i'm a medical student. One day while i was examining a patient with Chronic Renal Failure, i found stridor. Suddenly the patient passed stool involuntarily. This was never occurred before. Any correlation with patient's serum potassium level which was 7,7 mEq?
thank u for your help
It is not surprising to have a (K) so high ina patient with CRF. You were examining the patient and the patient exhibited stridor (monophonic wheezing sound), I assumed you did not need your stethoscope to listened to the stridor. What worries me is the potassiu level and if there is clinical correlation (cardiac conduction issues). My focus would be in the latter. because that is what will either kill the patient or simply just be a laboratory error (low yield in CRF, I would take it serious), The spontaneous BM and your concern of encopresis and the hyperkalemia, although might have a clinical explanation, it would be to me not a priority at this point). Now, you as a med student should know (and probably does) the cell physiology and the repercussion of potassium in the curve. Put the puzzle together, because as a teacher, I must leave you with that. Good question, but always remember: the patient, your clinical skills, your H&P and then any corroborating tests is what is important. The rest is just zeebras which makes us side track from the real problem at hand. Study hard. Be the best you can be and good luck. (+ info
How can I speed up curing encopresis I already have medicen?
Ok when I was about 11-12 I had encopresis and then about when I became 13 it stopped
but it has suddenly started again I got medicen for doctor but he said it can take
months to work if I go to school and anyone finds out my life will be over
Never be embarrassed for something that is happening naturally and try to follow the guidelines as stated below:
- Drink plenty of water and juices, especially orange juice.
- Eat foods that are high in fiber and avoid nuts.
- Exercise daily.
- Visit the bathroom as frequent as possible, especially when you get the slightest feeling of its need. You may also want to make scheduled trips and usually they work out better.
- Always make sure to use stool softeners or laxatives like Miralax, Lactulose, mineral oil, etc.
This condition will become better with time and as you grow older. So nothing to worry about young man.
Good Health To You! (+ info
Have any of you had a child with encopresis?
I was just wondering if any of you know about this condition and have gone through it with any of your children. It is hard for a child to go through, but it is a real condition.
It's a rather common condition in pre-schoolers and children in the early primary grades. It's part psychological and part physical. The child does not like the sensation of having a bowel movement so he (or she) holds it in. Parents may think that the child is straining to have a BM when actually he strains NOT to have a BM. Consequently the colon becomes very full.
As with many small children, the affected person often eats a very low fiber diet. Improving diet in children this age is a major challenge.
Often what happens next is that the child soils his pants. This is more liquid stool from farther into the colon that channels around the fecal mass in the rectum. The child may have no sensation of stooling until he feels the warmth on the skin of the buttocks, or he smells it.
Treatment has probably improved since my retirement. Back then we emphasized better nutrition, (more fiber in the diet), we gave a single enema, and we started on a regimen of stool softeners like mineral oil, plus laxatives. We also tried some behavior modification. Nowadays there may be better laxatives that I hesitate to mention by name. You should check with your doctor about this. (+ info
How can I find a Dr. in Phoenix Arizona specialist in encopresis?
My nephew who is in kindergarten has had it for a while now had bad experiences in the past
Call the Academy of Medicine for referral. (+ info
Kids with Encopresis?Big word for poop issues. please this is important?
where can i communicate with other kids who have encopresis? please help me find kids. this is an intestine problem that makes soil. soil is when you poop in your pants by accident.
you must get scared easily ;)
honestly, most grow out of this. and ive never heard of a support group. maybe a support group for incontinence, like at a retirement home or something.....that may be your best bet. still, havent heard of an incontinence support group. oh well. (+ info
does anyone have a school age child with encopresis?
My son is 6 and refuses to poop in the toilet .He says he is scared.So he holds it in and then gets sick from it. We've been to a gastroenterologist, he is on laxatives,and he leaks and smells. Bribes don't work,reasoning doesnt work. Any ideas from parents dealing with this?
you can tell him that he needs to learn to do it. ask him why he's afraid. that might help. you could also get him one of those little tiny toilets for tots that sits on the bathroom floor. (+ info
I think my son has a severe case of encopresis?
I need help with methods of how or what to do I have talked to my doctor. He is very active and setting"sit down" time is somewhat hard. Also what kind of laxative work best for you or your child? I want this to be as gentle and easy for him as possible. I have not been as understanding about the situation thinking it was just him being lazy.
Any info would help thank you
He is 10 years old
Metamucil, Milk of magnesia, Citrucel, or mineral oil. Unlike laxatives in adults, they are generally not considered to be habit forming. You should use them once or twice a day and work up on the dose until your child is having a soft BM each day. If you child starts to have diarrhea, then you are giving too much and you should cut back on the dose.
try increasing fiber, fluids and bran
decrease gas forming foods (+ info
Does anyone have a toddler with encopresis?
I really need help on this one...She has a wonderful G.I. doctor and I am doing everything they say...but it is as bad as it could get....
I was really hoping not to have to go to the therapy level, but next visit I am going to check on that...My insurance covers it..Thank you so much.
Does your insurance have mental health coverage? If so, may I suggest you consider seeking the aid of a trained pediatric psychologist who specializes in treating encopresis? There are many behavioral interventions that can help treat this disorder.
You can ask your GI physician if he/she knows of anyone. Additionally, if you have mental health coverage, there may be an 800 number on the back of your insurance card you can call to ask about specialists in your area.
Edit: There is no shame in seeking help. Additionally, a multidisciplinary approach is usually helpful in disorders like encopresis where there may be a biological component. Good luck:) (+ info
Anyone have a child w/ encopresis? Does anything work? Do they ever outgrow it? My son is 7 & nothing is?
Yes, I have tried the remedies for constipation. He was cleaned out & on miralax for a while.
well, its been a while since we've talked shit. lol
Derrick has an appointment for the gastroentoligist this tuesday. Its also his 10th birthday. fun, huh. anyways. I just keep up with the miralax, which is crap because there is no poop coming. and when it is, it either hurts, or its in his underwear. The only thing that helps is glycerian enemas. It just clears it out and doesn't sting, and he does them hisself. but we still have to look and see how much and the consistency.
You need to get up the doctors butt about it and ask for another treatment or even surgery. (+ info
PLEASE HELP! What is Encopresis and is there a cure for it or how to control it in a 10year old?
It's associated with going to the bathroom, mostly poop, gross as that is.
Here's more from webmd.com:
Encopresis is the repeated passing of feces into places other than the toilet, such as in underwear or on the floor. This behavior may or may not be done on purpose.
What Are the Symptoms of Encopresis?
In addition to the behavior of releasing waste in improper places, a child with encopresis may have other symptoms, including:
Loss of appetite
Loose, watery stools (bowel movements)
Scratching or rubbing the anal area due to irritation from watery stools
Decreased interest in physical activity
Withdrawal from friends and family
Secretive behavior associated with bowel movements
What Causes Encopresis?
The most common cause of encopresis is chronic (long-term) constipation, the inability to release stools from the bowel. This may occur for several reasons, including stress, not drinking enough water (which makes the stools hard and difficult to pass) and pain caused by a sore in or near the anus (the opening of the rectum in the fold between the buttocks, where waste is expelled).
When a child is constipated, a large mass of feces develops, which stretches the rectum. This stretching dulls the nerve endings in the rectum, and the child may not feel the need to go to the bathroom or know that waste is coming out. The mass of feces also can become impacted -- too large or too hard to pass without pain. Eventually, the muscles that keep stool in the rectum can no longer hold it back. Although the large, hard mass of feces cannot pass, loose or liquid stool may leak around the impacted mass and onto the child's clothing.
Factors that may contribute to constipation include:
A diet low in fiber
Lack of exercise
Fear or reluctance to use unfamiliar bathrooms, such as public restrooms
Not taking the time to use the bathroom
Changes in bathroom routines; for example, when going to school and there are scheduled bathroom breaks
Another possible cause of encopresis is a physical problem related to the intestine's ability to move stool. The child also may develop encopresis because of fear or frustration related to toilet training. Stressful events in the child's life, such as a family illness or the arrival of a new sibling, may contribute to the disorder. In some cases, the child simply refuses to use the toilet.
How Common Is Encopresis?
Encopresis is fairly common, even though many cases are not reported due to the child's and/or the parents' embarrassment. It is estimated that anywhere from 1.5% to 10% of children have encopresis. It is more common in boys than in girls.
How Is Encopresis Diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. The doctor may use certain tests -- such as X-rays -- to rule out other possible causes for the constipation, such as a disorder of the intestines. If no physical disorder is found, the doctor will base his or her diagnosis on the child's symptoms and current bowel habits.
How Is Encopresis Treated?
The goal of treatment is to prevent constipation and encourage good bowel habits. Educating the child and family about the disorder is another important part of treatment.
Treatment often begins by clearing any feces that has become impacted in the colon, also called the large intestine. The next step is to try to keep the child's bowel movements soft and easy to pass. In most cases, this can be accomplished by changing the child's diet, using scheduled trips to the bathroom and encouraging or rewarding positive changes in the child's bathroom habits. In more severe cases, the doctor may recommend using stool softeners or laxatives to help reduce constipation. Psychotherapy (a type of counseling) may be used to help the child cope with the shame, guilt or loss of self-esteem associated with the disorder.
What Other Problems Are Associated With Encopresis?
A child with encopresis is at risk for emotional and social problems related to the condition. They may develop self-esteem problems, become depressed, do poorly in school and refuse to socialize with other children, including not wanting to go to parties or to attend events requiring them to stay overnight. Teasing by friends and scolding by family members can add to the child's self-esteem problems and contribute to the child's social isolation. If the child does not develop good bowel habits, he or she may suffer from chronic constipation.
What Is the Outlook for Children With Encopresis?
Encopresis tends to get better as the child gets older, although the problem can come and go for years. The best results occur when all educational, behavioral and emotional issues are addressed. A child may still have an occasional accident until he or she regains muscle tone and control over his or her bowel movements.
Can Encopresis Be Prevented?
Although it may not be possible to prevent encopresis, getting treatment as soon as symptoms appear may help reduce the frustration and distress, as well as the potential complications related to the disorder. In addition, being positive and patient with a child during toilet training may help prevent any fear or negative feelings about using the toilet. (+ info
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Last update: September 2014