Encopresis in children and adults

What is encopresis?

Encopresis is a disorder characterized by the regular, but involuntary, passage of formed or semi-formed stool in inappropriate situations. To be considered as having this disorder, several symptoms must be present:

• Defecation should be regular; in children over 4 years old, it occurs daily or almost daily. In adults, it occurs at least two to three times a month.
• It is most often involuntary: simply relaxing the sphincter muscles results in the evacuation of stool.
• It is uncontrolled; the person suffering from this disorder defecates in their underwear or in inappropriate places, such as on the floor. It can also be retentional or non-retentional, meaning caused by a tendency to not want to defecate.
• It is linked to physiological and psychological disorders.

Cause of encopresis

Encopresis can present differently in individuals, and its causes are still difficult to identify. However, it is known that this condition has several causes. It most often has a physiological origin (malformation, trauma, constipation), but can also have a psychological cause, or both. Treatments exist but are not well understood; medication may be combined with psychological counseling to identify the underlying cause of the disorder.

Treatment of encopresis

Treatments exist, but vary depending on the type of encopresis. A medical diagnosis must be made before any treatment. Indeed, if this disorder is caused by infections or other physiological factors, the treatment will be medical or surgical. If there are no physical factors, the patient will need psychological support to determine the underlying causes of the disorder.

Treatment through psychological follow-up

An individual experiencing encopresis without physical causes (constipation, megacolon, and sphincter muscle problems) can consult a psychoanalyst to help treat this disorder. If the disorder appears in a young child, the parents should also consult a specialist. The therapeutic approach consists of determining the cause of the disorder. Generally, psychological causes are:

• strict potty training or starting too early
• A behavioral disorder, a personal blockage; for some patients, defecation is not straightforward and can be troubling.
• a history that has physically affected the individual, for example, acute constipation or anal fissures
• a psychiatric pathology

Psychological treatment aims to eliminate the fear or shock associated with defecation. It involves learning self-control through physical exercises, as well as by mastering one's body. Psychological treatment may be accompanied by medication.