Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment for encopresis may include:
- Removing the impacted stool
- Keeping bowel movements soft so the stool will pass easily
- Retraining the intestine and rectum to gain control over bowel movements
Your child’s healthcare provider may prescribe an enema to help remove the impacted stool. An enema is a liquid that is placed in your child's rectum. It helps loosen the hard, dry stool. Never give your child an enema without the approval of your child’s healthcare provider.
Your child's healthcare provider will likely prescribe medicines to help keep your child's bowel movements soft for several months. This will help stop stool from getting impacted again. Never give your child stool softeners without the approval of your child’s healthcare provider.
Treatment may also include diet and lifestyle changes. Help your child to eat more fiber by:
- Adding more fruits and vegetables
- Adding more whole-grain cereals and breads. Check the nutrition labels on food packages for foods that have more fiber. As a rule of thumb, great sources of fiber have at least 5 grams per serving. Good sources have 2.5 to 4.9 grams per serving.
- Some good sources of fiber are:
- Bread: Whole-wheat bread, granola bread, wheat bran muffins, whole-grain waffles and popcorn
- Cereal: Bran cereals (100% bran cereals are very good sources), shredded wheat cereals, oatmeal, Mueslix, granola and oat bran
- Vegetables: Beets, broccoli, Brussels sprouts, cabbage, carrots, corn, green beans, green peas, acorn and butternut squash, spinach, potato with skin and avocado
- Fruits: Cooked prunes, dried figs, apples with peel, dates, papayas, mangos, nectarines, oranges, pears, kiwis, strawberries, applesauce, raspberries, blackberries and raisins
- Meat substitutes: Baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, kidney beans, chili with beans, trail mix, peanut butter and nuts
Other diet changes that may help include:
- Offering your child fruit juice instead of soft drinks.
- Encouraging your child to drink more fluids, especially water.
- Limiting fast foods and junk foods that are often high in fats and sugars. Offer more well-balanced meals and snacks instead.
- Limiting drinks with caffeine, such as soda and tea.
- Limiting whole milk to 16 ounces a day if your child is 2 years of age or older. But don’t remove all milk from your child’s diet. Children need the calcium in milk to help their bones grow strong.
It’s also a good idea to have your child eat meals on a regular schedule. Eating a meal will often cause a bowel movement within 30 to 60 minutes. Also try to serve breakfast early. This will help give your child time to have a bowel movement at home before rushing off to school.
Try the following ideas to help reduce constipation.
Have your child get more exercise
Exercise helps with digestion. It helps the normal movements the intestines make to push food forward as it is digested. People who don’t move around much are often constipated. Have your child go outside and play rather than watch TV or do other indoor activities.
Set good bowel habits
Try to get your child into a regular toilet habit. Have your child sit on the toilet at least twice a day for up to 5 minutes. Start with a very short amount of time—like 30 seconds—and slowly work up to 5 minutes. Try to do this about 10 to 20 minutes after a meal. Be sure to make this a pleasant time. Don’t get mad at your child for not having a bowel movement. Use a reward system to make it fun. Give stickers or other small treats. Or make posters that show your child's progress.
In some cases, these changes may not help. Or your child’s healthcare provider may find another problem. If so, the provider may recommend using laxatives, stool softeners, or an enema. These products should only be used if recommended by your child's provider. Don’t use them without talking with your child's provider first.
Your child may still have accidents and soil underwear from time to time. This will happen until the intestine and rectum get their muscle tone back again. Preschool children may be able to wear disposable training pants until they can control their bowel. Have your child bring a change of underwear or pants to school. This can help your child feel less embarrassed. It may help improve your child's self-esteem.