Elimination Disorders (in Childhood): Causes, Symptoms And Treatment
Psychological problems in childhood usually cause suffering not only in the child, but also in the parents or the closest family around them. This psychological discomfort during childhood can manifest itself in unusual ways, this being the case of elimination disorders
These alterations related to sphincter control are usually related to the experience of feelings of discomfort and anguish. Throughout this article we will talk about the characteristics of each of them, as well as their causes, symptoms and possible treatments.
The concept of elimination disorders refers to an alteration that can appear during childhood, affecting both the psychological state and behavior of the child as generating feelings of worry and anxiety in the rest of the family. Sometimes, this alteration can become so pronounced that it ends up being a source of conflict within the family nucleus.
The nature of this disorder is related to the acquisition of sphincter control. Although there are individual differences in each of the children, this control is usually achieved between 18 and 36 months of age.
Among the behaviors or behaviors that fall within this category are nocturnal and daytime fecal continence and nocturnal and daytime urinary continence.
In the case of elimination disorders, The child fails to achieve this control, which usually results in two different events: functional enuresis or uncontrolled urination which tends to appear some time after the acquisition of urinary control, it is not usually diagnosed before the age of 5 and usually occurs during sleep.
On the other hand, we find functional encopresis, which refers to the evacuation of feces at inappropriate times and situations, both voluntarily and involuntarily. In this case, the approximate age for diagnosis is 4 years.
In most cases, both alterations appear accompanied by each other; However, this does not have to be the case. Furthermore, each of them is accompanied by characteristics, causes and characteristic psychological symptoms.
Despite this, In both enuresis and encopresis, the family usually feels helpless and disoriented The reason is that there is no single cause that can cause these behaviors and also the appearance of emotional symptoms on the part of the child makes the parents’ concern and frustration even greater.
Functional enuresis
By functional enuresis we mean the child’s inability to control urination, which leads to the expulsion of urine during the night or at inopportune times and places. This behavior usually occurs both involuntarily and voluntarily.
For a correct diagnosis of functional enuresis to be made, it must appear once the evolutionary guidelines have passed; That is, at that age the child should already be able to control urination (over 3 or 4 years old). Furthermore, it will first be necessary to rule out possible physical or organic causes,
1. Main features
There are a series of characteristics that define functional enuresis:
2. Possible causes
If physical problems related to the size of the bladder or muscle weakness, as well as hereditary causes or sleep cycles, can be ruled out. The medical professional or psychologist must then perform a psychological evaluation that reveals possible psychological factors or causes
Sometimes functional enuresis is accompanied by emotional and behavioral symptoms. However, it has not yet been possible to determine whether this is the cause or, on the contrary, an effect of the disorder itself.
Regarding the psychological origin of functional enuresis, the case studies point towards the idea that the experience of periods of stress and anxiety, as well as the experience of traumas and psycho-social crises such as the birth of a sibling, may be some of the causes of this problem.
3. Behavioral and physical symptoms
Functional enuresis may be associated with the following psychological and physical symptoms:
4. Treatment
Regarding the approach to the problem by parents and teachers, These should remain attentive to when enuresis occurs and, under no circumstances, reprimand or punish the child for doing it.
The most effective option is to go to a psychology specialist. Which, in addition to carrying out a psychological evaluation and intervention, will teach the minor sphincter control learning techniques or alarm techniques and devices.
Functional encopresis
In the case of functional encopresis, the elimination disorder is manifested by the voluntary or involuntary evacuation of feces at inappropriate times too. In this case, the diagnosis dictates that the problem must remain present for at least three months, with the child being more than four years old.
1. Main features
As in enuresis, functional encopresis has a series of characteristics that distinguish it:
2. Possible causes
By eliminating the possible physical causes of encopresis, such as constipation and fecal impaction, certain psychological factors can be found that cause this type of elimination disorder.
Deficient learning and training in hygiene issues, training too early or the appearance of an emotional condition such as oppositional defiant disorder or a behavioral disorder, are usually the main causes of this alteration.
3. Physical and psychological symptoms
In addition to the problematic behavior itself, functional encopresis presents a series of both physical and psychological symptoms:
4. Treatment
As in enuresis, neither parents nor teachers should reprimand the child when an unpleasant situation occurs, but instead It is necessary to talk to him in a language appropriate to his age, not as if he were a newborn
As for the medical and psychological approach, these will try to prevent constipation, as well as stimulate the development of correct defecation habits.
Through psychotherapy, the child can be helped to control and manage the emotional symptoms of this elimination disorder.
