Question
My son fell ill in the summer of his 9th year, and he had been experiencing daily fecal incontinence for about a week before recovering to normal. However, he has started having daily fecal incontinence again recently, and it has persisted for more than a dozen days without improvement. I would like to know what the cause is and how to treat it?
Answer
Functional encopresis refers to an uncontrollable bowel movement condition without any obvious organic problems or diseases, with an incidence rate of about 17% in 3-year-old children and 1% in 4-year-old children. Common causes include a child’s refusal to undergo toilet training or the inability to control bowel movements due to chronic constipation. Constipation is characterized by difficulty in defecation or infrequent bowel movements, with hard stools or a sensation of incomplete evacuation. Possible causes may include: unwillingness to use the toilet leading to incomplete evacuation; refusal to use the toilet; anal fissures; congenital anomalies such as spina bifida, anal atresia (following repair), or other related abnormalities; Hirschsprung’s disease (congenital intestinal abnormality); hyperthyroidism; malnutrition; cerebral palsy; or mental illness in children or family members. Treatment first requires explaining the causes of encopresis or chronic constipation to parents and children, eliminating the child’s guilt over not being able to control bowel movements, and alleviating any negative emotions that arise from this. An abdominal X-ray can show a large amount of feces in the intestines. If the preliminary medical history and physical examination rule out specific diseases, laxative treatment should be adopted, and measures should be taken to maintain regular bowel movements. The initial treatment plan is as follows: on the first day, use adult low-phosphate enema solution (for children over 7 years old, use 2 portions at a time); on the third day, use disodium phenylacetate…