A child with encopresis passes part or all of his normal stools into his underwear or diaper rather than the toilet.
The most common cause of long-standing soiling is resistance to toilet training (bowel training resistance). Many of these children also refuse to sit on the toilet or will use the toilet only if their parent brings up the subject and marches them into the bathroom. Any child who is over 3 years old, healthy, and not using the toilet after several months of encouragement to use it can be assumed to be resisting using the toilet. About 5% of children refuse to be bowel trained.
The most common cause of resistance to toilet training is that a child is strong-willed and has been reminded or lectured too much. Some children have been forced to sit on the toilet against their will, occasionally for long periods of time. A few have been punished for not cooperating. Many parents make these mistakes, especially if they have a child with a difficult temperament. Most children less than 5 or 6 years old with encopresis are simply engaged with you in a power struggle. More practice, such as you have used in toilet training, will not help. Instead, your child now needs full responsibility and some incentives to spark his motivation.
When encopresis begins suddenly in a toilet trained child, the cause is usually a new stress in the child's life. The stress may be a physical illness such as severe diarrhea or an emotional upset such as going to a new school. These children usually regain control of their bowels when the stress is reduced or removed.
Children who have chronic encopresis can be helped with the following suggestions. If your child starts holding back stools and becomes constipated, medicines will also be needed.
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