When a child is having accidents and the caregiver is attempting to sort out whether or not the accidents are being caused by too much laxative or if the accidents are from leakage around retained stool, it can be helpful to ask the child ‘Did you know you had an accident? Did you realize this was happening?’ If the child answers ‘no’, there could be retained stool and the laxative may be causing softer stool to leak around the harder stool. If the child answers ‘yes’ and attempted to get to the bathroom but did not make it, the dose of laxative may be too high.
These are things to consider when discussing encopresis issues with the child’s physician. If there is uncertainty about what is going on, an x-ray of the abdomen can sometimes be useful in determining if there is retained stool in the colon or not. Many gastroenterology practices as well as primary care providers are willing to check an x-ray to make this determination.
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