[Encopresis in children. Preliminary report of new therapeutic and diagnostic aspects]. / Enkopresis bei Kindern. Vorläufige Mitteilung über neue therapeutische und diagnostische Aspekte.

ABSTRACT

There appears to be no strict boundary between encopresis, which is defined as a psychogenic disorder, and incontinence, in which there is an inability to retain faeces voluntarily. Our findings over an 8-year period suggest that unrecognized functional or organic retention disorders are present in encopresis more often than previously thought. Of 16 children with encopresis who were examined by perfusion manometry 14 were found to have disorders of anorectal functions. Of these, 7 showed pathologically low sphincteral pressure rates and 3 abnormally high rates with coordination disorders. Four had normal sphincteral pressure rates but considerably disturbed sensitivity. In the 3 children examined by MRI so far clear morphological changes were found. The question of whether the deviations found were the result of primary or secondary changes could not be clarified. However, of key importance is that these additional findings enable the use of a combined course of treatment (passive sphincter training by electrostimulation and active sphincter training with biofeedback) that seemed to bring improvement quickly and reliably.