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Clinical Pediatrics
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No-Enema Therapy for Idiopathic Constipation and Encopresis

Elizabeth E. Gleghorn

Associate, Pediatric Gastroenterology and Nutrition, Children's Hospial Medical Center, Oakland, CA

Melvin B. Heyman

Director, Division of Pediatric Gastronterology and Nutrition, University of California San Francisco, San Franisco, CA

Colin D. Rudolph

Assistant Professor of Pediatrics, Division of Gastroenterolgy and Nutrition, Children's Hospital Medical Center, University of Cincinati School of Medicine, Cincinnati, OH

Idiopathic constipation and encopresis of childhood are thought to occur when children volitionally withhold stool. Withholding may be prompted by social pressures or by episodes of painful defecation. Repetitive withholding may result in colonic dilatation and colorectal dysfunction. Therapy involves removal of impacted stool, stool softening, and behavioral therapy. The use of enemas in this therapy is widespread but may be counterproductive. A retrospective review of patients treated without enemas revealed 45 patients whose course could be followed for six months. Ninety-eight percent of these had successful initial cleanouts without enemas; 94% had continued success at six months. These results, comparable with other treatment programs, demonstrate that therapy without enemas is a reasonable alternative in the treatment of childhood constipation and encopresis.

Clinical Pediatrics, Vol. 30, No. 12, 669-672 (1991)
DOI: 10.1177/000992289103001203
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