It is an involuntary defecation,especially associated with emotional disturbance or psychiatric disorder.It Is also known as paradoxical diarrhea, is voluntary or involuntary fecal soiling in children who have usually already been toilet trained.
Symptoms: Signs and symptoms of encopresis may include: Leakage of stool or liquid stool on your child's underwear. Constipation with dry, hard stool. Passage of large stool that clogs or almost clogs the toilet. Avoidance of bowel movements. Long periods of time between bowel movements, possibly as long as a week.
Diagnosis: The psychiatric (DSM-IV) diagnostic criteria for encopresis are: Repeated passage of feces into inappropriate places (e.g., clothing or floor) whether voluntary or unintentional. At least one such event a month for at least 3 months. Chronological age of at least 4 years (or equivalent developmental level). The behavior is not exclusively due to a physiological effect of a substance (e.g., laxatives) or a general medical condition, except through a mechanism involving constipation.
Treament: The initial clean-out is achieved with enemas, laxatives, or both. The predominant approach today is the use of oral stool softeners like Movicol, Miralax, Lactulose, mineral oil, etc. Reduction in the intake of constipating foods such as dairy, peanuts, cooked carrots, and bananas Increase in high-fiber foods such as bran, whole wheat products, fruits, and vegetables Higher intake of water and liquids, such as juices.
Epidemology: The Italian Club of Nocturnal Enuresis promoted a prevalence study of nocturnal enuresis using a self-administered questionnaire in seven cities in Northern, Central and Southern Italy. The overall prevalence was 3.88% and showed a decreasing trend with increasing age. Bedwetting was more frequent in boys than in girls.