Fecal Incontinence – What it is, Symptoms and Drug Treatments. Also, Fecal Incontinence is the inability to control the elimination of stool . Also, Fecal Incontinence (en-ko-PREE-sis), sometimes called encopresis or fouling, is the repeated passage of stool (usually involuntarily) on clothing.
It usually happens when impacted stool accumulates in the colon and rectum: the colon becomes too full and liquid stool flows around the retained stool, staining underwear. Eventually, retention of stool can cause bloating (distention) of the bowels and loss of control over bowel movements.
Fecal Incontinence usually occurs after the age of 4, when the child has already learned to use a toilet. In most cases, Fecal Incontinence is a symptom of chronic constipation.
Much less often it occurs without constipation and can be the result of emotional problems. Fecal incontinence can be frustrating for the parent – and embarrassing for the child. However, with patience and positive reinforcement, treatment for Fecal Incontinence is usually successful.
Causes of Fecal Incontinence: There are several causes of Fecal Incontinence , including constipation and emotional problems.
Constipation : Most cases of Fecal Incontinence are the result of chronic constipation. With constipation, a child’s stool is hard, dry, and can be painful to pass. As a result, the child avoids going to the bathroom, making the problem more difficult. The longer the stool remains in the colon, the harder it is for the child to push out stool.
The colon stretches, affecting the nerves that signal when it’s time to go to the bathroom. When the colon becomes too full, soft or watery stools may flow around the retained stool or loss of control over bowel movements may occur. Some causes of constipation include:
- Stool retention due to fear of using the bathroom (especially when away from home) or because the stool is painful
- Not wanting to interrupt the game or other activities
- eating little fiber
- Not drinking enough fluids
- Drinking a lot of cow’s milk or, rarely, cow’s milk intolerance – although research results conflict on these issues
Emotional Problems: Emotional stress can trigger Fecal Incontinence . A child may experience stress from:
- Premature, difficult, or conflicting toilet training
- Changes in the child’s life, such as changes in diet, toilet training, starting school, or schedule changes.
- Emotional stressors, for example a parent’s divorce or the birth of a sibling
Symptoms of Fecal Incontinence: Signs and symptoms of Fecal Incontinence can include:
- Leaking stools or watery stools on underwear, which can be mistaken for diarrhea
- Constipation with dry, hard stools
- Passage of large stools that cover or nearly obstruct the toilet
- Avoid bowel movements
- Long periods of time between bowel movements
- Lack of appetite
- Abdominal pain
- Problems with daytime wetness or enuresis (enuresis)
- Repeated bladder infections, typically in girls
When to See a Doctor: Call your doctor if your child is already toilet trained and begins to experience one or more of the symptoms listed above.
Risk Factors for Fecal Incontinence: Fecal incontinence is more common in boys. These risk factors can increase the chances of having Fecal Incontinence :
- Using medications that can cause constipation, such as cough suppressants
- Attention deficit/hyperactivity disorder (ADHD)
- Autism Spectrum Disorder
- anxiety or depression
Fecal Incontinence Complications: A child who has Fecal Incontinence can experience a range of emotions including embarrassment, frustration, shame and anger. If your child is teased by friends or criticized or punished by adults, he or she may feel depressed or have low self-esteem.
Diagnosing Fecal Incontinence: To diagnose encopresis, your child’s doctor may:
- Perform a physical exam and discuss symptoms, bowel movements, and eating habits to rule out physical causes of constipation or soiling
- Do a digital rectal exam to check for impacted stool by inserting a lubricated, gloved finger into your child’s rectum while pressing down on their abdomen with your other hand
- Recommend an abdominal radiograph to confirm the presence of impacted stool
- Suggest that a psychological assessment be done if emotional issues are contributing to your child’s symptoms
Fecal Incontinence Treatments: Generally, the sooner treatment begins for Fecal Incontinence , the better. The first step involves cleansing the colon of retained and affected stool. After that, treatment focuses on encouraging healthy bowel movements. In some cases, psychotherapy can be a useful addition to treatment.
Eliminating Impacted Stool Colon: There are several methods to cleanse the colon and relieve constipation. Your child’s doctor will likely recommend one or more of the following:
- certain laxatives
- rectal suppositories
Your child’s doctor may recommend close follow-up to check the colon cleansing progress .
Encourage Healthy Bowel Movements: Once the colon is cleansed, it is important to encourage your child to have regular bowel movements. Your child’s doctor may recommend:
- Dietary changes that include more fiber and drinking adequate fluids
- Laxatives, gradually discontinuing once bowel returns to normal function
- Training your child to go to the bathroom as often as possible when the urge to have a bowel movement occurs
- A brief trial of quitting cow’s milk or checking for cow’s milk intolerance, if indicated
Behavior Modification: Your child’s doctor or mental health professional can discuss techniques for teaching your child to have regular bowel movements. This is sometimes called behavior modification or bowel recycling.
Your child’s doctor may recommend psychotherapy with a mental health professional if fecal incontinence may be related to emotional issues. Psychotherapy can also be helpful if your child experiences shame, guilt, depression, or low self-esteem related to Fecal Incontinence .
Drugs for Fecal Incontinence: Fecal incontinence can have several causes, so the treatment varies according to the diagnosis established by the doctor. Therefore, only a trained specialist can tell you which drug is most suitable for your case, as well as the correct dosage and duration of treatment. The most common medications used to treat Fecal Incontinence are:
- Pinaverium Bromide 100mg
- Pinaverium Bromide 50mg
NOTE: Only a doctor can tell you which drug is most suitable for you, as well as the correct dosage and duration of treatment. Always follow your doctor’s instructions to the letter and never self-medicate. Do not stop using the drug without consulting a doctor first, and if you take it more than once or in much larger amounts than prescribed, follow the instructions on the package insert.