Encopresis

What is Encopresis?

Encopresis, according to the Encyclopedia of Mental Disorders, “is an elimination disorder that involves repeatedly having bowel movements in inappropriate places after the age when bowel control is normally expected.” By age four, children are expected to be potty trained. When children four or older continue to have inappropriate bowel movements, this action may be intentional or unintentional. Either way, the child may be diagnosed with encopresis.1

Types of Encopresis

Involuntary encopresis can occur as a result of severe constipation, and when a child cannot control the movement of feces outside of the bowel. While constipation is the main cause of involuntary encopresis, the constipation in such people may be a result of “experiencing a stressful life event, harsh toilet training, toilet fear, or emotionally disturbing events.”1

Voluntary encopresis occurs when a child has control over his or her bowel movements, but chooses to have them in inappropriate places and often smear the feces in a visual place. In younger children, children may be acting this way in order to defy their guardian during potty training. According to the Encyclopedia of metal disorders “in older children, voluntary encopresis is often associated with oppositional defiant disorder(ODD), conduct disorder, sexual abuse, or high levels of psychological stressors.”1

Treatments

According to the Mayo Clinc, involuntary encopresis can be treated in the by using the following tools:

  • Stool softeners, such as lactulose or glycopyrrolate
  • Colon lubricants, such as mineral oil
  • Rectal suppositories
  • Enemas
  • More fluids2

For voluntary cases where there is a power struggle between the child and guardian during potty training, the adult should try variations of behavior modification while also making the toilet experience a pain-free and more pleasurable experience. However, when the child is older, encopresis may be the result of a mental disorder that needs to be solved through counseling and possibly psychiatric interventions.1

How this is Relevant to the Classroom Experience

I chose to research this topic because I have had two students with encopresis, one involuntary and one voluntary. I had a very difficult time working with both students because I did not understand their disorder. I would rather not go into details in this posting, but I will say that both students were textbook examples of students with encopresis. I wish I would have better understood the disorder when I taught the student with voluntary encopresis because I didn’t handle the situation as well as I should have. I had heard about the students incidences at his previous school, yet when he was transferred to my classroom, I had no idea what I was supposed to do. I could have helped the child in a number of ways, including seeking professional help. Instead, I was grossed out and wrote a referral to the office. It wasn’t until the summer, after the child had been suspended for the rest of the school year, that I realized sexual abuse was a leading cause of voluntary encopresis. I did not understand the disorder and misdiagnosed the child altogether.

This page was added by Susan Oliver.

Footnotes

1. Encyclopedia of Mental Disorders. “Encopresis.” 18 July 2007.
http://www.minddisorders.com/Del-Fi/Encopresis.html

2. MayoClinic.com. “Encopresis.” 18 July 2007 http://www.revolutionhealth.com/articles/?id=99A01721-E7FF-0DBD-10B0F6BE7A3200CC&msc=N02472&section=section_00