Encopresis and Constipation in Children

Soiling, stool soiling, or fecal soiling refers to the leakage of stool that a child cannot control. This condition happens in children who are toilet trained. One of the major reasons that causes soiling is constipation, as large amount of stool gets accumulated in their colon. This is commonly known as encopresis, a condition that is not a disease or caused by a disease, and is quite common in children who are past their toilet training age.

Soiling also happens due to Irritable Bowel Syndrome (IBS), or for the simple reason that the kid is afraid to poop in the toilet bowl. Whatever the reason, in most cases, fecal soiling is involuntary, which means the child doesn’t poop in his/her underpants on purpose.

Understanding the Problem

Many children with encopresis tend to suffer from prolonged constipation episodes, which often last more than two weeks. While they do have regular bowel movements, it happens in their underpants and not on the toilet. This leads to the changing of their underpants several times a day. In fact, they try their level best and put in a lot of effort to avoid pooping on the whole. Due to the bad odor emanating from their soiling habit, these kids are often socially rejected, which affects them and their families too. To top it all, there will be no physiological factor that causes their fecal soiling episodes.

There are other cases with a similar issue. Some kids do have bowel movements on the toilet, but they tend to be few and far between. They withhold their bowel movements and remain constipated for more than two weeks. They soil their clothes, and in some cases, kids might even need to be taken to the ER due to stool that accumulate over long periods. Even with doctors recommending the use of enemas and MiraLAX – a medication used to treat constipation – the problem continues to exist for a long time. No physiological or psychological treatments work for them.

With so many similar cases to analyze, Dr. Kushnir concludes that the problem behind these issues is some form of psychological force that controls the child. This is if all the possible physiological factors have been ruled out. Whether the kid is anxious about peeing and pooping in general, afraid of using the toilet, or a combination of different factors, the psychological force pushes them in a rather unpleasant direction, and the problem tends to pertain for several months or even years at times. While some parents can recall a specific event that acted as the trigger point for their child’s soiling habit, others cannot recall any such event.

There are some common factors that could be triggers to encopresis in children. The child experienced a painful bowel movement that made him/her anxious about the next one; the issue escalated, making the condition go from bad to worse. One of the other crucial factors that can cause constipation and encopresis in children is their diet; for instance, lack of sufficient fruits, vegetables, and fibre content in their diet. Instead, their diet contains high quantities of carbs like potatoes, rice, etc., which can worsen the condition.

When it comes to the treatment procedure followed by Dr. Kushnir, the primary reason for the problem or condition is of no concern. His treatment approach works, regardless of the triggering events behind a child’s encopresis or soling and constipation situation.

The Treatment Approach

Once you contact your pediatrician, and he/she decides if there are some tests to be taken, like blood tests and stool test, your child may be referred to a gastroenterological evaluation. After any possible physiological issue is ruled out, and it is confirmed that your child doesn’t need medical intervention, parents could go forward and apply Dr. Kushnir’s behavioral treatment.

The aim of his treatment approach is to uproot the psychological force that has the child in control, and thereby reduce the chances of the issue escalating. Many parents, when they first hear the treatment’s description, are taken aback, in shock, have reservations, and some even find the approach to be over-intrusive and encroaching the child’s privacy. Thus, before using the treatment method, Dr. Kushnir always encourages parents to take their time to think it through; this is because it is vital that they implement it with full understanding and acceptance.

Objections to Adopting the Treatment

With this treatment approach for encopresis and constipation, the initial resistance or hesitation starts from the child. However, it is important that the treatment takes place every single day, even if it is against the interest of the kid. In a few days, they are most likely to become more willing and the process will get easier.

Parents should understand that their child’s resistance to the treatment arises from the profound anxiety that is controlling them from the inside. As a result, no matter how much your kid is willing to poop in the toilet bowl, like everyone else, the anxiety stops them from doing so. Following Dr. Kushnir’s treatment approach will help children to stop giving into that profound anxiety, and within a short period of time, they start to feel free and will no longer submit to the anxiety.

Ultimately, what really matters is that parents give themselves enough time to think about the encopresis treatment approach. This helps them to be at ease with their decision and implement the steps with complete confidence.


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