This book describes Encopresis (Fecal Incontinence), Diagnosis and Treatment and Related Diseases They seek it here, they seek it there The Feces seek the potty or loo everywhere Is it in heaven or in purgatory That elusive lavatory Fecal incontinence Fecal incontinence is the inability to control bowel movements Fecal incontinence can often be eliminated by proper treatment First there must be mental ability to respond to the urge to have a bowel movement The doctor should begin by identifying the cause of the incontinence. Fecal incontinence can be upsetting and embarrassing, Passing stool into one’s underwear without being aware of it happening Fecal incontinence may be due to constipation. Take fiber and fluid to prevent further fecal impaction Changing the diet may reduce the occurrence of fecal incontinence Kegel Exercises can help the person move abnormal bowel function Bowel training involves trying to have bowel movements The body becomes used to a bowel movement consistence Medications such as loperamide (Imodium) may be used to control the diarrhea Sacral nerve stimulation can be done under local anesthesia Some patients may be treated with an artificial bowel sphincter Exercise the anal sphincter sitting in a few inches of warm water -An original poem by Kenneth Kee Encopresis is the voluntary or involuntary passage of feces outside of toilet trained situations in children who are 4 years or older and after a natural cause has been excluded. Encopresis may be the repeated passing of feces into places other than the toilet, such as in underwear or on the floor. This behavior is (voluntary encopresis) or is not (involuntary encopresis) done on purpose. Encopresis is also termed "soiling" or "fecal incontinence." Encopresis in adults in not infrequent, although the incident of this disorder is more prevalent in children who are not toilet trained. The causative factors in adults and children may differ. Involuntary encopresis is a disorder of soiling the underwear with loose stool in a constipated person. Adults suffering from chronic constipation may occasionally develop this annoying disorder. When a patient is constipated, a large mass of feces forms, which stretches the rectum. This stretching numbs the nerve endings in the rectum, and the patient may not feel the need to go to the bathroom or know that the feces are coming out. The mass of feces also can become impacted too large or too hard to pass without pain. Ultimately, the muscles that keep stool in the rectum can no longer keep it back. While the large, hard mass of feces cannot pass, loose or liquid stool may leak around the impacted mass and go on to the patient’s clothing. There are 2 main types of encopresis with different causes. With involuntary encopresis, a person has no control over removal of feces from the bowel. The feces are semi-soft to almost liquid, and it leaks into clothing without the person making any effort to force it out. Leakage normally happens during the day when the person is active and varies from rare to frequent. Involuntary soiling normally happens from constipation. A person with voluntary encopresis has control over when and where bowel movements happen and opts to have them in inappropriate places. Constipation is not a factor, and the feces are usually a normal consistency. Voluntary encopresis is not true fecal incontinence. Often feces are smeared in an obvious place or hidden around the house. The purpose of encopresis treatment is to avoid constipation and encourage good bowel habits. The next step is to attempt to keep the patient’s bowel movements soft and easy to pass. TABLE OF CONTENT Introduction Chapter 1 Encopresis (Fecal Incontinence) Chapter 2 Causes Chapter 3 Symptoms Chapter 4 Diagnosis Chapter 5 Treatment Chapter 6 Prognosis Chapter 7 Difficult Defecation Chapter 8 Enuresis Epilogue