Encopresis and Enuresis are disorders in kids that parents and family should be knowledgeable of in order to deal with them.
Encopresis is a disorder that poses repeated feces passage at inappropriate places which include the floor or the clothing of the child. Most of the cases of Encopresis Disorders are involuntary, but there are situations when the act is intentional.
Involuntary Encopresis is usually related to the following:
- Retention with Subsequent Overflow
Due to psychological reasons, constipation may develop in the process. As explained also in Family Hype website, it could be due to the anxiety of having no control to defecate in a particular place or the necessity to follow a pattern of oppositional or anxious behavior. With this anxiety, it forces the person, in the end, to avoid defecating at all.
Some of the physiological predispositions when it comes to constipation are the following:
- Medication Side Effect
- Dehydration Associated with Febrile Illness
Complications may even occur once constipation has developed, including:
- Anal Fissure
- Painful Defecation
- Further Fecal Retention
The consistency of the feces may vary from normal to liquid form. Most of the cases for the latter though is a result of overflow incontinence secondary to the fecal retention.
Encropesis disorder cases can occur for at least 3 months. Its chronological age, which is equivalent to the developmental level, can reach up to at least 4 years. This disorder is not related to general medical conditions or as a physiological side effect of substances like laxatives.
For treatment of Encropesis disorder, some experts would encourage appropriate bowel habits. For severe cases though, they may recommend laxatives or stool softeners to cater to constipation. “A physician should rule out the presence of physical causes for the presence of fecal soiling in children over age four years. The physician may proceed with treatment typically using top down oral medications on a maintenance basis following a clean out of a colon that is overfilled with feces,” according to Dr. Collins, a licensed psychologist.
The problem will be more complicated if the child has other mental health issues. As mentioned by Dr. Elizabeth Woodcock, a clinical psychologist, in her website, “Co-existing emotional and behavioural disorders should be treated separately according to evidence-based recommendations. If your child also has anxiety, depression, or oppositional defiant disorder (ODD), these conditions should be treated concurrently.”
Enuresis disorder is the repeated voiding of urine that can either be involuntary or intentional. The voiding of urine can happen anytime, from the day to night and even when on the bed. The disorder can be manifested by:
- Twice a week or at least 3 consecutive months of occurrence
- Clinical distress in professional, academic, or social functions
Its developmental level can take at least 5 years and it may not be exclusively caused by direct physiological effect from a substance or a medical condition. “Enuresis is the inappropriate elimination of urine. The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) indicates that the prevalence of enuresis is around 5%- 10% for children 5 years old and 3 % – 5% of 10 year olds,” according to Erica David, PsyD.
There are three subtypes of Enuresis Disorder that a child can suffer in, including the following:
Diurnal Only. This specific subtype is when the person voids urine during waking hours. More common in females compared to males, the Diurnal Enuresis Disorder becomes uncommon after the age of 9 years. The incidences occur more frequently during the early afternoon. It is sometimes caused by the person’s reluctance to use the toilet due to preoccupation with an activity or it can be due to social anxiety.
Nocturnal Only. This is considered to be the most common form of Enuresis Disorder, where kids void urine at night. Incidents usually occur on the first one-third of the night and happen most commonly during the REM or rapid eye movement stage of sleep. In fact, the kid may even recall a dream that includes the act of urinating.
Diurnal and Nocturnal. This is the subtype combination of both the two forms mentioned above.
Treatment for Enuresis Disorder comes in the form of Desmopressin acetate. This therapy is for children and known to lessen the frequency of instances.