Encopresis: developmental, behavioral and physiological considerations for treatment.
Encopresis (soiling in the clothing) is a complex condition presenting a treatment challenge for health care providers. It is a disruptive event, placing both the child and family at risk for crisis. The definition, incidence, etiology and relevant medical, behavioral and developmental theory are discussed. A multi-dimensional encopretic evaluation and management model is presented that addresses encopresis at developmental, behavioral and physiological levels. This system includes a detailed historical, demographic, behavioral and school-performance profile of the child; appropriate physical and laboratory examinations; and a treatment approach that incorporates bowel evacuation, a high-fiber diet, techniques of behavior modification, and maintenance on either contingent rectal cathartics or oral laxatives. If there are significant behavioral concerns and/or the family is dysfunctional, collaborative psychiatric management can be arranged.
Kaiser Permanente, Hayward, Calif.
J M
JM
Sprague-McRae
D002648:Child; D002657:Child Development; D002675:Child, Preschool; D002985:Clinical Protocols; D004688:Encopresis / Q000209:etiology / Q000451:nursing / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009722:Nurse Practitioners; D009730:Nursing Assessment