As parents, we may observe that the child has started to soil his or her underpants even after they are toilet trained. It strikes at around the age of four and may continue till around 12 years of age.The loose stool is often mistaken as diarrhoea, but it is a symptom of chronic constipation called encopresis. The reason for watery stool coming out is that the hard, dry stools are blocked up, and the liquid faeces trickles past them.The point to note is that the child from long enough has a history of constipation and painful and has a fearful defecation experience. This deadly combination often results in encopresis.
The vicious cycle of soiling the underpants becomes worse as the children get habituated and often do not feel the smell and do not notice it anymore. So the main crux of the problem is constipation, and this has to have an efficient management of constipation and lifestyle changes.
- Check constantly to ensure that your child has no constipation. Ask regularly whether he or she has passed stool and enquire it was hard or regular
- Constipation is the major culprit. You should ensure the child drinks enough water. Mark the bottle for daily intake and always insists on it, however, nagging it may sound.
- Regulate the food habit of your kid. Green vegetables and fruits are the key ingredients to draw moisture to the stool. There are millions of recipes out there try a few and let the kid enjoy. Cut the intake of sugar and flour. Wheat is more aiding in relieving constipation. Simply make different veggieswith rice.
- As the child is growing to make him or her aware of the changes he or she needs to undertake to alleviate the condition. Do not get bored or over emphasis on how others will react. Explain the simple medical facts. Kid are smart enough to understand. It is important to involve the child in the process to cooperate. Otherwise, all efforts will turn futile.
Apart from these, there are medicines available mainly laxatives which are necessary to use. Moreover, you can move on to the natural ingredients which have equal laxative power in Ayurveda.
- Bael or Bilva or Billu which is widely available in India is an excellent laxative and fibre content. Mix it with curd or yoghurt. At least twice a week would make the stool soft.
- Triphala Powder (A concoction of amla powder, Haritaki Powder and Vibhibati Powder ). Half to one tablespoon of the powder in warm water before going to bed.
- Physical activities and Yoga postures relieve the stomach bloating and helps in the working of the colon muscles and the rectal muscles to decrease the continence.
- Suppositories can be safely given in home to trigger the rectal reflex and soften the faeces where it is backed up and often the culprit for the pain. Once the plug gets cleared the fear of sitting in the toilet reduces significantly.
When the child is affected with encopresis, the foremost thing as the parent you have to do is to have patience and positive reinforcement of the fact that he or she will get over it. The steps you can undertake are as follows:
- Check the underwear and also ask your child to check it himself or herself. Give an extra set of underwear to school so that he or she could change and save the embarrassment of being a smelly one.
- Inform of the problem to the school teacher so that they take proactive steps in helping your child and empathise with him or her.
- After your child has recovered a lot of positive reinforcement is required to ward off the fear of potty sitting. Encourage them to have some fixed schedule especially after meals.
The cumulative effect of discouraged parents and embarrassing situation the child faces makes them lower self-esteem. So the support of the parents and encouragement helps the kids to go through the bumpy ride of food adjustments and retraining. The psychological effect of the kid involved should not be overlooked in these cases.