A case report of an adolescent with primary encopresis is presented in which the patient responded to standard medical interventions despite apparent significant psychopathology in the child and family. Psychological symptoms proved to be secondary and resolved with successful medical treatment and with attending to other concerns, such as this patient's school problems. Behavioral and medical literature related to encopresis is reviewed. It indicates that encopresis is associated more consistently with physiological abnormalities of the bowel rather than definable psychological disorders.
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References
1.
Fisher SMEncopresis. In: Noshpitz JD, ed. Basic Handbook of Child Psychiatry. New York: Basic Books, 1979;556-68.
2.
Loening-Baucke VASensitivity of the sigmoid colon and rectum in children treated for chronic constipation. J Pediatr Gastroenterol Nutr1984;3:454-9.
3.
Loening-Baucke VAAbnormal rectonanal function in children recovered from chronic constipation and encopresis. Gastroenterology1984;87:1299-304.
4.
Pinkerton P.Psychogenic megacolon in children: The implications of bowel negativism. Arch Dis Child1958;33:371-80.
5.
Bellman M.Studies on encopresis. Acta Paediatr Scand1966;170:1-51.
6.
Wolters Whg, Wauters Eak.A study of somatopsychic vulnerability in encopretic children. Psychother Psychosom1975;26:27-34.
7.
Levine MDChildren with encopresis: A descriptive analysis. Pediatrics1975;56(3):412-6.
8.
Levine MD, Mazonson P., Bakow H.Behavioral symptom substitution in children cured of encopresis. Am J Dis Child1980;134:663-7.
9.
Abrahamian FP , Lloyd-Still JDChronic constipation in childhood: A longitudinal study of 186 patients. J Pediatr Gasteroenterol Nutr1984;3:460-7.
10.
Lifshitz M. , Chovers A.Encopresis among Israeli Kibbutz children. The Isr J Psychiatry RelatSci1972;10(4):326-40.
11.
Gabel S., Hegedus AM, Wald A., et al. Prevalence of behavior problems and mental health utilization among encopretic children: Implications for behavioral pediatrics. J Develop Behav Pediatr1986;7(5):293-7.
12.
Arhan P., Devroede G., Jehannin B., et al. Idiopathic disorders of fecal continence in children. Pediatrics1983;71(5):774-9.
13.
Meunier P., Mollard P., Marechal JMPhysiopathology of megarectum: The association of megarectum with encopresis . Gut1976;17:224-7.
14.
Molnar D., Taitz LS, Urwin OM, et al. Anorectal manometry results in defecation disorders. Arch Dis Child1983;58:257-61.
15.
Loening-Baucke VA, Cruikshank BMAbnormal defecation dynamics in chronically constipated children with encopresis. Pediatrics1986;108:562-6.
16.
Mikkelsen EJ , Brown GL, Minichiello MD, et al. Neurologic status in hyperactive, enuretic, encopretic, and normal boys. J Am Acad Child Psychiatry1982;1(21):75-81.
17.
Krisch K.Some somatic variables in encopretic children. Int J Rehabil Res1979;2(4):521-2.
18.
Bartolo Dcc , Jarratt JA, Read MG, et al. The role of partial denervation of the puborectalis in idiopathic faecal incontinence. Br J Surg1983;70:664-7.
19.
Keighley Lrb , Fielding WLManagement of faecal incontinence and results of surgical treatment. Br J Surg1983;70(8):463-8.
20.
Wunderlich M., Parks AGPhysiology and pathophysiology of the anal sphincters. Int Surg1982;67: 291-8.
