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Encopresis: A guide for Psychiatric Nurses

  • Lyons T. Hardy
    Correspondence
    Corresponding Author: Lyons T. Hardy, M.S.N., R.N., 824 N 35th St., Richmond, VA 23223.
    Affiliations
    Virginia Treatment Center for Children, Virginia Commonwealth University Health System, Richmond, VA.
    Search for articles by this author
Published:January 16, 2009DOI:https://doi.org/10.1016/j.apnu.2008.09.002
      Encopresis is an elimination disorder that involves symptoms of fecal incontinence in children. It affects an estimated 1.5% to 7.5% of children ages 6 to 12 and accounts for approximately 3% to 6% of psychiatric referrals. The etiology of encopresis is thought to be related to physiologic problems such as constipation; however, it is also a psychiatric diagnosis and anecdotally may have some association with psychiatric problems. Publications on this association and publications directed toward psychiatric nurses are limited. Encopresis is typically treated with nutritional and medical management along with behavioral modification. Psychiatric nurses working with patients who have encopresis in inpatient settings will have unique concerns and challenges. This article gives an overview of published literature from the past 10 years on the etiology and treatment of encopresis. Specific suggestions for inpatient psychiatric nurses based on published literature and the author's professional experience are provided.
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      References

        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        4th ed., text revision. Author, Washington, DC2000
        • Bishop E.
        • McKinnon E.
        • Weir E.
        • Brown D.W.
        Reflexology in the management of encopresis and chronic constipation.
        Paediatric Nursing. 2003; 15: 20-21
        • Cerezo M.A.
        • Pons-Salvador G.
        Modifying the family process in two cases of physical child abuse and secondary functional encopresis.
        Child Maltreatment. 1998; 3: 171-185
        • Croffie J.M.
        • Ammar M.S.
        • Pfefferkorn M.D.
        • Horn D.
        • Klipsch A.
        • Fitzgerald J.F.
        • et al.
        Assessment of the effectiveness of biofeedback in children with dyssynergic defecation and recalcitrant constipation/encopresis: Does home biofeedback improve long-term outcomes?.
        Clinical Pediatrics. 2005; 44: 63-71
        • Ehrenreich J.T.
        • Boggs K.M.
        • Seif T.A.
        • Strother D.M.
        • Gross A.M.
        It's a dirty job: Mental health consultation and the challenge of treating encopresis in a preadolescent.
        Clinical Case Studies. 2003; 2: 20-33
        • Field C.E.
        • Friman P.C.
        Encopresis.
        in: Fisher J.E. O'Donohue W.T. Practitioner's guide to evidence-based psychotherapy. Springer, New York2006: 277-283
        • Foreman D.M.
        • Thambirajah M.S.
        Conduct disorder, enuresis, and specific developmental delays in two types of encopresis: A case-note study of 63 boys.
        European Child & Adolescent Psychiatry. 1996; 5: 33-37
        • Foreman D.M.
        • Thambirajah M.
        Letter to the editor.
        Child Abuse & Neglect. 1998; 22: 337
        • Goldenthal P.
        Helping children and families: A new treatment model integrating psychodynamic, behavioral, and contextual approaches.
        John Wiley & Sons, Inc, Hoboken, NJ2005
        • Johnson C.H.
        • Mullins L.L.
        • Walker C.E.
        Elimination disorder.
        in: Hersen M. Clinical behavior therapy: Adults and children. John Wiley & Sons, Inc, New York2002
        • Joinson C.
        • Heron J.
        • Butler U.
        • von Gontard A.
        • the Avon Longitudinal Study of Parents and Children Study Team
        Psychological differences between children with and without soiling problems.
        Pediatrics. 2006; 117: 1575-1583
        • Klages T.
        • Geller B.
        • Tillman R.
        • Bolhofner K.
        • Zimmerman B.
        Controlled study of encopresis and enuresis in children with a prepubertal and early adolescent bipolar-I disorder phenotype.
        Journal of the American Academy of Child and Adolescent Psychiatry. 2005; 44: 1050-1056
        • McGrath M.L.
        • Mellon M.W.
        • Murphy L.
        Emprically supported treatments in pediatric psychology: Constipation and encopresis.
        Journal of Pediatric Psycholgoy. 2000; 25: 225-254
        • Mellon M.W.
        Enuresis and encopresis.
        in: Bear G.G. Minke K.M. Children's needs III: Development, prevention, and intervention. National Association of School Psychologists, Bethesda, MD2006: 1041-1053
        • Mellon M.W.
        • Whiteside S.P.
        • Friedrich W.N.
        The relevance of fecal soiling as an indicator of child sexual abuse: A preliminary analysis.
        Developmental and Behavioral Pediatrics. 2006; 27: 25-32
        • Mikkelsen E.J.
        Enuresis and encopresis: Ten years of progress.
        Journal of the American Academy of Child and Adolescent Psychiatry. 2001; 40: 1146-1158
        • Morrow J.
        • Yeager C.A.
        • Lewis D.O.
        Encopresis and sexual abuse in a sample of boys in residential treatment.
        Child Abuse & Neglect. 1996; 21: 11-18
        • Murphy S.
        • Carney T.
        The classification of soiling and encopresis and a possible treatment protocol.
        Child and Adolescent Mental Health. 2004; 9: 125-129
        • O'Connor T.
        Helping children with enuresis and encopresis.
        Kai Tiaki Nursing New Zealand. 2003; 9: 21
        • Philichi L.
        When the going gets tough: Pediatric constipation and encopresis.
        Gastroenterology Nursing. 2008; 31: 121-130
        • Radford J.
        • Anderson M.
        Encopresis in children on the autistic spectrum.
        Early Child Development and Care. 2003; 173: 375-382
        • Reid H.
        • Bahar R.J.
        Treatment of encopresis and chronic constipation in young children: Clinical results from interactive parent–child guidance.
        Clinical Pediatrics. 2006; 45: 157-164
        • Ritterband L.M.
        • Cox D.J.
        • Walker L.S.
        • Kovatchev B.
        • McKnight L.
        • Patel K.
        • et al.
        An internet intervention as adjunctive therapy for pediatric encopresis.
        Journal of Consulting and Clinical Psychology. 2003; 71: 910-917
        • Secco L.
        Review: Behavioural interventions plus laxatives are effective for defecation disorders in children, but biofeedback does not add benefit.
        Evidence Based Nursing. 2002; 5: 76
        • Thomson L.
        Hypnosis for children with elimination disorders.
        in: Wester W.C. Sugarman L.I. Therapeutic hypnosis with children and adolescents. Crown House Publishing, Bethel, CT2007: 387-415
        • Ünal F.
        • Pehlivantürk B.
        Comorbid psychiatric disorders in 201 cases of encopresis.
        Turkish Journal of Pediatrics. 2004; 46: 350-353
        • van Dijk M.
        • Benninga M.A.
        • Grootenhuis M.A.
        • Onland-van Nieuwenhuizen A.-M.
        • Last B.F.
        Chronic childhood constipation: A review of the literature and the introduction of a protocolized behavioral intervention program.
        Patient Education and Counseling. 2007; 67: 63-77
        • VanScoyoc S.M.
        Elimination disorders.
        in: Waller R.J. Fostering child & adolescent mental health in the classroom. Sage Publications, Thousand Oaks, CA2006: 45-55
        • Vitito L.M.
        Self-care interventions for the school-aged child with encopresis.
        Gastroenterology Nursing. 2000; 23: 73-77
        • von Gontard A.
        Elimination disorders: Enuresis and encopresis.
        in: Gillberg C. Harrington R. Steinhausen H.-C. A clinician's handbook of child and adolescent psychiatry. Cambridge University Press, Cambridge2006: 625-654
        • Walsh T.
        • Menvielle E.
        Disorders of elimination.
        in: Wiener J.M. Dulcan M.K. The American Psychiatric Publishing textbook of child and adolescent psychiatry. American Psychiatric Publishing, Washington, DC2004: 743-750