Encopresis is defecation (BAB) in pants accidentally in children who pass the age of toilet training (can already defecate in the toilet). Because each child achieves bowel control at different ages. Medical professionals do not consider BAB in pants to be a medical condition unless the child is at least 4 years old.
In the United States, it is estimated that 1-2 percent of children less than 10 years experience encopresis. More boys than girls experience encopresis, about 80 percent of boys.
Causes of Encopresis
Encopresis is caused by anatomic abnormalities or congenital disease. In most cases, encopresis develops as a result of chronic constipation.
Many people think that constipation or constipation is a condition of not defecating every day. However, everyone has their own schedule for bowel movements, and many healthy people do not defecate every day. A constipated child may defecate every three days or even more rarely. Constipation means not only the intestinal peristalsis is rare, but also experiencing difficulty or experiencing pain during bowel movements.
In most children with encopresis, problems starting with bowel movements are very painful. This can occur long before encopresis begins, and the child may not remember this when asked. Over time, children become reluctant to bowel movements and hold them back to avoid pain. Restrain bowel movements become a habit that persists long after constipation or pain when defecating.
Other causes of encoression include:
- As more and more stool accumulates in the child’s large intestine (colon), the large intestine slowly widens (sometimes called megacolon)
- Because the large intestine widens in more and more sizes, the child loses the natural urge to make bowel movements
- Finally, the stool is formed at a place earlier than it should be so that stool forms harder, into the rectum and then “leak” out of the anus (the opening of the large intestine from the rectum outside the body)
- Often at first, only small amounts of stool leak, causing lines to form on children’s clothing. Typically, parents assume the child has not wiped or cleaned the anal area well after bowel movements and does not consider this important
- Over time, the child is less able to hold stool, more and more stool leakage, and finally the child throws the entire stool when defecating in the pants
- Often children do not realize that has defecated
- Because stool does not pass through the large intestine normally, stool often becomes very dark and sticky and may have a very foul odor
Then, over time children with encopresis will have impaired intestinal muscle coordination. In many children, the contraction of the anal spincter muscles is more relaxed when they try to encourage bowel movements. This interferes with the coordination of muscle function which causes stool to hold, which is the key to diagnosis, and is often called an anusal contraction or paradoxical contraction of the pelvic floor for defication.
Causes of Constipation
- Children lack eating fibrous foods such as vegetables and fruit
- Drink less water
- Constipation can also occur due to family history
- There is no apparent cause of constipation in most children
Encopresis can frustrate many parents. Many parents become angry when they see their children repeatedly defecating in their pants. Many parents think that this often happens because children are lazy or happen accidentally. However, this is not the cause. But scolding a child is not the right solution because it will affect the emotional child.
More than 80 percent of children with encopresis have a history of constipation or defecating. In many cases, constipation or pain occurs many years before encopresis occurs, and this point will come to the attention of the doctor.
Many children with encopresis say that they do not feel like pooping when finally there is feces in their pants. Defecation in pants takes place when the child is still awake and active. Many school-age children defecate in their pants in the afternoon after school. Defecation in pants during the night is rare. In children with encopresis, the colon or large intestine has widened.
Medical help when a child experiences the following:
- When constipation feels heavy, continuous, or repetitive
- Pain during bowel movements
- Difficult to have bowel movements, including holding bowel movements
- Occurs in children over 4 years