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What is Encopresis?
There are a number of different schools of thought on this dependent on where you live!
This is part of an email I received from a clinician in England- My concern about this area starts with definitions. You have probably realised that there is some confusion about this as the American and English terms vary. Essentially Americans use encopresis as a term for any soiling regardless of cause while the English (following Graham Clayden's lead) use encopresis to refer to just those rare children who have a definite psychological cause.	A trained nurse/encopresis specialist of Nova Scotia writes "While there are rare cases where encopresis CAN be caused by behavioral situations, the norm is that 70% of cases are the result of ongoing, chronic constipation for one reason or another. As I see it, encopresis is a medical condition. It results in behavioral changes but these are usually the result of the child's methods of coping with the encopresis, in the first place. If we look at it from the point of view of the comments to the left, we'd likely change our behavior accordingly, as well, especially in such an embarassing situation. We'd certainly become more secretive in order to hide the problem.
This is the definition given at "Telemedicine Canada", an online and print publication of the Faculty of Medicine of Toronto Hospital and the University of Toronto. "Repeated voluntary or involuntary defecation into clothing or in other innapropriate places, occurring in children 4 years of age and older, on a regular basis over at least 1 month's duration." It has to be said that to get a diagnosis at all was difficult for us. We examined the childrens diets, we racked our memories trying to think of any incident that might have caused it to occur. All to no avail.
The eldest was allowed into the mainstream kindergarten and primary school and rarely met with any major difficulties. There was the odd accident, but nothing that could not be dealt with swiftly and without fuss. All the way the staff were given as much information as we had. We had regular meetings with the staff at the school. Everything went as smoothly as we could have hoped for. In the case of the youngest boy. Although in the same school, the accidents were more often and more demanding, due to the larger class size and the amount of time they could allocate. This resulted in him being taken to a special needs nursery where he continued with his preliminary educational needs and there were trained staff on hand to deal with his accidents. He was eventually accepted back into the school but the problem continued - although much reduced. The school were satisfied with our suggestion that, if needed, mum would attend to him. That was until we relocated and had to change schools.	Now we saw a different side to the coin. Some staff were very helpful, others were quite simply insulting and abusive to the children. Unwilling and inflexible to the degree of dismissing any literature we presented as "nonsense" and verbally deriding the children with such comments as (and I quote!) *"Only an animal would carry on like that."* You can imagine Tony's reaction to that!
Sadly, it is precisely that sort of insulting attitude from some people, meeting with Encopresis for the first time, (We feel, because of a need to hide ignorance of the subject), along with the fact that the child probably has few friends, feels rejected by relatives, all leading to a very low self esteem, that drives families with children who suffer, to hide away and not admit the problem. The longer it is left - the more potential permanent damage can result; both physically and mentally.

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