[ NEW QUESTIONS ] Q: How long after encopresis appears to be resolved should a patient continue to take the medicine prescribed to treat it? My daughter's encopresis had successfully resolved for 2 weeks, which was wonderful, but then I began to see evidence of soiling in her underwear; also, she seemed to lose her appetite somewhat. View Answer > Q: My 4-year-old brother has a problem with soiling his underwear. Because of this, he has to have baths 4-5 times a day and needs his bedding changed at least twice each night. This has become very hard on my mom, who also has 2 other children to look after. What sort of help might be available for this problem? View Answer > Q: My 10-year-old daughter has always had extremely large bowl movements, sometimes even larger than the toilet drain. I have to remove it from the bowel or break it up to flush the toilet. She can easily go 10 days or so between bowel movements. She never complains of pain or cramping, but she almost always has seepage in her underpants. I've tried laxatives, fiber, and other things; even enemas don't work. Physicians have told me she will outgrow this problem, but I wonder if another solution is available? View Answer > Q: My 4-month-old son has been suspected of having Hirschsprung disease since he was 2 weeks old, when he was hospitalized for severe abdominal distension and bile vomiting. Ever since, he has been unable to pass stool or passes it very infrequently. He continues to have vomiting and abdominal distension. We give him lactulose daily to encourage regular bowel movements. He has had a biopsy and anorectal manometry, both of which had negative results for Hirschsprung disease. Our gastroenterologist now seems to be considering a diagnosis of some form of encopresis or perhaps even laziness resulting from his frequent irrigations. Is it possible for children this young to develop encopresis? View Answer > Q: I am working with a kindergarten student who has been diagnosed with sickle cell disease. He often experiences urinary and fecal incontinence. He wears pull-up diapers to school. The urine problem seems to be a complication of sickle cell disease. I have not been able to find any research indicating that the fecal incontinence can also be related to the sickle cell disease. He does well academically and seems to be a bright boy; however, at school, he averages 2 bowel movement accidents each day. This is becoming a problem for his kindergarten teacher and the school nurse, who have to clean him up and change his pull-up diapers. Please offer insight into this problem and its possible relationship to sickle cell disease. Also, any advice on therapy would be helpful. View Answer > [ PAST QUESTIONS ] Q: My 9-year-old grandson has encopresis but seems to have better control during the summer months, when he is not in school. He is harassed a lot by his 2 sisters because they are responsible for doing his laundry. Also, his mother doesn't seem to care about his problem and does nothing, dietary or otherwise, to help. How can I help the family get along better? Also, is the mother's lack of concern grounds for child abuse? View Answer > Q: My child has recently been diagnosed with encopresis and is taking polyethylene glycol 3350 (Glycolax). She has always had chronic stomachaches. Could this also be a symptom of encopresis? View Answer > Q: My 4-year-old son has recently been diagnosed with encopresis. He has always been a fussy eater and has had constipation since age 18 months. We have altered his diet in order help with the problems; his doctor also prescribed lactulose, which gave him severe stomach pains and may have made matters worse. He now takes senna (Senokot) every other day, and I also give him fresh-squeezed orange juice to make his stools softer to pass. The doctor recommended that I give him Senokot twice a day every day, but this caused stomachaches. I now give it to him every other day. I have a visit scheduled with another doctor, who said he will give us another medicine, but I am starting to worry about relying on medicines for my son to pass stool. Also, he acts very embarrassed about toileting and seems to hate sitting on the toilet. I believe he is holding back his stool, refusing to have a bowel movement. He once went 8 days (even while taking laxatives) without passing stool, and when he passes gas, diarrhea comes out. He also is under the care of a dietitian, but the progress seems extremely slow. All he used to eat was French fries, but I recently got him to eat some roast and a sausage, which was encouraging. He starts school soon, and, because of his soiling problems, I am worried about how he will cope. Finally, he wets his bed at night, and I wonder if this is connected in some way with the encopresis? View Answer > Q: My 12-year-old son has been diagnosed with abdominal migraines. Is this a real diagnosis or just a theory, and how can we be sure that we have the correct diagnosis? He has had 2 episodes of nausea and vomiting 4 years apart that lasted 4-6 weeks each. He was been tested for many diseases during his illness and hospitalizations. My question is, have all enzymes required for digestion been identified, and, if so, are tests available for testing levels of these enzymes? View Answer > Q: My 10-year-old son has had encopresis since he was very young. While his condition is controlled to the point where he no longer has problems at school, he still has problems on weekends. Why has he been able to resolve it in some situations and not others? When I talk with him he is still obviously very upset about the accidents but does not understand why they happen. One therapist thinks he is repressing anger, but he doesn't seem angry about anything other than how this affects him. I have searched high and low for information on the emotional effects this may have on my son. Do you have any insight to offer? View Answer > Q: My 7-year-old son has been having soiling problems for more than 4 years. He has accidents at school, daycare, and home. He claims he cannot feel when he needs to use the bathroom, and he does not even know when he has soiled himself. After a visit to the doctor, she diagnosed him with attention-deficit/hyperactivity disorder, thinking that the medication for this disorder would help him recognize when his body was telling him to use the bathroom. This worked for about 2 weeks, and then he started soiling his pants again. His doctor wanted us to go to a counselor, but our insurance wouldn't pay for it and we couldn't afford it otherwise. So, we asked for a referral to a gastroenterologist, who started my son on polyethylene glycol (Miralax). He also received a barium enema and had 2 rectal biopsies. The biopsy results were normal. Can my son still have encopresis even though he has normal rectal biopsy results? View Answer > Q: My 9-year-old son is still having bowel movements in his pants. He did not have trouble with potty training, and he was completely trained until he was aged 4 years. For the past 5 years, he has bowel movements in his pant 4-5 times a week. I have taken him to several different specialists, but they have not found anything wrong with him. I was told that some children just do this. I have tried to control the problem by ignoring it and by taking away things he loves. Sometimes these methods work for a short time, but most of the time they do not help. He says he does not know he has to go to the bathroom until it starts coming out. I wonder why sometimes he can control it but other times he cannot. No dramatic changes have recently occurred in our home (eg, divorce, new baby). At a previous visit to the doctor, he had a rectal examination and the doctor pressed on his stomach, but that was the extent of his evaluation. Are any tests available to determine if he truly has a medical condition or if the problem is related to something else? View Answer > Q: My stepdaughter has encopresis, and she has seen a pediatric gastroenterologist. She has soiling accidents once a day, usually in the evening. She is currently taking 1 capful of polyethylene glycol (Miralax) each morning. In the event we forget to give her the medicine in the morning, should we give it to her at night and in the morning the next day or should we just skip the dose for that day? View Answer > Q: My 9-year-old old son has encopresis. He has had it for 2 years. We have tried everything with him, but nothing has worked. He refuses to report his frequent soiling to us, he refuses to sit on the toilet for any length of time, and he hides his underwear to make us think he is not having accidents. He is being very stubborn, and we have now put him in diapers to try to stop the hiding of underwear. We recognize he has a medical problem, but we feel he needs to take some responsibility for the problem and he should be part of the solution. Can you offer any advice to alter his defiant behavior regarding this problem? View Answer > Q: My son is aged 3 years, and I have heard that most health professionals do not diagnosis encopresis until a child is aged 4 years. However, my son has had problems going to the bathroom since birth. His constipation causes significant crying and straining when he attempts to have a bowel movement. My son has been toilet trained for almost 9 months, but he still soils his pants and does not seem to realize he is having a bowel movement. He also has markings in his pants, even when he has not had a bowel movement for days. His stomach seems to be constantly bloated. All efforts (eg, rewarding good bathroom behavior) to help him correct this behavior have failed. He is starting nursery school soon, and I do not want him to feel self-conscious about this problem. Although I have scheduled a visit with his physician, please offer your opinion about this situation. View Answer > Q: Is it possible that my child developed encopresis as a result of a slight anal fissure when he was aged 2.5 years? He is now aged 4.5 years, and his pediatrician has suggested that his problem is related to potty training. However, I disagree because he was doing fine before the fissure. Also, can this condition run in families? View Answer > Q: Can encopresis be caused by a child not wanting to have a bowel movement outside of his or her own home? My 6.5-year-old son does not like to go to the bathroom anywhere other than home unless we “can check if he has wiped enough.” He is having occasional accidents at school at the end of the day or when he is on “play dates” with friends after school. The problem is affecting him socially. Other children are being cruel to him about the problem. Is this a behavioral problem? Is self-imposed constipation causing this condition? View Answer > Q: I have a 10-year-old son, and I am worried that he hardly ever has bowel movements. He never complains about gas or pain, but his stomach is big and hard as a rock. The last time he had a bowel movement was approximately 3 weeks ago. I know he's holding it all in because he hates to use the toilet for some reason. Even though everything seems normal and he does not complain, I am still worried. What could be the problem, if any? View Answer > Q: I am a school nurse and have cared for a 10-year-old student who soils himself at school. He also has severe ichthyosis. His parents initially were reluctant, but recently they admitted he also has soiling problems at home. At school, he soiled himself twice in 1 month. The school guidance counselor called the mother to seek help, but the mother was again reluctant to agree her son has a problem. Do you have any suggestions on how to proceed with this situation? View Answer > Q: My 4-year-old daughter has had gastroesophageal reflux disease (GERD) since birth. She was treated with cisapride (Propulsid), cimetidine (Tagamet), an aluminum and magnesium antacid (Mylanta), and thickened food. She has also had constipation since birth. My pediatrician suggested the constipation was caused by the GERD and resultant delayed gastric emptying. We attempted to control her diet to resolve the constipation problem, but this has been unsuccessful. Her stomachaches continued, and she began therapy with ranitidine (Zantac) and then famotidine (Pepcid). Her constipation continues to be a problem, and I wonder if this might be encopresis. When she has a bowel movement, it is large and unusually smelly. She also soils herself on occasion. Although I am reluctant to take her to a pediatric gastroenterologist because I do not want to subject her to unnecessary invasive testing (and, possibly, anesthesia), do you think this might be appropriate? Also, could the GERD (and medications) possibly be related to encopresis? View Answer > Q: My 7-year-old son has started having bowel movements while he is taking a shower. This started approximately 2 weeks ago, and it occurs almost every night. He says he does not know why he is doing this and that he cannot help it. Could he possibly be engaging in some sort of self-exploratory behavior while showering that may stimulate a bowel movement? Also, I am an expectant mother and I wonder if my son's excitement over the birth of his new brother or sister may be contributing to the problem. Finally, my son has attention-deficit/hyperactivity disorder (ADHD). View Answer > Q: I am the daytime guardian of a 4-year-old boy who refuses to have bowel movements. After approximately 5 days, he eventually has a large bowel movement in the middle of the night, described as a 'blow out' by his mother. One doctor suggested having the child wear diapers at school and at home. I feel this will be humiliating for the child. What other information might be valuable in this situation, and what options are available to the parents of this child? View Answer > Q: My 13-year-old stepson has had encopresis since age 4 years. He did not receive treatment for this problem. Currently, he soils his underwear daily and he sometimes hides the evidence to avoid embarrassment. Additionally, when he does have a bowel movement, it is very large and sometimes plugs the toilet. Finally, he has an obvious odor of soiled underpants. This situation seems unusual and unhealthy. Because he is a teenager and is sensitive, I would like to address the problem discretely to avoid embarrassing him. What advice or information can you offer?? View Answer > Q: My son was born with cerebral palsy and currently is aged 12 years. He has limited use of his right leg and arm. He also has some short-term memory problems. However, overall, he is a reasonably intelligent boy. The problem is that he still soils himself, and this situation is causing significant problems at school. Other children are mocking him, and this is dramatically lowering his self-esteem. Oddly, he does not know it when the soiling occurs. Sometimes he will not have an accident for several days, but other times, he will have 3-4 in one week. His doctors cannot find anything physically wrong with his colon and believe the problem is more psychological. I wonder if my son has encopresis; his symptoms seem similar. Unfortunately, he was not in my care for the first 4-5 years of his life so I do not know if he had major constipation with pain as a young child. I am unsure if his problem is arising as part of his cerebral palsy, as encopresis, or as some other condition. Please offer any advice or information you think may be helpful. View Answer > Q: Our 3.5-year-old daughter has had constipation since age 1.5 years. Over this time, she has become reluctant to pass stools and says "it hurts" She has been taking polyethylene glycol powder (Miralax) for a year, and we have also tried numerous home remedies. She was scheduled for a barium enema, but we canceled the procedure because her symptoms appeared to lighten for a month. Since then, her symptoms have gotten worse and we are now considering rescheduling the procedure. However, our fear is that the test results will not indicate a problem and we will have put our daughter through an extremely upsetting ordeal for no reason. Is our daughter's constipation a problem that will eventually resolve on its own over time, or should we reschedule her for the barium enema? View Answer > Q: What is constipation? View Answer > Q: Is it true that children with encopresis start soiling to get attention or because they are lazy? View Answer > Q: Can my child become dependent on laxatives if she uses them too long? View Answer > Q: Can the effects of laxatives diminish as my child uses them over a long period of time? View Answer >

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