Treatment

Generally, the earlier that treatment begins for encopresis, the better. The first step involves clearing the colon of retained, impacted stool. After that, treatment focuses on encouraging healthy bowel movements. In some cases, psychotherapy may be a helpful addition to treatment.

Clearing the colon of impacted stool

There are several methods for clearing the colon and relieving constipation. Your child's doctor will likely recommend one or more of the following:

  • Certain laxatives
  • Rectal suppositories
  • Enemas

Your child's doctor may recommend close follow-up to check the progress of the colon clearing.

Encouraging healthy bowel movements

Once the colon is cleared, it's important to encourage your child to have regular bowel movements. Your child's doctor may recommend:

  • Dietary changes that include more fiber and drinking adequate fluids
  • Laxatives, gradually discontinuing them once the bowel returns to normal function
  • Training your child to go to the toilet as soon as possible when the urge to have a bowel movement occurs
  • A short trial of going off cow's milk or checking for cow's milk intolerance, if indicated

Behavior modification

Your child's doctor or mental health professional can discuss techniques for teaching your child to have regular bowel movements. This is sometimes called behavior modification or bowel retraining.

Your child's doctor may recommend psychotherapy with a mental health professional if the encopresis may be related to emotional issues. Psychotherapy may also be helpful if your child feels shame, guilt, depression or low self-esteem related to encopresis.

Oct. 13, 2016
References
  1. AskMayoExpert. Encopresis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  2. Sood MR. Functional fecal incontinence: Definition, clinical manifestations, and evaluation. http://www.uptodate.com/home. Accessed Aug. 8, 2016.
  3. Sood MR. Chronic functional constipation and fecal incontinence in infants and children: Treatment. http://www.uptodate.com/home. Accessed Aug. 8, 2016.
  4. Turner TL, et al. Toilet training. http://www.uptodate.com/home. Accessed Aug. 8, 2016.
  5. Tabbers MM, et al. Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations for ESPGHAN and NASPGHAN. Journal of Pediatric Gastroenterology and Nutrition. 2014;58:258.
  6. Nurko S, et al. Evaluation and treatment of constipation in children and adolescents. American Family Physician. 2014;90:82.
  7. Encopresis. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Aug. 8, 2016.
  8. Manini ML (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 12, 2016.