Stephen Borowitz, MD
Bhupinder Anand, MD
IN THIS ARTICLE
Establishing Regular Soft and Painless Bowel Movements
Establishing regular soft and painless bowel movements is mostly a matter of retraining the child to give up the habit of "withholding" stool. This is accomplished by giving a laxative or stool softener every day in doses sufficient to produce one or two soft bowel movements every day. If the bowel movement is soft enough, the child will not have to strain very hard to pass it, and perhaps more importantly, they will not have pain when they pass it. This will encourage the child to pass regular bowel movements rather than holding stool in. Remember that fecal retention and soiling go together and so, as long as the child has a large amount of stool retained in the rectum, the soiling will persist.
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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."