ABSTRACT
Background: Encopresis is incontinence of stool not resulting from organic defects or illness. Encopresis affects 1% to 3% of children
Objective: Current treatment of encopresis has been disappointing. In this study, emphasis was placed on treating and diagnosing children attending NHTMRI complaining of various forms of Encopresis. Design: Prospective study. The study was conducted from June 2001 to June 2002. Setting: National Hepatology and Tropical Medicine Research Institute [NHTMRI]
Materials and Methods: Sixty two children attending NHTMRI complaining of various forms of Encopresis ranging from mild fecal soiling of underwear to the passage of large amounts of fecal material were studied and treated over one year with use an approach consisting of three phases: cleanout phase, aimed to evacuate the colon using isotonic saline ,enemas and laxative [lactulose]. The 2[nd] phases aimed to prevention of reimpaction: for 6 month's consists of mineral oil 0.5 to 2.5 ounces twice daily depending on patients age between meals, diet modification and change dietary and behavioral habits, fiber diet 0.5 gm /kg/B.Wt. The phase aimed to establish a regular bowel habits through encouraging patients to sit on toilet for terminates after breakfast and after evening meal and is rewarded by star chart, successful toilet attendance is marked by a star with collaborative protocol between medical clinician, children and families. The patients were followed up 12 months to assess treatment outcome. While fifty patients cooperated in the study, 12 patients were excluded from the final statistics because they decided to discontinue the trial for unknown reason
Results: after 6 months, 58% of our children were successfully treated and 20% improved with the program applied in this study. By the end of the year success rate reached 92%
Conclusion: Most patients can be effectively treated as out patients with use of an approach consisting of colonic evacuation, stool softeners, dietary manipulations, bowel training and behavioral management