Elimination Disorders: Biological Factors

Elimination disorders are thought to have both biological and behavioral underpinnings. This entry defines encopresis (i.e., involuntary defecation) and enuresis (i.e., involuntary urination) and addresses biological factors associated with each disorder. Treatment of encopresis begins with medical management of constipation, present in between 85% and 90% of cases of encopresis, prior to behavioral toilet training. Constipation increases transit time, stool size, and stool firmness and decreases muscle tone in the rectum. A number of potential biological causes for enuresis exist and must be evaluated when treating this condition. At present, there are no evidence-based biological treatments for nocturnal enuresis in children.

Encopresis and Constipation

Encopresis, or the regular passage of stool in inappropriate places in children older than 4 years (or developmental equivalent) of age, was ...

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