Article Text

ENCOPRESIS: EXPERIENCE OF A DISTRICT HOSPITAL
  1. S M Lima1,
  2. I Loureiro1,
  3. E Marques1,
  4. M Costa1
  1. 1Department of Paediatrics, Hospital Sao Miguel, Oliveira Azemeis, Portugal

Abstract

Introduction Encopresis is defined as passage of feces into inappropriate places after a chronological or development age of 4 years. It affects 1 to 2% of children less than 10 years, with male predominance. In 80% of the cases it’s associated with constipation. Emotional and psychological disturbances may occur as cause or consequence.

Material and Methods Retrospective study of children followed in the Paediatric Gastroenterology ambulatory care with the diagnosis of encopresis.

Results The study included 44 children, with male predominance (80%). The median age on first visit was 7,6 years (range 4–13) with symptoms being present for a medium time of 35 months. The most frequent signs and symptoms were an abdominal mass (68%), fecal impactation (72%) and fecal retention (75%). In only 48% of the cases parents referred to their children as being chronically constipated. Sphincter control was achieved at a median age of 28 months (range 18–48). Eight children also had enuresis and nine had development delay. The hospital protocol includes medical treatment associated with dietary and behavioural approaches. Hospital admission was necessary in five children. Cure was achieved in 80% at median time of 3,5 months (range 1–30).

Conclusions As described in literature, male predominance was seen. There was a considerable delay between development of encopresis and referral to speciality, probably due to social connotation and shame. Hospital admission was necessary in a small number of children and cure was achieved in the majority. Early management of constipation is an important factor to prevent future encopresis.

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