I NEED A RESPONSE TO THIS ASSIGNMENT 

2 REFERENCES

Parental Guide Week 10 Encopresis

Group D

James, Robert

Kurth, Tiffany

Lawal, Musediq

Akron Children’s Hospital

“If your child has bowel movements (BMs) in places other than the toilet, you know how frustrating it can be. Parents might assume that kids who soil their pants are misbehaving or too lazy to use the bathroom when they have the urge to go.

But many kids beyond the age of (generally older than 4 years) who soil their underwear have a condition known as encopresis. They have a problem with their bowels that dulls the normal urge to go to the bathroom. So they can’t control the accidents that usually follow” (Akron Children Hospital, p1). Encopresis, sometimes called fecal incontinence or soiling, is the repeated passing of fecal material into inappropriate places, usually underclothes by a child who has previously been toilet trained and is at least four years old. Gleason (2019) explained that encopresis results from impacted stool collection in the colon and rectum, which becomes too full, and liquid stools leak around the retained stool, staining underwear. The DSM-5 diagnostic criteria definition of encopresis (F98.1) include repeated inappropriate passage of feces, usually involuntary, that occur at least once a month for at least three months, of children with the chronological age of four years and above, with the exclusion of a substance or medical condition as a cause (American Psychiatric Association, 2013; Sadock, Sadock, & Ruiz, 2017, pg. 3658).

Signs and Symptoms

According to Harvard Medical School (2018), the signs and symptoms of encopresis are:

· Underpants are soiled

· The smell of stool or foul-smelling of the child

· Large bowel movements that alternate with constipation

· Presence of blood on toilets or tissue used to clean the anal opening

· Clothes with stool stained hidden in closets around the house

· Pain in the rectum and lower abdomen

· Nocturnal enuresis due to pressure from the rectum

· Smearing of stool on walls, floors, and furniture in the house

Pathophysiology

According to Coehlo (2013), encopresis results from unpleasant events that must have occurred in the child’s life during toilet training, which could have affected the child to pass feces voluntarily. Other contributing factors are constipation in childhood, poor muscle tone coordination, short attention span in children, and male children.

Kidshealth.org

How the Disorder is Diagnosed

Coehlo (2013) used the following criteria in diagnosing children with encopresis, these are:

· Accidental or purposeful and repeated passing of feces by a child in inappropriate locations (clothing and on the floor).

· The act is done once a month in a three months period and the child is at least four years old in chronological age.

· The behavior is not influenced by physiological factors or substance used by the individual.

Treatment Options

According to Anderson (2019), current evidence-based treatments include:

· Fecal disimpaction and laxative therapy can be achieved by oral or rectal medication.

· Dietary interventions should address overall eating habits, water intake, and fiber intake. The focus should be to increase the consumption of specific fruits and vegetables, decrease the consumption of foods that are high in fat and sugar, and decrease the consumption of constipating foods, such as white bread, banana, and excessive dairy.

· Behavioral modification/intervention; implementation and maintenance of bowel and bladder-voiding schedule and log to monitor for constipation. Behavioral modification of the child’s posture (knees are above the hips) while on the toilet to allow for a more effortless stool flow.

· Child and family education should be child-friendly and age-appropriate explanations to the child and family about the disorder, the process of normal defecation, and the pathology of functional constipation to help alleviate anxiety, clarify misconceptions, and help support the child, family, and therapist relationship.

References

Akron Children’s Hospital (2021). For Family Members of Patients. Retrieved from

https://www.akronchildrens.org/kidshealth/en/parents/encopresis.html

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Washington, DC. Retrieved from

https://doi-org.ezp.waldenulibrary.org/10.1176/appi.books.9780890425596

Anderson, B. (2019). Physical Therapy for a Child with Encopresis: A Case Report. Pediatric Physical

Therapy: The Official Publication of the Section on Pediatrics of the American Physical Therapy Association, 31(3), E1–E7. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1097/PEP.0000000000000631

Coehlo, D. P (2013) Encopresis: A Medical and Family Approach. Journal of Pediatric nursing. Retrieved

from

http://pediatricnursing.net/ce/2013/article107112

Gleason, W. A. . J. (2019). Soiling. Magill’s Medical Guide (Online Edition). Retrieved from

https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=1&sid=f02d8258-6c61-46b9-93a3-a1bcd7ea0987%40pdc-v-sessmgr01&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=89093555&db=ers

Harvard Medical School. (2018) Encopresis (Fecal Soiling). Harvard Health Publishing Retrieved from

https://www.health.harvard.edu/a_to_z/encopresis-fecal-soiling-a-to-z

KidsHealth.org (n.d) Soiling (Encopresis). Retrieved from

https://kidshealth.org/en/parents/encopresis.html

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Kaplan & Sadock’s comprehensive textbook of

psychiatry (10th ed.). Philadelphia: Lippincott Williams & Wilkins