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Encopresis (cont.)

Emptying the Colon of Stool

Medical professionals usually refer to emptying stool from the colon and rectum as evacuation or disimpaction. Evacuation of the colon can be accomplished in the following ways:

  • Administer strong laxatives and/or stool softeners: Most laxatives and stool softeners work by increasing the amount of water in the large intestine. Some laxatives and stool softeners cause the lower intestine to secrete water and others work by decreasing the amount of water absorbed in the lower intestine. In either case, the end result is much more water in the lower intestine when using these medicines than when not using them. This large amount of water softens formed or hard stool in the intestine and produces diarrhea. Medicines used commonly for this purpose include polyethylene Glycol 3350 (Miralax, Glycolax, etc), polyethylene glycol electrolyte solution (GoLYTELY, Colyte, etc.) , sodium biphosphate and sodium phosphage (Fleet Phospho-soda) or magnesium citrate (Citrate of Magnesia, Citroma). Treatment for several days may be needed to completely evacuate the colon.
  • Administer an enema or series of enemas: An enema pushes fluid into the rectum. This softens the stool in the rectum and creates pressure within the rectum. This pressure gives the child a powerful urge to have a bowel movement, and the stool is usually expelled rapidly. The fluid in most enemas is water. Something is usually added to keep the water from being absorbed by the intestinal lining. Widely used enemas include commercial phosphosoda preparations (such as Fleet saline enemas), slightly soapy water, and milk and molasses mixtures. Daily enemas for several days can be used to completely evacuate the colon.
  • Administer a suppository or a series of suppositories: A suppository is a tablet or capsule that is inserted into the rectum. The suppository is made of a substance that stimulates the rectum to contract and expel stool. Popular suppositories include glycerin and commercial products such as Dulcolax and BabyLax. Daily suppositories for several days can be used to completely evacuate the colon.
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Encopresis »

According to the Diagnostic and Statistical Manual of Mental Disorders, Third edition (DSM-III), encopresis is defined as the "repeated involuntary passage of feces into places not appropriate for that purpose...the event must take place for at least 6 months, the chronologic and mental age of the child must be at least 4 years."

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