# Encopresis in Children: A Report of 20 Cases

## TL;DR

This study examines 20 children with encopresis, finding that most cases are linked to chronic constipation and occur after age five.

## Contribution

The study highlights the predominance of secondary encopresis and the importance of early multidisciplinary treatment.

## Key findings

- Chronic constipation was the main cause in 85% of cases.
- Most children were from urban areas and started showing symptoms after age five.
- Treatment with PEG-based laxatives and behavioral interventions showed favorable outcomes.

## Abstract

Introduction: Encopresis, or fecal incontinence, is a distressing condition in children over the age of four characterized by the repeated passage of stool in inappropriate places. It is often associated with chronic constipation and can have significant psychosocial impacts on affected children and their families.

Objective: The objective of this study was to describe the epidemiological, clinical, and therapeutic characteristics of children aged four years and older diagnosed with encopresis and followed in a pediatric gastroenterology outpatient clinic, with particular attention to distinguishing secondary encopresis in children who have previously achieved bowel continence.

Methods: A retrospective descriptive study was conducted using data from HOSIX hospital software (SIVSA, Spain). All pediatric patients diagnosed with encopresis, regardless of etiology, and seen in consultation during 2021 and 2024 were included.

Results: The mean age of symptom onset was five years. Most cases (80%, N = 16) occurred after the age of five, with no instances of primary encopresis identified. The majority of patients (70%, N = 14) were from urban settings. Chronic constipation was the leading cause (85%, N = 17), followed by neurological etiologies (10%, N = 2) and a single case of congenital megacolon. The average delay between symptom onset and initiation of treatment was 12 months. Treatment strategies primarily involved polyethylene glycol (PEG)-based laxatives, dietary modifications, and behavioral interventions, with favorable outcomes in most cases.

Conclusion: Encopresis is a prevalent condition in pediatrics, typically secondary to chronic constipation. Early diagnosis and a multidisciplinary management approach are crucial for effective treatment. Delayed care remains a challenge and may contribute to the chronicity.