Soiling Solutions

Diagnosis and Overview

Introduction
The Diagnosis of Bedwetting
The Diagnosis of Soiling
Diurnal or Daytime Enuresis

Introduction:

In the vast majority of cases bedwetting (nocturnal enuresis) and soiling (encopresis) do NOT derive from bad parenting, naughty children, or emotional disturbances. Almost all of us are born wetting and soiling. You learn bladder and bowel control. Learning and conditioning are very powerful tools that can even overcome genetic dispositions that may bias toward nocturnal enuresis or encopresis.

Today, the cultural phenomenon of overly busy families, changes in child rearing styles, and the convenience of diapers may put off toilet training. Indeed, TIME magazine ("War of the Diapers", 1/25/99, p. 64) reported that in 1961, 10% of 2-1/2 year olds were in diapers as contrasted to 78% in 1997! Delaying can create chronic problems and more difficult interventions. Children can actually learn more effective "resistance" techniques and fight training, as they get older and smarter. In addition, more children have come to be toilet trained, but when they do poop, they will do so only into a diaper, rejecting sitting on the toilet! This is a true example of old fashioned, simple, association-based conditioning. These children then can become encopretic over attempts to get them to use the toilet. Children often act out of immediate self-interest. Parents can act earlier based on long term considerations, but may not because of various pressures or beliefs. Sooner or later children do have to learn how to hold and when and where to relax and "let go" on the toilet! Learning to pee in the toilet during the day is much less of a problem for kids than pooping.

Nocturnal enuresis is a major problem because it is difficult to teach or to learn bladder control in sleep. Encopresis is more likely today because it is difficult to form a reliable, daily bowel habit after a meal in today's hectic world. ADHD children are at special risk for daytime wetting and encopresis. Soiling Solutions knows how to help you via its manuals. If you would prefer to work with your physician, he or she can order our manuals in bulk at reduced rates from our store or calling us.

The Diagnosis of Bedwetting (nocturnal enuresis):

This is a very private and common problem, which occurs in the quiet of the night. It can be hidden from the outside world. It does not usually elicit the intense reactions that go with encopresis or fecal soiling. It occurs in sleep and the child is more likely to be viewed as unfortunate and a victim of a sleep disorder. Many health providers and caretakers don't take it very seriously because it is not a source of any major health problems. A common impression is that the child will "grow out of it". But do they, and just what is bedwetting?

Bedwetting is a "habit deficiency" occurring in 10% to 20% of children. The vast majority of children establish a dryness habit between 2 and 3 years of age. But, after that, certainly by age 5, "growing out of it" becomes much less likely. The diagnostic manuals of the World Health Organization and the American Psychiatric Association define nocturnal enuresis as a diagnosable disorder only at 5 years of age, which is well after the condition has already been quite firmly established. Specifically, the odds are one-in-four for four year olds decreasing to one-in-six chances of being dry sometime in the next year as they get older. As time passes the personal "costs" become greater. Your child may wish to stay over with friends or go camping, but avoids doing so because he/she might have a very embarrassing accident. Children may feel like failures because they have no control over a basic body function. They experience negative and upset reactions from family members. Why should everyone be unhappy or miserable for two, three, or more years? Finally, there is some evidence of medical consequences in that urinary tract infections (UTI's) do occur with greater frequency in persistent bed wetters than for non-bed wetters. The tendency toward UTI's becomes greater for children who also soil. UTI's can become really serious if they progress to a kidney infection. If you want authoritative and comprehensive information about treating enuresis start by clicking on the Dry Bed Treatment tab above. When you are on that page check out some of the hyperlinks on the top right of that page for yet more pages of interest. Some of the other tabs above will also contain information about our enuresis treatment, especially the Press Clippings and the Scientific Articles tabs.

The Diagnosis of Soiling (encopresis):

This problem causes the most distress for parents and children. The vast majority of children establish a daily bowel habit between 2 and 3 years of age. The diagnostic manuals of the World Health Organization and the American Psychiatric Association define encopresis as a diagnosable disorder at 4 years of age, which is well after the condition was successfully dealt with in 1961 by 90% of parents. Our culture has almost zero tolerance for human feces and rightfully so. Regulating human waste has been a major means for disease prevention. For related reasons UTI's are more likely with encopresis. In reaction to our strong feelings, our children may hide their soiled clothing, fight toileting, and appear totally indifferent to their problem. Parents who expect schools and day care settings to gracefully accept and attend to their children are dreaming. Even if they do get some accommodation I doubt that those children will receive "unconditional positive regard" from their attendants. Anger, conflict, blaming, and negative labeling are likely to take over, which only leads away from a solution focus. Almost everyone can become trapped in a problem focus. Being a "do it yourself culture we try to do it all ourselves. We encourage you to become very informed by reviewing the literature and information available at this site. The founder of this site has written some of the peer reviewed published scientific articles. Take your time and thoroughly explore the large number of informational pages on this site. If you are specifically interested in encopresis, just click on the Clean Treatment Tab above for a very informative page. Then, if you want still more information check the hyperlinks toward the bottom portion of that page which will take you to a great variety of other very informative pages. Parents and professionals alike will find much useful information.

Diurnal or Daytime Enuresis:

A free treatment guide is provided for you on our Daytime Bladder Accidents treatment page.

Soiling Solutions

an End to Encopresis!