Treatment guidelines for primary nonretentive encopresis and stool toileting refusal

Brett R Kuhn, Bethany A. Marcus, Sheryl Lin Pitner

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency. An organic cause for nonretentive encopresis is rarely identified. The medical assessment is usually normal, and signs of constipation are noticeably absent. A full developmental and behavioral assessment should be made to establish that the child is ready for intervention to correct encopresis and to identify any barriers to success, particularly disruptive behavior problems. Successful interventions depend on the presence of soft, comfortable bowel movements and addressing toilet refusal behavior. Daily scheduled positive toilet sits are recommended. Incentives may be used to reinforce successful defecation during these sits. A plan for management of stool withholding should be agreed on by the parents/caretakers and the family physician before intervention.

Original languageEnglish (US)
Pages (from-to)2171-2178
Number of pages8
JournalAmerican Family Physician
Volume59
Issue number8
Publication statusPublished - Apr 15 1999

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ASJC Scopus subject areas

  • Family Practice

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