Excretory disorders occur in children who've problems going to the bathroom – each bowel movements and urination. Although it is just not unusual for young children to have occasional “accidents,” it may be an issue if this behavior occurs repeatedly for greater than three months, especially in children over 5 years old.
There are two sorts of excretory disorders: encopresis and enuresis.
- Encopresis is the repeated leakage of feces into places apart from the bathroom, corresponding to in underwear or on the ground. This behavior may or will not be intentional.
- Enuresisis repeated urination in places apart from the bathroom. Enuresis, which occurs at night, or bedwetting, is probably the most common type of excretory disorder. As with encopresis, this behavior may or will not be intentional.
In addition to defecating in inappropriate places, a baby with encopresis may produce other symptoms, including:
- Loss of appetite
- stomach pain
- Soft, watery stools (bowel movements)
- Scratching or rubbing within the anal area as a result of irritation from watery stools
- Decreased interest in physical activity
- Withdrawal from family and friends
- Mysterious behavior related to bowel movements
The commonest reason for encopresis is chronic (long-term) constipation, which is the shortcoming to pass stool from the intestines. This could be attributable to a wide range of reasons, including stress, not drinking enough water (which makes bowel movements hard and difficult), and pain attributable to a sore in or near the anus.
When a baby is constipated, a big mass of feces is produced, which stretches the rectum. This stretching causes the nerve endings within the rectum to dull, and the kid may not feel the necessity to go to the toilet or bear in mind that waste is coming out. The mass of feces will also be affected – too large or too hard to pass without pain. Over time, the muscles that hold stool within the rectum can not hold it back. Although the big, hard mass of feces cannot pass, loose or runny stool may leak across the affected mass and onto the kid's clothing.
Factors that may contribute to constipation include:
- A low fiber food regimen
- Lack of exercise
- Fear or reluctance to make use of unfamiliar toilets, corresponding to public toilets
- I don't take the time to go to the bathroom
- changes in bathroom routine; for instance, planned bathroom breaks at college or summer camp
Another possible reason for encopresis is a physical problem related to the intestines' ability to maneuver stool. The child may develop encopresis as a result of anxiety or frustration related to bathroom training. Stressful events within the child's life, corresponding to an illness within the family or the birth of a brand new sibling, can contribute to the disorder. In some cases, the kid simply refuses to make use of the bathroom.
Encopresis is fairly common, although many cases go unreported as a result of embarrassment to the kid and/or parents. It is estimated that between 1.5 and 10% of kids suffer from encopresis. It occurs more often in boys than in girls.
If symptoms of encopresis are present, the doctor will begin the assessment by conducting a whole medical history and physical examination. The doctor may perform certain tests, corresponding to X-rays, to rule out other possible causes of constipation, corresponding to intestinal disease. If no physical disorder is identified, the doctor will base the diagnosis on the kid's symptoms and current bowel habits.
The goal of encopresis treatment is to forestall constipation and promote good bowel habits. Another vital a part of treatment is educating the kid and their family in regards to the disorder.
Treatment often begins with removing any fecal matter that has lodged within the colon, also often known as the big intestine. The next step is to maintain the kid's stools soft and lightweight. In most cases, this could be achieved by changing the kid's food regimen, providing regular toileting, and inspiring or rewarding positive changes within the child's toileting habits. In more severe cases, the doctor may recommend using stool softeners or laxatives to cut back constipation. Psychotherapy (a type of counseling) could also be used to assist the kid take care of the shame, guilt, or lack of self-esteem related to the disorder.
A baby with encopresis is vulnerable to emotional and social problems related to the condition. They may develop self-esteem problems, turn out to be depressed, perform poorly at school, and refuse to socialize with other children, including not wanting to go to parties or attend events that require an overnight stay. Teasing from friends and scolding from relations can increase the kid's self-esteem and contribute to the kid's social isolation. If the kid doesn't develop good bowel habits, she or he may suffer from chronic constipation.
Encopresis tends to enhance because the child ages, although the issue may appear and disappear over years. The best results are achieved when all educational, behavioral and emotional issues are addressed. A baby should still have the occasional accident until he regains muscle tone and control of his bowel movements.
Encopresis attributable to constipation can often be prevented by ensuring the kid drinks enough water and eats a high-fiber food regimen. Although it is just not all the time possible to forestall encopresis, treatment as soon as symptoms appear will help reduce the frustration and stress in addition to the possible complications related to the disorder. Additionally, being positive and patient with a baby during toilet training will help prevent anxiety or negative feelings about toileting.