Psihološki vidiki enkopreze brez organskega izvora
Psychological aspects of encopresis without organic ethiology

slovenian

2016

volume 85, issue 9

child   children   comorbidity   encopresis   psychological health   therapeutic interventions

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Abstract Encopresis is defined as a voluntary or involuntary passage of stool in inappropriate places or in clothes by a child aged four years or above when bowel control can normally be expected. It affects 1 to 3 % of paediatric population. This article focuses on retentive encopresis that is most often related to chronic constipation. Incomplete bowel control has an important impact on physical health, psychosocial functioning and family life. Personal and contextual predisposing, precipitating, maintaining and protective factors for encopresis in a context of etiological hypotheses are discussed. Most children with encopresis have no physical problems to explain the disorder. The text is focusing on chronic constipation, chaotic family environment, parent-child interaction, developmental delay, and avoidance of defecation, the role of family, stressors and anxiety over toileting. Common causes of encopresis include a low fibre diet, lack of hydration, little or no exercise and premature toilet training. There is comorbidity with cognitive delays, learning disabilities, attention deficit disorder, conduct or oppositional disorders. In solving this problem, the most effective treatment method seems to be a combination of medical and behavioural approach. The main components are psychoeducation, clearing the faecal mass with laxative use and bowel retraining with toileting, accident management, diet and exercise. With effective strategies encopresis can be eliminated, but relapses may occur.

03.03.2017