Encopresis refers to lack of control over one's
bowels. Generally it is not used to talk about
acute conditions like
diarrhaea due to illness, but rather to a
chronic behavior involving passing
stool at inappropriate times or places. It also does not apply to young children who have not been
toilet-trained, but only to ones over four years of age (this is the
arbitrary cutoff chosen by the
medical profession). In other words, for an act of inappropriate
defecation to be coded as
encopresis, it should be clear that the subject has the physical capacity for control, and is lacking in training or desire. Otherwise, the proper term is
incontinence.
Nearly all cases of encopresis occur in young children. Many stem from
inadequate toilet-training. Of course, children will have widely varying requirements in this area, so this is not to say that the child's parents or caretakers are themselves inadequate or
culpable. Suggestions for treatment and prevention involve not beginning toilet training at too young an age and never punishing the child for "
accidents," which will lead to negative assocaitions with defecation and make it more difficult for them to discuss it and learn to handle it appropriately.
Another potential contribution to encopresis is,
paradoxically,
constipation. Children who experience pain passing
stool will end up trying to hold it, and possibly losing control. This can be treated in the short-term by administering small doses of
laxatives that empty the
colon before the fecal matter is compacted. Long-term treatments are essentially the same as those for adults: the child should drink more
water and eat more
fiber (
insoluble fiber, specifically). Even though this increases the size of the stool, it also softens it so that it can pass more easily.
An interesting
anthropological note: For
humans, the only appropriate time to
defecate is when one is sitting or
squatting in one of a very few narrowly-defined places, such as a
toilet,
outhouse, or specifically-designated
pit. Often, it is a mistake to
pathologize behavior that violates such restrictive guidelines, when it may merely be a sign that a person is from a different
culture, or otherwise thinks differently. However, people of almost all
nations and
eras have noticed the danger of having
excrement lying around, and taken steps to separate and dispose of it, hence the old saying "
don't shit where you eat". Thus, encopresis -- if not a disease in the same sense as
cholera -- can legitimately be classified as a real problem and not a harmless personal difference.
An interesting
etymological note: encopresis shares its prefix with the more common
enuresis, or loss of
bladder control. The prefix en- means "to make" or "to cause to do." The root meaning "defecation" can be seen most clearly in the english words
coprolite and
coprophilia.