Etiology and Incidence
Constipation can have many causes, such as changes in diet, dehydration, lack of exercise, emotional stress, certain drugs, pain from anal fissures, or excessive milk intake. If the child has no neurologic or anatomic disorders, encopresis is usually the result of recurrent fecal impaction and an enlarged rectum caused by chronic constipation. Factors predisposing to encopresis include inadequate or inconsistent toilet training or some type of psychological stress, such as starting school or the birth of a sibling.
Constipation can affect any child at any time. At least 3% of all visits to thepediatrician and at least 25% of pediatric gastroenterologist visits are constipation related (Greenwald, 2010). Encopresis affects an estimated 1.5% to 7.5% of children ages 6 to 12 years, with three to six times more boys than girls affected (Hardy, 2009). The incidence of encopresis is higher in lower socioeconomic classes and among children with learning disabilities.