Recurrence of Encopresis during Maintenance Therapy

Stool with­hold­ing is a behav­ior best con­trolled by com­bin­ing sen­na (Ex-lax) with behav­ior mod­i­fi­ca­tion. An expert in the treat­ment of with­hold­ing and enco­pre­sis (soil­ing) should remain involved con­tin­u­ous­ly. The treat­ment process can be quite chal­leng­ing, both to the fam­i­ly and the doctor.

Stool with­hold­ing can­not be cured, but the fre­quen­cy of episodes can be con­trolled and man­aged allow­ing for the child to be clean and ful­ly func­tion­al. The process of main­te­nance demands slow wean­ing of the sen­na and a watch­ful eye on the part of the fam­i­ly and the guid­ing physi­cian. If a relapse occurs, par­ents’ recog­ni­tion of the prob­lem and advice from a knowl­edge­able pro­fes­sion­al should be help­ful.  At times of relapse, sen­na inter­ven­tion should be imme­di­ate and brief in duration.

There is always a light at the end of the tun­nel. As chil­dren get old­er, although they often con­tin­ue to with­hold stool, i.e. in school, enco­pre­sis (soil­ing) becomes less com­mon. The num­bers of pread­o­les­cents and and ado­les­cents who soil appears to be extreme­ly small giv­en the num­bers of chil­dren with a his­to­ry of with­hold­ing and enco­pre­sis. Social embar­rass­ment from enco­pre­sis is an infre­quent con­cern for pread­o­les­cents and ado­les­cents with withholding.