Encopresis occurs when a child will deliberately resist having bowel movements, sometimes referred to as “stool holding.” This will usually develop after a child has had a bout with chronic constipation, and less commonly, can be related to developmental or emotional issues. In my son’s case, he had become constipated from taking vitamins with added iron.
When my son was around the age of 2 1/2, he was already partially potty trained and was still making progress in this area. Then came a checkup appointment where his blood count, or hemoglobin, came back showing he was just a little low on iron. It was suggested at the health clinic that I start giving my son a multi-vitamin containing iron. This was the beginning of all our problems and his bout with encopresis.
It is commonly known that iron can be constipating, and the added iron in the children’s vitamins eventually caused my son to become constipated after taking them for awhile. I began to notice he wasn’t having regular bowel movements and that after a few days of this, his stomach would become a little distended.Then when he did have a bowel movement, it was always hard and difficult to pass.
I also noticed changes in his appetite, and that when he would sit down to eat, it would almost immediately trigger his urge to have a bowel movement, which he would then resist. Instead of going to the bathroom as he used to, he would fight it, breaking into a sweat. No matter how much I encouraged him to go , he would still fight it, and since he was still in a diaper because he was not 100 percent potty trained , he would claim he was “trying to push it out”, when in reality, he was doing his very best to avoid pushing it out.
With the development of encopresis, comes the association of pain with bowel movements, therefore, leading the child to try to keep from having them. After so long, the bowels become impacted, causing fecal matter in the colon and rectum to collect. As the colon and rectum become overloaded, a foul smelling liquid may leak from the anal region, causing “soiling.” The result is chronic constipation with rock like stools and leakage. This can result in what is referred to as a “mega colon.” After some time of this stool withholding, the colon becomes stretched and may affect the nerves that signal the body to tell it that it’s time for a bowel movement.
Encopresis is more common in boys than in girls, and many times will occur around the age of four years old, after the child is fully potty trained. This can be very emotionally frustrating for both child and parent, as it causes a huge setback with the occurrence of constant soiling.
If you notice your child resisting the urge to have a bowel movement, notice they haven’t gone in several days, or if they are experiencing a lack of appetite or abdominal pain, it’s time to see your pediatrician.
I stopped giving my son the vitamin with iron, thinking things would return to normal within a few days. He was still suffering with constipation. After trying the obvious potential solutions at home with my son, such as children’s glycerin suppositories, and stool softeners, even a child’s laxative, and having nothing be more than minimally effective, I took him to the doctor. As it turned out, I was doing the correct things, but leaving out the key element to really “clean him out.”
After a doctor recommended combination of children’s enemas to clear the impaction, mineral oil to clean out the colon, and a combination stool softener/laxative, my son was finally “cleaned out”. It took a little time, as the colon has stretched, for things to return to normal, but after awhile, he was having regular bowel movements again and acting upon the urge to eliminate, finally became fully potty trained (because this was holding him back in a big way), and started getting his appetite back. He was no longer associating “making a poopy” with pain.
I am not offering medical advice here, but simply relaying what I was told by my son’s doctor. Please consult your child’s physician before administering any enema, stool softener, laxative, or mineral oil, as any or all of these can be dangerous if used or given incorrectly. This was such a hard thing for my son and myself to go through, so if any other parent can learn something from this article that can help them in any way, I consider it well worth it. If you now realize your child may be suffering from more than simple constipation, please see your pediatrician as soon as possible, because this can become a very serious problem. please visit http://www.mayoclinic.com/health/encopresis/DS00885 for more information on encopresis.