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What Is the Difference between Encopresis and Enuresis?

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  • Written By: B. Chisholm
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 02 December 2016
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Encopresis and enuresis, while both referring to types of incontinence, are very different. Encopresis refers to soiling of the pants by feces, usually due to an impacted stool in a child who resists having bowel movements. Enuresis is urinary incontinence, most often seen in small children at night and referred to more commonly as bed-wetting.

While symptoms of both encopresis and enuresis may be seen during toilet training, and enuresis may be a normal developmental stage in children, both may become problematic if they are prolonged, or found in adults. Incontinence is common in the elderly, due to a loss of bowel and bladder control. Some medications may also cause encopresis and enuresis, and removing causative factors such as these are 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 this, fecal soiling is normally just part of toilet training. Encopresis occurs because the feces become impacted and cause small amounts of liquid stool to soil the pants. This is called paradoxical diarrhea. It may be caused by chronic constipation, and there is sometimes a psychological component to the problem, which may require treatment.

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Enuresis is urinary incontinence. In young children it is often just a stage, most commonly occurring at night, but may be a sign of psychological disturbance, which should be fully investigated. In adults, enuresis may occur in old age, or may be a sign of an underlying disorder such as a urinary tract infection, physiological urinary tract problems, or bladder cancer. Enuresis in adults requires 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 using laxatives where necessary and bowel training. Enuresis in children is treated firstly with non-drug measures such as moisture alarms and routine changing or cognitive therapy. In severe, non-responsive cases, anti-diuretic hormones such as desmopressin or DDAVP, anti-cholinergic drugs such as oxybutynin, or tricyclic antidepressants such as imipramine may be prescribed.

The first step in the treatment of encopresis and enuresis is removal of the causative factor, be it constipation, a urinary tract infection, or a psychological condition. While the conditions differ, both may 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 either condition.

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bagley79
Post 7

I ended up getting secondary enuresis because of constant urinary tract infections. I had frequent infections like this, but never realized the long term effects something like this could have.

Whatever reason someone has incontinence can be embarrassing and annoying. This is something that is not easy to talk about, but that doesn't help anything.

If you have ever noticed those commercials that sell products to deal with urinary incontinence you get a better understanding of what I mean. They come in the mail in unmarked boxes so people don't know what is being delivered.

I don't have this all of the time, but never know when it might happen. It is better to be prepared than embarrassed.

julies
Post 6

I think most older adults must have problems with enuresis. If you have ever spent much time in a nursing home, it is hard to get past the lingering smell of urine.

No matter how clean things are kept, it seems like this smell is stronger. I think most of the residents in these homes wear adult diapers because they have trouble controlling their bladders at this stage of life. It doesn't matter if it is during the day or night.

Nobody wants to grow old, and I am sure this is something that is hard for most people. At least they have much better products available today for this than they did several years ago.

golf07
Post 5

Something like enuresis and encopresis in children really does take a lot of patience to deal with. Many times there are underlying issues that are the cause of this. Getting to the root of these can be half of the battle.

Before my husband and I were married, my step-son had problems with enuresis. At first they were told he would just outgrow it, but it never happened.

He would wet the bed every night and this was becoming a strain on everyone. He was around 8-9 years old. During this time, his parents were going through a divorce and there was a lot of tension and unrest in the home.

They still don't know if it was a combination of growing older or how much things calmed down once the divorce was complete. Either way, he did stop wetting the bed, but it took a lot of patience on everyone's part as they were working through that.

LisaLou
Post 4

When I was growing up I shared a bedroom with my younger sister who is mentally handicapped. When I left for college, we had no idea how much this would affect her.

She begin wetting the bed at night which she had never done before. This was one of the ways she was demonstrating how upset she was even though she couldn't clearly voice her frustration.

One of the forms of enuresis treatment is using a moisture alarm. My parents ended up using this to help her stop the bed wetting. When this happened in the night, an alarm went off alerting my parents.

They would get up and wash her face so she was fully awake

, and have her go to the bathroom. They had tried this in the past, but didn't have her wash her face.

A psychologist told them she was doing this in her sleep because she was not fully awake and didn't remember it. Once she was awake and understood what she was doing, she eventually stopped wetting the bed at night.

ddljohn
Post 3

I have never heard of these terms before. Thanks so much for the information. My son has been having soiling issues for the past month. I've been trying to do my share of research to understand it a little better. I'm glad to know what I should call them now.

I don't think that encopresis or enuresis is listed as a symptom of ADHD (Attention Deficiency and Hyperactivity Disorder), but I do believe that there might be a connection. My son has ADHD and I've read on several forums that other kids with ADHD have had some soiling issues as well.

Has anyone else experienced ADHD and encopresis or enuresis together? Do you think there is a connection?

fify
Post 2

@turquoise-- I'm not sure about enuresis, but I do know about encopresis because I went through it when I was young, around the same age as your niece.

From my experience, it happened because of constipation. After my first several incidences of constipation, I learned that defecating is very painful. It would also cause bleeding and hemorrhoids which was very uncomfortable. To avoid going through this pain, I refused to go to the bathroom in time which of course, ended up in encopresis.

I think encopresis is a combination of a physical problem that gets exacerbated by psychological conditioning. So even though the root of my problem was a physical one- constipation- my psychology turned it into chronic

encopresis.

After I saw a doctor and had a proper constipation treatment, a change in diet in addition to support from a child psychologist, was I able to overcome this.

Please don't ignore the underlying physical problem that might be there with your niece. That should be the first step of encopresis treatment in my view. And it should be supported with psychological help if necessary.

turquoise
Post 1

My seven year old niece has enuresis and encopresis, however she appears to do this voluntarily. My sister has done everything possible to have have her treated. She has taken her to behavior therapy and a child psychologist but neither have worked.

My niece's explanation of why it happens is that she doesn't want to take time out to go to the bathroom when she needs to. She prefers to keep playing or doing whatever she's doing at the moment.

But I think this might be her way of justifying it. I don't think she can be too happy about this as she's started school and I know she is being made fun by her classmates.

What do you think might be going on? And is it possible that the encopresis is triggering enuresis or vice versa? Or should we look into treating both separately?

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