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The Merck Manual--Second Home Edition logo
 
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Chapter 269. Behavioral and Developmental Problems in Young Children
Topics: Introduction | Eating Problems | Bed-Wetting | Encopresis | Sleep Problems | Temper Tantrums | Breath-Holding Spells | School Avoidance | Attention Deficit/Hyperactivity Disorder | Learning Disorders | Dyslexia
 
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Encopresis

Encopresis is the accidental passing of bowel movements that is not caused by illness or physical abnormality.

About 17% of 3-year-olds and 1% of 4-year-olds have encopresis, most often from resistance to toilet teaching. However, chronic constipation, which stretches the bowel wall and reduces the child's awareness of a full bowel, impairing muscle control, sometimes causes encopresis.

A doctor first tries to determine the cause. If the cause is constipation, a laxative is prescribed and other measures are instituted to ensure regular bowel movements. Once regular bowel movements are achieved, the leakage often stops. If these measures fail, diagnostic tests may be performed, such as abdominal x-rays and rarely a biopsy of the rectal wall, in which a tissue sample is taken and examined under a microscope. If a physical cause is found, it often can be treated. In the most severe cases, psychologic counseling may be needed for children whose encopresis is the result of resistance to toilet teaching or other behavioral problems.

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