title: [Psychosomatic approach to encopresis].
abstract: Encopresis most often results from functional constipation and a behaviour disorder characterised by retention of faeces. Rarely it is a passive or active expulsion of normal faeces. It indicates a failure in the education of sphincter control, often with a preferential development of autoerotic versus relational investments. A depressive component is frequent. We propose a bidisciplinary approach with a somatic and psychological evaluation of the encopretic child from the first visit. The physical examination assesses constipation and stercoral stasis. Associated psychopathological symptoms or a pathogenic psychosocial situation must be sought. The therapeutic means must be directed towards the different etiologic features. Explanations of the physiopathology of the symptom and discussion with the child and the parents on the origin of the dysfunction must be accomplished first. A medical treatment of the constipation is generally indicated. Psychotherapy is initiated according to the background and associated psychopathological symptoms.
authors.affiliation: Service de pédiatrie, hôpital Andre-Mignot, Le Chesnay, France.
authors.forename: N
authors.initials: N
authors.lastname: Boige
authors.forename: S
authors.initials: S
authors.lastname: Missonnier
authors.forename: M
authors.initials: M
authors.lastname: Bellaïche
authors.forename: P
authors.initials: P
authors.lastname: Foucaud
mesh_terms: D000367:Age Factors; D002648:Child; D003248:Constipation / Q000628:therapy; D004688:Encopresis / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D011613:Psychotherapy