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Encopresis is soiling of pants due to impacted stool in children who resist bowel movements, while enuresis is urinary incontinence, commonly seen in young children at night. Treatment differs, but removing causative factors is the first step. Both can cause distress and require patience.
Encopresis and enuresis, while both referring to types of incontinence, are very different. Encopresis refers to soiling of the pants by stool, usually due to impacted stool in a child who resists having a bowel movement. Enuresis is urinary incontinence, most often seen in young children at night and more commonly referred to as nocturnal enuresis.
While symptoms of both encopresis and enuresis can be seen during toilet training, and enuresis may be a normal developmental stage in children, both can become problematic if they are prolonged or experienced in adults. Incontinence is common in the elderly, due to loss of bowel and bladder control. Some medications can also cause encopresis and enuresis, and removing causative factors such as these is the first step in treatment.
Encopresis usually occurs in children who refuse to defecate. It is only diagnosed after the age of four, as before, fecal soiling was normally only part of toilet training. Encopresis occurs because the stools get impacted and cause small amounts of loose stools to soil the pants. This is called paradoxical diarrhea. It can be caused by chronic constipation and sometimes there is a psychological component to the problem, which may require treatment.
Enuresis is urinary incontinence. In young children it is often just one stage, most commonly occurring at night, but it can be a sign of a psychological disorder, which should be investigated thoroughly. In adults, bedwetting can occur in later life or it can be a sign of an underlying disorder such as a urinary tract infection, urinary tract physiological problems, or bladder cancer. Enuresis in adults requires a thorough medical investigation to establish the cause.
Treatment for encopresis and enuresis differs due to their different mechanisms. Encopresis caused by chronic constipation is treated with laxatives where necessary and bowel training. Bedwetting in children is treated primarily with non-drug measures such as moisture alarms and routine change or cognitive therapy. In severe, unresponsive cases, antidiuretic hormones such as desmopressin or DDAVP, anticholinergic drugs such as oxybutynin, or tricyclic antidepressants such as imipramine may be prescribed.
The first step in the treatment of encopresis and enuresis is the removal of the causative factor, whether it is constipation, a urinary tract infection or a psychological condition. While the conditions differ, both can cause extreme distress in children and adults, often resulting in a vicious cycle of anxiety and worsening of the problem. Patience is key in treating both conditions.
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