chapter  Twenty Six
6 Pages

Faecal soiling/encopresis

WithQuentin Spender, Niki Salt, Judith Dawkins, Tony Kendrick, Peter Hill, David Hall, Jackie Carnell

Encopresis can be defined as repeated voluntary or involuntary defecation in inappropriate places, occurring in children aged four years or older on a regular basis for at least one month. faecal incontinence usually implies that the passage of stool is involuntary. Faecal soiling is the passage of faeces, often loose, into clothing in association with chronic constipation. The child becomes constipated for a variety of reasons, and the impacted faeces then block and distend the rectum, impairing anal tone and faecal retention. Stool, which may be of any consistency, leaks around the mass. Parents may become exasperated, and find it impossible not to be angry with the child about the smell and the mess. The self-esteem of the scapegoated child plummets further, and the whole family sinks into a slough of despondency. The child's weight and height should be plotted on a centile chart. Palpate the abdomen for faecal masses, and check the anus for visible fissures.