BOWEL CONTROL AND PROBLEMS WITH SOILING
Q] What is the bowel control?
A] Ability to pass stool at a time and place that is socially conducive is called as bowel control. Most children can control their bowels and are toilet trained by four years of age.
Q] What is soiling?
A] Even after bowel control has been achieved, sometimes, bowel accidents can occur and a child can pass stools in the panty and that is called as soiling. It leads to frustration sometimes to the child, parents, teachers and other people important in the child’s life. Many times social difficulties can aggravate this problem and can be severe.
Q] What is the main reason for soiling?
A] This problem generally starts during toilet training with too vigorous or early attempts to toilet train before the child is ready for it. This leads to the child holding back at stools and constipation and then dribbling of the loose stools from around the heard stools leading to soiling. Sometimes physical disabilities that lead to the inability to keep clean and continuous dribbling of stool can occur. Emotional problems with parents are the main reasons. It may start with stressful changes in the child’s life such as birth of sibling or divorce of parents, working parents, family transfers or other family problems. It is also very common in boys.
Q] What is the encopresis?
A] Soiling problem in children who do not have any type of illness or disability is called encopresis. Children often have other problems like short attention span, hyperactivity and low frustration tolerance and poor coordination.
Q] How to treat soiling?
A] First complete physical check up by family physician or pediatrician is required to rule out a physical disability. If there is no physical problem then next step is referral to a child psychologist who can check for emotional problems that could be contributing to the problem. Patience is required as long term treatment is required and progress is slow. Many times early diagnosis and early treatment can help and shorten treatment duration. If constipation is the cause, then stool softeners with laxatives are used for a short time till bowel habits normalize.