Concept about Encopresis – This book covers the entire syllabus of “Psychiatric Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate the latest information and topics. This book is an examination-friendly setup according to the teachers’ lectures and examination questions.
At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Concept about Encopresis
Encopresis:
Encopresis is the repeated voluntary or involuntary passing of faeces in inappropriate places after the age at which bowel control is usual, in the absence of known organic cause.
[Ref: KP /1/NeerajaVol-2/3311
Or
Encopresis, indicating a more serious emotional disturbance than enuresis, is characterized by passage of feces into inappropriate places at any age (usually after 5 years) when bowel control is expected to be accomplished,
[Ref-Suraj Gupto/11/5
Causes of encopresis:
1. Emotional disturbances.
2. Too rigid toilet training
3. School stress
4. Peers may make this situation as embarrassing and humiliating results in with holding defecation rectal and anal sensations may cease
5. Constipation
6. Parental over concern
7. Congenital anorectal anomalies
8. Fissures
9. Over aggressiveness
10. Fear related to toilet
11. Attention deficit
12. Prolonged gastroenteritis
13. Psycho-social stress
14. Poor parent-child relationship
(Ref: KP Neeraja/1/Vol-2/531-32)
Types of encopresis:
1. With constipation and overflow incontinence
2. Without constipation and overflow incontinence.
[Ref-MR Khan/334)
Management of encopresis:
Clinical features:
➤ If the child withholds defecation, abdomen becomes distended with faeces and gas
➤ Diarrhoea results due to irritation of the intestinal tract
➤ Tensed up.
Diagnosis:
➤ Obtain developmental history of bowel training
➤ Collect information about current pattern of toilet use, eg where the child passes stools, how loty, etc.
➤ Ascertain about family situation
Treatment;
1. latablish regular bowel habits, eg. ask the child to sit on toilet seat for at least 10 minutes twice a day
2. If the child is able to understand, explain the physiology of bowel elimination and importancs of regular evacuation
3. Liquid paraffin, a mild laxative may be used for 4-6 weeks
4. Provide roughage diet with adequate fluids 5. Reestablish a pattern of bowel elimination
6. Psychiatric assistance may be required to treat persistent unresolved psychological problema
[Ref: KPNV-212
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