Retentive encopresis is characterized by chronic constipation due to withholding of stool followed by recurring fecal leakage in the absence of organic causes. Other signs and symptoms can include abdominal pain, lack of appetite, urinary incontinence, nocturnal enuresis, and urinary tract infection. Clinical exam may reveal soiled underwear, signs of constipation, fecal rectal mass, retentive posturing, blood in stool, anal irritation, and anal fistula. Nonretentive encopresis, which accounts for less than 20% of cases, is soilage without constipation and is considered to be of a behavioral / psychologic etiology.
Management includes educating patient / caregivers about constipation-withholding-overflow incontinence, restructuring bowel regimen, avoiding behavioral power struggles, relieving impaction (enema, stool softeners), and adding dietary fiber. Behavior management may require psychiatric counseling / therapy. Other types of behavioral management include stress reduction and relaxation techniques.
R15.9 – Full incontinence of feces
F98.1 – Encopresis not due to a substance or known physiological condition
302690004 – Encopresis