Childhood Encopresis

　　What are the causes of childhood encopresis? It may be related to genetic factors, delayed maturation of the nervous system, inappropriate educational methods, and psychosocial factors. Encopresis mainly occurs in children aged 5 or older.

　　Most of the time, it is kept inside the pants, with normal bowel shape, not diarrhea, and there are no abnormalities found during physical examination. Most children with encopresis can recover spontaneously as they grow older. Encopresis in children often accompanies enuresis.

　　Children are able to control defecation at the age stage of development, but frequently appear unable to control the excretion of feces, most of which are defecated in their pants, with normal feces shape, not diarrhea, and no abnormalities in physical examination.

　　The basic measures for preventing childhood fecal incontinence are to pay attention to the child's toilet training, followed by improving the dietary structure, reasonably arranging the diet, keeping the bowels smooth, and parents should also pay attention to eliminating adverse factors and creating a good living environment.

　　The diagnosis of childhood fecal incontinence relies not only on clinical manifestations but also on related auxiliary examinations. The main examinations include fecal routine, blood routine, gastrointestinal ultrasound examination, gastrointestinal CT examination, and gastrointestinal function dynamic examination.

　　In addition to routine treatment for children with fecal incontinence, it is necessary to encourage drinking water, keep the mouth and tongue moist, and urinate smoothly. Parents should pay attention to the child's nutrition, do not arbitrarily avoid certain foods, and also pay attention to the smooth defecation.

　　The cause of childhood fecal incontinence should be sought, and treatment measures should be given for relevant factors, and the training and guidance of the child's health habits should be strengthened.
　　1. Behavioral Therapy:Positive reinforcement can be used, and praise and rewards should be given when the child can defecate normally and not soil their pants. When there is still involuntary defecation, do not scold or frighten them, but comfort them to relax their spirit. It has been proven that behavioral therapy is a very effective treatment method.
　　2. Adjunctive Treatment:Antianxiety drugs or tricyclic antidepressants can be used for treatment if necessary, combined with psychotherapy using a low dose of imipramine. There may still be fecal incontinence or chlorpromazine 10-25 mg/day, taken for several months, with significant efficacy.
　　3. Bowel Movement Treatment:The initial bowel movement treatment is carried out according to the following program for 1-4 courses: On the first day, use adult low-phosphate enema solution (children over 7 years old use 2 portions at a time); on the second day, use diclofenac rectal suppositories (10mg); on the third day, take diclofenac tablets orally (5mg). An abdominal X-ray can be taken to check if the enema is sufficient. Maintenance treatment can use various vitamins, light mineral oil, and last for 4-6 months.