1: Psych - Enuresis and Encoparesis Flashcards
What is encopresis
Voluntary defecation in unacceptable places
When is encopresis not used as a term
- Not used under 4-years
- Not used if organic cause
What needs to be excluded in cases of suspected encopresis
Constipation with overflow
Which gender is encopresis more common
Males
What can cause children not to use potties
Developmental Delay
Constipation: Hirschsprungs, Anal fissure, Fear of defecation
Impaired recognition of need to defecate
Impaired behavioural management
Emotional disturbance: abuse
When are children usually toilet trained
18 months - 4-years
What is important in investigation of encopresis
History: behaviour towards toileting, Parent’s attitude towards problem
Exam: abdominal and rectal to exclude constipation. May need plain film AXR
Outline management of encopresis
- Make potty an non-threatening environment: musical
potty, use books - Reward chart: reward the child for sitting on the potty
three times a day after meals - Control constipation: high fibre diet, fluid and laxatives
- If child is smearing poo on the wall this is a sign of abuse and needs CAMS assessment
Define enuresis
Involuntary passage of urine, with no underlying organic cause, after 5-years in girls and 6-years in boys
How can enuresis be divided
- Primary enuresis
- Secondary enuresis
What is primary enuresis
Individual has had no period of urinary continence
What is secondary enuresis
Child has been dry for at least 6-months before
When is urinary continence usually established
4-years
What % of children still wet the bed by age 5
10%
What % of children still wet the bed by age 10
5%
