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| |    Demystifying Encopresis by Robert Needlman, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. From a child's point of view, encopresis is completely unfair. A child with encopresis has no way of understanding why it is that he soils himself. "Trying harder" does no good, because he has lost the ability to sense when his rectum is full of stool. Other children avoid him or tease him about the odor. But he isn't able to smell himself (people generally can't smell their own body odors, simply because they are around them all of the time), which only makes the circumstances that much harder to bear. In this situation, most children conclude that they are somehow to blame. Either there is something wrong with them or they are being punished for some awful deed or thought. Since everybody has awful thoughts from time to time--wishing your baby brother were dead, for example--there are always plenty of imagined crimes for the child to choose from. Generally, parents are as much in the dark. They may think that the child is being bad or lazy, neither of which is true. And they may also harbor fears that the problem is due to something they did or failed to do. It can be a big relief to children and parents alike to find out that encopresis usually develops as a result of constipation that simply gets out of hand, and that usually there is no underlying illness and nothing to feel guilty about, Why it's important to demystify (empowerment) Other than making your child feel better, the other main reason he needs to understand about his encopresis is so that he can take charge of it. Once he knows that the main problem is that his intestines (similar to a really long tube or hose) are clogged up with hard BMs, he will understand why he needs to take mineral oil, or use enemas, to clean himself out. He also will understand why sitting on the toilet, to give his bowels time to work, is important. He can also do abdominal muscle exercises to tone up and train his whole abdomen to work better, as these muscles are helpful in pushing out the stool. . Basic physiology, explained in child language Some of the words you might use in helping to explain the situation to your child:
Along with this talk, you can draw a simple picture showing how the food comes in at the mouth, goes down the esophagus into the stomach, then around and around the intestines, and finally out the rectum. How to ensure your child understands Even though you've explained to your child what is going on with his body, you can't be sure he really understood unless he is able to explain it back to you. (Asking, "do you understand?" is worthless--children always say yes, even when they haven't got a clue). One way to check is to ask a few open-ended questions, such as "So, how did you get this encopresis, anyway?" or "So, how is it that your body is going to get better?" (It is always a good idea to focus on the positives so that your child will remember that he will indeed get better in time.) There is sometimes a fine line between encouragement and nagging. Generally, it's best if you can stay on the encouragement side of things. Also, you don't have to do all of this explaining by yourself. Your child's doctor will probably say something similar. The information in this article should help you to answer questions that come up and offer the kind of informed encouragement that will help your child succeed.
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