Encopresis is fecal incontinence, the inability to control the act of defecation. They are usually observed in children. In adults, encopresis is traditionally of an organic nature (trauma, tumor, rectal prolapse). Encopresis is often preceded by stool retention. The frequency is 1.3% among children over 4 years of age. Prevailing age: in 70% of patients, the disease begins before 5 years of age. The predominant gender is male (1.5:1).


    • Psychological reasons
    • Untimely inculcation of hygiene skills
    • Having to use the toilet in an unfamiliar place (school, summer camp)
    • organic causes
    • Fissure of the rectum or pain in the act of defecation of another origin
    • Muscular hypotension
    • Insufficient peristalsis
    • Hirschsprung disease
    • Spinal cord injury
    • Stenosis of the anus
    • Anterior displacement of the anus: anogenital index >0.34 in girls and >0.45 in boys
    • Postoperative strictures of the anus or rectum
    • Volumetric education in the pelvic region
    • Neurofibromatosis
    • Dietary or metabolic causes
    • Insufficient fiber in food
    • Excessive consumption of milk or meat
    • Insufficient fluid intake
    • Hypothyroidism. Risk factors
    • Male gender
    • Delayed stool, coprostasis.

Clinical picture

    • Abdominal, pelvic, or rectal examination reveals a large amount of stool in the intestine
    • Doughy stool
    • Fecal or putrid odor coming from the patient
    • Intermittent pain in the umbilical region
    • Sometimes passing large amounts of stool
    • Affected children sometimes appear indecisive and depressed, sometimes they tend to be secretive or aggressive.
    • Recurrent urinary tract infections are possible.

Laboratory research

    • General test and urine culture (to detect urinary tract infection)
    • Investigation of the functions of the thyroid gland.

Special Studies

    • Radiography of the abdominal organs with suspected coprostasis, not detected by palpation and rectal examination
    • Detailed history and complete physical examination, neurological examination (including examination of the lower extremities and genital area), rectal examination
    • Prolonged stool retention in the first month of life is a sign of intestinal agangliosis. In this case, an abdominal x-ray with barium contrast and/or rectal biopsy is indicated.


Tactics of conducting

    • Diet
    • Increasing the content of vegetable fiber in food
    • Decrease in the amount of milk

bananas, apples and products containing gelatin

    • Early instillation of hygiene skills
    • Before the start of maintenance treatment – elimination of coprostasis
    • Prevention of re-development of coprostasis
    • Avoid frequent digital rectal examinations, enemas and suppositories
    • Surgical treatment (in the presence of organic pathology). Observation
    • Maintenance treatment for 0.5–2 years
    • Reviews in 4-10 weeks
    • Child psychologist consultation. Drug therapy
    • Drugs of choice (prior to maintenance therapy)
    • On the first day of treatment 2 tbsp. vaseline oil inside
    • The next day, 1-3 enemas (if necessary, the procedure is repeated for 2 consecutive days) until the intestines are completely cleansed in the following sequence:
    • Vaseline oil
    • Sodium hypophosphate 3 g / kg or sodium bicarbonate (2 tablespoons per 1 liter of water at room temperature, 60 ml / year of life, but not more than 480 ml)
    • Bisacodyl suppositories may be given to facilitate evacuation of intestinal contents
    • Alternative regimen: 30% polyethylene oxide 400 ml orally at a rate of 20 ml/kg/h for 4 hours (2 consecutive days).
    • Maintenance therapy – for at least 6 months (until the act of defecation becomes regular and the fecal masses are soft)
    • Vaseline oil 2 tbsp. per day (can be mixed with cool juice)
    • Stool softening and bulking drugs (lactulose, psyllium [flea grass], seaweed)
    • Water mines every day inside; should not be taken simultaneously with vaseline oil, which disrupts the absorption of fat-soluble vitamins (A, D, E, K).


    • Frequent use of enemas and suppositories can cause colitis
    • Perianal dermatitis
    • Anal fissure. Course and forecast
    • Usually responds well to treatment, although relapses are possible
    • Encopresis that has psychological causes is less likely to respond to treatment.


    • Selection of the optimal diet
    • Recommendations for the formation of skills of the act of defecation
    • Treatment of perianal dermatitis to prevent pain during defecation
    • Prevention of psychological and dietary causes of encopresis.

See also Constipation


    • F98.1 Encoprese, inorganic
    • R15 Incontinence


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