Most children will pass a stool every 2 to 3 days without straining or discomfort. For constipation (encopresis) to be diagnosed in children aged over 4 years they must have two of the following symptoms;
- Two or less poo’s in the toilet/ nappy per week.
- At least 1 accident per week (if toilet trained)
- A history of holding postures.
- A history of very large or wide poo’s
- Poo that may obstruct the toilet.
Soiling can occur when rectum becomes overstretched and stool can pass without the child feeling it. This presents in most children around the ages of 7-8 years.
Bowel assessment and retraining will involve an individualised program of education, removing guilt and setting expectations for treatment. It may involve a bowel diary, abdominal palpation or real time ultrasound to assess the colon and rectum. Medications may be advised from your GP, age appropriate routine will be implemented, hygiene and skin care, advocacy for the child at school or care and referral to further specialists if needed.