Enuresis and Encopresis Elimination problems The development of bladder and bowel control occurs in a stage-wise manner in most children during the first five years of life. Problems with elimination can have a negative impact on children's social, emotional and educational development. Children with elimination problems may be excluded from school, ostracized by their peers, develop low self-esteem and often have conflictual relationships with their parents. What is enuresis? Enuresis is a disorder characterized by the involuntary voiding of urine which is abnormal in relation to the child's mental age and which is not a consequence of a lack of bladder control due to any neurologic disorder or structural abnormality of the urinary tract. Enuresis is typically not diagnosed until five years of age. What is encopresis? Encopresis is a disorder characterized by the repeated passage of stool, usually of normal or near normal consistency, into inappropriate places. This condition may represent a lack of adequate toilet training or it may stem from physiological retention, involving the impaction of stool, with secondary overflow. Such retention may arise from parent-child battles over bowel training or because of withholding stool due to constipation and subsequent painful defecation(s). Encopresis is usually not diagnosed until four years of age. Features common to both disorders Wetting or soiling may occur during the day or at night and may be intentional or unintentional. These conditions may have been present from birth or there may have been a period of bladder or bowel control which, at some point, was lost. How to you treat enuresis and encopresis? Over the past twenty five years I have successfully treated many children with these disorders, beginning in the Encopresis Clinic at Children's Hospital in Seattle and, subsequently, here at ABCD. My approach to treatment incorporates those strategies which clinical practice and research has found to be most effective. These include education, in which a rationale for treatment and treatment procedures is explained to both the child and parents and behavioral therapy, which involves shaping and maintaining toileting routines through the use of positive reinforcement. The treatment of night wetting almost always includes the use of a urine-activated alarm. For children who soil, treatment often includes the use of laxatives and stool softeners. For both disorders, parents are centrally involved in the implementation of treatment procedures and the family's pediatrician or family practice physician are routinely consulted. Click here for client testimonial. Return to Providers: Thomas DuHamel, Ph.D. 155 NE 100th St., Suite 306 Seattle WA 98125 206.361.6884     Copyright © 2009-2012, ABCD, Inc.