Encopresis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Causes
- Encopresis is commonly caused by constipation, by deliberate withholding of stool, by various physiological, psychological, or neurological disorders, or from surgery (a somewhat rare occurrence).
- The colon normally removes excess water from feces. If the feces or stool remains in the colon too long due to deliberate or incidental constipation, so much water is removed that the stool becomes hard, and becomes painful for the child to expel in an ordinary bowel movement. A vicious cycle can develop, where the child may avoid moving his/her bowels in order to avoid the "expected" painful toilet episode. The hardened stool continues to build up and stretches the colon or rectum to the point where the normal sensations associated with impending bowel movements do not occur. Eventually, softer stool leaks around the blockage and cannot be withheld by the anus, resulting in soiling. The child typically has no control over these leakage accidents, and may not be able to feel that they have occurred or are about to occur due to the loss of sensation in the rectum.
- Encopresis may also be due to psychological problems, such as oppositional defiant disorder or conduct disorder which are often viewed as a kind of "parental control" attempt by the child. Or, encopresis may be the result of a fear of the commode and its flushing action, or by simple reluctance to "let go" of the stool into the toilet. Health practitioners, however, typically think of encopresis as mainly a physical problem with a psychological component (but not cause). Encopresis is also a symptom of child sexual abuse.[1]
- Organic causes such as Spina bifida or Hirschsprung's disease are rare.
References
- ↑ Evaluating the Child for Sexual Abuse. Sheela L. Lahoti, Rebecca Girardet, Margeret McNeese, Kim Cheung. University of Texas Medical School at Houston, Houston, Texas