals over the age of four or five, however; this age somewhat arbitrarily being designated to be the "last call" for toilet training in young children. Additionally, encopresis refers to a consistent habit, not sporadic accidents. It is commonly called an elimination disorder, and so in such a way is grouped with enuresis, the failure to pass urine in the proper location.

The causes of encopresis can be divided into three basic categories

* A lack of or regression from toilet training, whether willful or unintentional.

* Numerous psychological or behavioral difficulties.

* A medical inability to feel or control the urge to defecate.

The first cause is, naturally, restricted primarily to the very young. Children of early school age may, if not properly toilet trained, regress easily into habits of encopresis, sometimes as a way to lash out or gain attention. Often, children will become secretive about their bowel movements, and may defecate outside, in the bath, or (the dreaded example) in the pool. Encopresis is most commonly a disorder of the very young and (in cases of medical or psychological inability) the very old. Even if you suspect your child may be exhibiting willful encopresis, you should often refrain from relying upon disciplinary action in response; unless your child is still very young, this sort of behavior may be indicative of greater emotional or behavioral trauma than everyday misbehavior, especially if it is repeated.

More common than willful encopresis is that which cannot be controlled. In the elderly, encopresis is commonly the result of severe dementia, such as that which results from Alzheimer's or Parkinson's diseases, or other conditions which tend to cause mental trauma later in life. In children (and some adults), severe anxiety surrounding the process of defecation or of having to defecate in a public place may lead an individual to hold in a bowel movement to such a degree that it can no longer be controlled, resulting in inadvertent defecation. Anxiety this severe can be debilitating and is often very embarrassing, and such cases can be referred for professional analysis. There are drugs and therapies that can help relieve forms of anxiety, including elimination anxiety, and one should not be afraid of the stigma of professional treatment.

Medical encopresis is perhaps the most common form, affecting virtually all age groups. It can be the result of chronic constipation or diarrhea, but it can also result from serious medical conditions, including those that can cause serious chronic elimination problems. Symptoms of chronic constipation or diarrhea can include:

* Abdominal pain.

* Poor appetite or nausea.

* Weight gain.

* Dehydration.

Some conditions may exist where an individual is unable to feel the urge to move one's bowels until it is too late to prevent defecation. This may indicate, among other conditions, the possibility of nerve damage to the colon and lower large intestine. This is a serious condition that should be observed by a doctor, as it can cause chronic constipation and even potentially serious damage to the lower digestive tract.

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