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What Are Elimination Disorders?

Elimination disorders are present in children that urinate or defecate in places other than the toilet.

Children with these disorders are usually past the age where such acts are common behavior.

child on a toilet

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This condition is diagnosed in children between the ages of 7 and 12.

This means children may urinate or defecate on their beds or clothing without intending to.

To help with overcoming elimination disorders, well examine possible treatment methods to encourage normal waste disposal.

Types of Elimination Disorders

Elimination disorders are broadly categorized into enuresis andencopresis.

Enuresis

This disorder is more commonly known as bedwetting.

Children with this condition are unable to control their urine.

This usually results in frequent or irregular release on their beds or elsewhere.

In households made up of young children, especially boysenuresis is a common occurrence.

Around 20% of five-year-olds live with this condition.

This number goes down to 5%-10% in seven-year-olds.

Bedwetting is however more common in the latter age group.

Enuresis may occur in two forms:

Despite taking place during waking hours, diurnal enuresis is involuntary.

A child may pass urine where they feel an increased urge to pee.

Other times, this urination is the result of pressure on the abdomen.

When children delay urination while in public spaces, this may worsen their chances of involuntary expulsion.

Unplanned urination may also take place when laughing.

Encopresis

As a benchmark, encopresis occurs in children no younger than four years old.

This condition is characterized by children passing stool in inappropriate locations like their underwear.

This condition may be voluntary or involuntary, and is a common occurrence in male children.

About 4.1% of children between five to six years of age will defecate in unsuitable locations.

In 11- to 12-year-olds, this number drops to 1.6%.

Encopresis usually takes place in daytime.

This condition may be observed in children that have received, and those that are lacking toilet training.

To confirm a case of enuresis, other similar disorders should be ruled out.

This includes medical conditions such as a UTI, diabetes,seizures, sickle cell, or asleep disorder.

Likewise, bedwetting could be medication-induced, and not the result of enuresis.

SSRIs, antipsychotics, and diuretics may cause incontinence.

When these factors are ruled out, a pediatrician can then determine whether a child is living with enuresis.

This may be achieved by examining medical history, or through physical examinations.

When making an encopresis diagnosis, the pediatrician may ask about the childs history of strained bowel movements.

This questioning can also require answers about toilet training and diet.

An accurate encopresis diagnosis may also require a rectal examination.

The doctor could require an x-ray of the childs abdomen in deciding a diagnosis.

There is no precise cause of enuresis.

Different factors are however linked to bedwetting, or passing urine in inappropriate places.

Where the bladder suffers a delay in maturity, this can affect its capacity to hold urine.

Likewise, levels of vasopressina hormone that promotes water retention in the kidneysmay decrease.

This can impact the chances of holding urine in.

Certain risk factors also increase the chances of enuresis.

This condition may result from constipation.

A low-fiber diet and poor hydration.

Even stress over potty training can contribute to this condition.

Other contributing factors are bullying and behavioral problems like depression or social anxiety.

Poor performance in school could also be a factor.

Other options include imipraminea tricyclic antidepressant that helps to relax the bladder, preventing enuretic episodes.

It should be noted that pharmaceutical measures produce higher relapse rates compared to the bell and pad method.

To avoid constipation, parents can encourage a healthy diet high in fiber.

Children should also drink more water to alleviate constipation.

Parents can also assist with good bowel habits by planning bathroom time after meals.

They may also praise their children for using the toilet.

This can encourage regular toilet usage and may prevent excrement on clothing.

A Word From Verywell

Elimination disorders are a common occurrence in children.

But that doesn’t prevent them from being a worry to caregivers and wards alike.

With the right habits or interventions, enuresis and encopresis can be properly managed in children.

To ensure children are receiving appropriate care, expert opinion should be considered.

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Last reviewed May 2018

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