Elimination disorders

enuresis and encopresis

Enuresis is defined as the repeated voiding of urine into inappropriate places like clothes or bed, whether the voiding is involuntary or intentional. Enuresis is diagnosed only after 5 years of age

Types Based on the Onset: Primary enuresis and Secondary enuresis. Based on the time: Nocturnal enuresis, Diurnal enuresis and combined diurnal and nocturnal. Primary and nocturnal types of enuresis are more common than the others.

Etiology:  delayed or lax toilet training, psychosocial stress, genetic and physiological factors like delays in development of normal circadian rhythms of urine production.

Treatment: Behavioral interventions, Retention control training (RCT), Dry bed training, Drug treatment and Psychotherapy.

  1. Encopresis: this refers to the repeated passage of feces in inappropriate time and/or place, after bowel control is physiologically possible, whether voluntary or involuntary. It is not due to the presence of any organic cause, which is called as fecal incontinence.

 Types 1. Primary type-where toilet training has never been achieved 2. secondary type-where Encopresis emerges after a period of fecal continence. This type typically occurs between the ages of 4 &8.

Cause: Inadequate, inconsistent toilet training, Ineffective and inefficient sphincter control, Neuro developmental problems like easy distractibility, short attention span, low frustration tolerance and hyperactivity. Also Fear of toilet, Emotional reasons like fear, anxiety and anger. Sibling rivalry, Maturational lag, intellectual disability, Childhood schizophrenia, Autistic disorder

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