Reply to question about why most doctors know little about encopresis treatment by Dr Daum

Yes­ter­day, a moth­er wrote me this very thought­ful and impor­tant ques­tion: Dr. Fredric Daum- so many doc­tors- even pedi GI docs do not know much about this diag­no­sis- oth­er than a def­i­n­i­tion. There is a sig­nif­i­cant lack of pro­fes­sion­al knowl­edge. Ulti­mate­ly, and unfor­tu­nate­ly, many of us don’t get the prop­er treat­ment pro­to­col for our indi­vid­ual chil­dren- to meet their unique needs. It’s a “cook­book recipe” for treat­ment vs an indi­vid­u­al­ized treat­ment plan.

My reply follows:
I have prac­ticed in New York for over 40 years. It has been a chal­lenge to try to edu­cate health pro­fes­sion­als as to the frus­tra­tions that par­ents have in try­ing to deal with enco­pre­sis. Few health pro­fes­sion­als, as you have stat­ed, take this prob­lem seri­ous­ly. Per­haps, because I have per­son­al­ly expe­ri­enced it with one of my own chil­dren, I feel the frus­tra­tion and pain of par­ents going through this. In med­ical school and in res­i­den­cy, there is almost no edu­ca­tion in enco­pre­sis for doc­tors who have cho­sen to be pedi­a­tri­cians. In my own insti­tu­tion, I am now see­ing more and more res­i­dents come to my sem­i­nar — which is a good start, but only a start. It has tak­en me years to learn how to approach enco­pre­sis, not only in chil­dren with­out spe­cial needs, but also chil­dren with autism, Down syn­drome and oth­er genet­ic chal­lenges. By part­ner­ing with Michelle and by being active on sup­port groups around the world, i learn every day from par­ents and from patients, the nuances of treat­ment for enco­pre­sis. Although we work 7 days a week, includ­ing week­ends and hol­i­days, to help resolve enco­pre­sis, it is not real­is­tic to expect that most doc­tors are going to make this sort of com­mit­ment. It cer­tain­ly is not some­thing that would attract doc­tors eco­nom­i­cal­ly. The amount of hours, the weeks, the months, that go into the main­te­nance aspect of treat­ment for enco­pre­sis are count­less. It is a prob­lem for which there is a light at the end of the tun­nel, but only with the stead­fast com­mit­ment of fam­i­lies and health pro­fes­sion­als alike. I don’t know if this state­ment is of help to you, but Michelle and I con­tin­ue to have the same pas­sion and com­mit­ment as we have always had in deal­ing with enco­pre­sis. Dr. Daum