ENCOMPRESIS

Encompresis is an excretionary disorder that can be defined as the voluntary or involuntary passage of stools in a child in unsuitable locations despite being toilet trained. This disorder can be observed in 1-3% of children. A study conducted in Turkey has shown that this number is 4%.

Criteria for Diagnosis

  • The repetitive passing of stool in unsuitable locations (soiling clothes or furnishings), either voluntarily or involuntarily
  • Having a calendar age of at least 4 (or equivalent development stage)
  • The independence of this behavior from direct physiological effects of a substance or a general medical condition not related to constipation

Most patients with encompresis exhibit constipation. A suitable age to start toilet training is at 1.5-2 years of age, during which the child begins to gain control over his/her sphincter. From a developmental point of view, starting toilet training during a period in which it is impossible for the baby to control his/her sphincter tonus, or not starting toilet training even though the child has control over his/her sphincter are among reasons causing encompresis. Difficult life situations such as significant changes or losses in the family setting carry causal importance. Encompresis may be the result of sexual abuse. Encompresis is seldom observed alone, unaccompanied by any psychological disorder. Most often it is accompanied by enuresis (bed wetting), oppositional defiant disorder, anxiety disorders, attention deficit hyperactivity disorder, depression, behavioral disorders and sexual abuse.

Treatment

Keeping Record and Rewarding: Children with encompresis are asked to keep a record under two columns. The first column contains information whether the child has gone to the bathroom after breakfast for each morning. The second column contains a record of possible accidents. It would be more suitable if rewarding is basen on the first column.

Routinizing Defecation: Particularly in the case of children with constipation, it is important for contributing to the treatment to agree with the child to strain (push) for 3-4 minutes after breakfast until he defecates. Consumption of food with pulp and liquids are important points to pay attention to in the diet.

Cases deemed necessary are treated with medication.