Often parents wonder why their child has encopresis. Although identifying the exact cause of the child’s encopresis may not change the recommended strategies, it often eases parents’ worries about whether there is something “wrong” with their child, and enables them to better focus on the behavioral strategies designed to end encopresis.
A study by the American Academy of Pediatrics provides more evidence about what is likely happening for these children. The article, “During Toilet Training, Constipation Occurs Before Stool Toileting Refusal,” explains that constipation and encopresis are the result of hard and painful bowel movements. “Stool toileting refusal” is the term used to describe when a child will refuse to defecate in the toilet. The toilet training study included 380 children between 17 and 19 months whose age of potty training completion ranged from 22-54 months. These children were otherwise healthy. It is important to note that some were 4.5 years old when toilet training was completed, which is not unusual. Of these 380 children, more than 24% met the criteria for stool toileting refusal, giving further evidence that this affects more children than the general public may realize. Of this 24%, more than 90% had hard bowel movements before developing stool toileting refusal and more than 70% had painful bowel movements before developing stool toileting refusal. For most of these children, their parents had reported hard bowel movements in multiple telephone calls to the clinician prior to the onset of stool toileting refusal. Also, the children with more frequent hard bowel movements typically refused to use the toilet for defecating for a longer period of time than children without hard bowel movements or children with less frequent hard bowel movements. In sum, this study shows that constipation precedes stool toileting refusal in a large percentage of cases and is often what contributes to the onset of encopresis. Taken a step further, when encopresis originates from a child’s desire to avoid hard or painful bowel movements, this highlights the importance of not only keeping the stool soft and easy to pass but also the importance of addressing the withholding behaviors. Changing patterns of behavior is a key part to successfully treating encopresis.
For more information on this article and to understand how UCanPoopToo can help you both take action now and regularly monitor your child’s progress, visit www.ucanpooptoo.com.