Encopresis: Note to Child

This information sheet is for children over age 6 who want to get over their constipation and encopresis. Some children are confused about how the body works. Some of them try to prevent stool leakage by holding back BMs rather than releasing them. Ask your child to read these instructions (or read them to your child) every morning during breakfast until following them becomes automatic. Your wish:

* To stay clean and not have any poops leak out * To not have any pain from big poops

How to do it:

* Keep your body (rectum) empty of poop * Don't let yourself get blocked up ever again

Your job:

* Go poop every day (don't let it build up inside) * Sit on the toilet at least 3 times a day. Unless you do this, your medicines won't work. * Take your medicine every day * If your poops aren't coming out like they should, sit on the toilet more often. Also ask your parent for extra medicine. * If only a small poop comes out, sit on the toilet again in 5 minutes.

For poop that leaks out:

* The first thing to do is sit on a toilet until a poop comes out. * Leakage always means there's a big poop inside (in the rectum) trying to get out. * Clean up after you have passed the big poop.

Definitions:

* Constipation means no poop for 3 or more days. By 4 or 5 days the poop gets stuck inside. * Encopresis or soiling means poop leaks out.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books. Published by McKesson Provider Technologies. Last modified: 2005-11-07 Last reviewed: 2005-06-01 Encopresis (Soiling): Note to School Staff

Name of Child: ______

Date: ______

This child occasionally has a problem with leakage of bowel movements (BMs) into the underwear. The main cause of the problem is constipation. With a medicine and diet program, bowel control is now greatly improved. You can help this youngster in your school setting in the following ways:

* Prevention

Please give the child permission to leave and use the restroom at any time without seeking approval from the teacher, playground supervisor, or lunchroom supervisor. (Note: Encopresis commonly occurs during sports, gym, or other physical activities.) Sometimes this child has very urgent bowel movements and must go to the restroom without delay. Please let this child come in from recess if necessary. * Detection of soiling

If a member of the school staff feels that this youngster has soiled himself (because of odor, etc.), please act rather than ignoring the situation. Speak with the child in a private setting and request him to change. Also ask him if he needs any help. It is better to act on your observations than to allow other children to detect the soiling and possibly ridicule the child. * Changing when soiled

The child's parents will bring you one set of clean underwear and some wet wipes to keep at school in case of soiling. Please give the child access to a bathroom where he can clean up without being interrupted by other students. It is possible that he may need some assistance with this. Remind the child that before cleaning up, he should always sit on the toilet and try to pass a BM. (Reason: Soiling always means there is a larger BM inside that has caused the leakage. Unless it is released, leakage with soon recur).

Thanks for helping this child through this difficult time. Please feel free to call our office if you have any questions.

Physician's name: ______

Physician's signature: ______

Phone: ______Daily Record

Date Time Soiling Accidents Appropriate Toileting