Early Constipation and Toilet Training in Children With Encopresis

Fishman, Laurie N.; Rappaport, Leonard; Cousineau, Dominique; Nurko, Samuel

doi:10.1097/00005176-200204000-00013

Cited by 39 publications

(43 citation statements)

References 15 publications

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“…These children attended paediatric clinics for the first time at an older age than those who had constipation (on average 9.2:6.5 years). It is surprising that only 29% of these children had ever visited a doctor to address the problem (19,20). Very often, FNRFI is not recognized as a distinct clinical entity by general practitioners and paediatricians, which frequently results in inadequate treatment with a negative response in the follow-up and deepens the problem.…”

Section: Discussionmentioning

confidence: 99%

Encopresis in Children: An Overview of Recent Findings

Vuletic

2017

Serbian Journal of Experimental and Clinical Research

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Section: Discussionmentioning

confidence: 99%

Encopresis in Children: An Overview of Recent Findings

Vuletic

2017

Serbian Journal of Experimental and Clinical Research

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“…A detailed parent questionnaire developed by Levine was used in its original format between 1980 and 1999. 17 This questionnaire was completed by the family at home before the first visit and was reviewed with a staff physician at the time of the initial consultation. The questionnaire included inquiries about the characteristics of current and past bowel habits, previous diagnostic procedures, and previous therapeutics used.…”

Section: Methodsmentioning

confidence: 99%

Trends in Referral to a Single Encopresis Clinic Over 20 Years

Fishman¹,

Rappaport

Schonwald

et al. 2003

Pediatrics

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ABSTRACT. Objective. To compare the characteristics of children with encopresis referred to a single encopresis clinic over the course of 20 years, including symptoms, previous diagnostic and therapeutic interventions, and parental attitudes.Methods. A retrospective study was conducted of an encopresis clinic at a tertiary care pediatric hospital. Questionnaires at initial evaluation elicited information about bowel habits, soiling, previous evaluations, previous treatments, and parental attitudes.Results. In 503 children with encopresis, the average age of referral dropped from 115 months during the earliest 5 years to 77 months during the most recent 5 years. Children who had soiling for >3 years before referral decreased from 63% to 12%. The use of barium enema before referral decreased from 14% to 5%, as did psychological evaluation, from 25% to 14%. Previous therapy with enemas decreased from 45% to 27%. Mineral oil use remained at approximately 50%, and 20% of children had no previous treatment. Symptoms at referral and parental attitudes did not change across the years.Conclusions. Children are now referred at an earlier age to our tertiary encopresis clinic. The number of invasive and psychological evaluations has decreased before referral. However, treatment by many primary care providers before the referral has not changed. These data may suggest that pediatricians have increased awareness of encopresis and greater appreciation of its primarily physical rather than psychological nature. Additional studies will be needed to determine how these factors affect outcome. Pediatrics 2003;111:e604 -e607. URL: http: //www.pediatrics.org/cgi/content/full/111/5/e604; toilet training, encopresis, constipation, children. E ncopresis remains a significant problem in children. It is estimated to afflict 1% to 3% of the general pediatric population. [1][2][3] In 1975, Levine 4 wrote a classic paper outlining the descriptive characteristics of 102 children with encopresis seen at Children's Hospital in Boston. He described age of onset, type and timing of fecal accidents, and patient demographics. These data helped to corroborate his formulation of a relatively new approach to encopresis, using disimpaction, training, and education as treatment for this disorder. Although his approach is now widely used 5-10 and his descriptions of a typical child with encopresis are often quoted, there has been little reevaluation of his findings. 1,2,[11][12][13][14][15][16] We examined the characteristics of 503 children who over the next 20 years attended the encopresis clinic that Levine founded to determine whether the classic descriptions still were valid. We also wanted to explore whether there were changes in the age of referral, type and duration of symptoms, and parental attitudes about encopresis. Furthermore, we looked at the evaluations and treatments that the children had undergone before referral as an indirect reflection of primary care practice at that time. METHODSThe study population consisted of children who were ...

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“…A vicious cycle is thereby established, the initiating factor of which, in truth, remains unclear. 38,65,66 For a long time it was believed that premature toilet training could result in refusal to go to the toilet. Taubman 45,64 published a conflicting result, reporting that children who were late to start toilet training were more likely to refuse.…”

Section: Constipation Refusal To Go To the Toilet And Encopresismentioning

confidence: 99%

“…71,[74][75][76] Coercive or permissive methods of toilet training may be associated with the development of enuresis 22,77 and encopresis. 65 Analyzing the references identified, similarities can be observed between the recommendations, following the method described by Brazelton in 1962. 22 The guidelines are practical, appropriate and many of them stimulate the purchase of accessories for training.…”

Section: Enuresismentioning

confidence: 99%

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

Mota¹,

Barros²

2008

J. Pediatr. (Rio J.)

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Objective: To review both the scientific literature and lay literature on toilet training, covering parents' expectations, the methods available for achieving bladder and bowel control and associated morbidities. Summary of the findings:Parents have unrealistic expectations about the age at which diapers can be withdrawn, not taking child development into account. Toilet training strategies have not changed over recent decades, and in the majority of countries the age at which children are trained has been postponed. Training methods are rarely used.Starting toilet training prematurely and stressful events during this period can extend the training process. Children who have not been trained correctly present with enuresis, urinary infection, voiding dysfunction, constipation, encopresis and refusal to go to the toilet more frequently. Literature intended for lay parents is both abundant and adequate, available in book form and on the Internet, but it is not widely available to the Brazilian population. Just three international pediatrics societies have published guidelines on toilet training. Conclusions:Toilet training is occurring later in the majority of countries. The training methods that exist are the same from decades ago and are rarely used by mothers and valued little by pediatricians; incorrect training can be a causative factor for bladder and bowel disorders, which in turn cause problems for children and their families.J Pediatr (Rio J). 2008;84(1):9-17: Toilet training, enuresis, child, urinary tract infection, elimination disorders.

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Early Constipation and Toilet Training in Children With Encopresis

Cited by 39 publications

References 15 publications

Encopresis in Children: An Overview of Recent Findings

Encopresis in Children: An Overview of Recent Findings

Trends in Referral to a Single Encopresis Clinic Over 20 Years

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

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