I added a new word to my vocabulary today: encopresis. In brief, encopresis can be either voluntary or involuntary bowel movements at an age when developmentally it is expected that children can contain them. Involuntary encopresis has an organic cause such as precipitating constipation. The hard fecal matter was not expelled while constipated, and comes out involuntarily at such a time when the bowel regulates once again. Voluntary encopresis typifies some sort of internal or external emotional struggle and is often found in children with mental health issues such as Oppositional Defiance Disorder (ODD) or Conduct Disorder.

Tonight we had our first tantrum in almost seven weeks – but, thankfully, it did not (or has not yet) escalated into a rage. Our daughter continues to choose to “squeeze in” that last bit of television before going to bed and has chosen to do so over choosing to eliminate in the bathroom. For that choice, she lost television privileges. She has received a consequence around this before, and that was to lose the privilege of watching her very favorite shows – the ones which habitually resulted in the choice to pee and poop wherever she happened to be rather than taking time away to go to the restroom. Previous instances also resulted in my insistence that she learn to do her own laundry when making this choice. So, now she has lost television privileges altogether, so as not to distract her from making the appropriate toileting choice.

True, there is more at work here than just toileting. She does suffer from a psychiatric condition, and it is manifesting itself in this particular arena. To her credit, though there was a lot of huffing and puffing, grousing, insistence that no one in the family loved her (despite my reassurances while meting out the punishment), name calling (though no profanity, this time!), and attempts to lie, she did not escalate into a rage. We are making progress!

If you have encountered encopresis, feel free to share any words of wisdom, strategies that worked, or lessons learned from what could have been done better.

For more reading on the subject:

Encopresis

The School child with Encopresis

Elimination Disorders

Encopresis at Medline Plus

Encopresis at SelfGrowth.com

Encopresis at PsychNet.com

Encopresis at Able Development

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