Differential Diagnosis for Encopresis
- Single Most Likely Diagnosis
- Functional constipation: This is the most common cause of encopresis, accounting for approximately 90% of cases. It occurs when a child has a bowel movement in an inappropriate location, often due to chronic constipation and fecal impaction.
- Other Likely Diagnoses
- Oppositional defiant disorder (ODD): Children with ODD may exhibit intentional soiling as a form of defiance or rebellion against authority figures.
- Anxiety or stress: Emotional distress can contribute to encopresis, particularly if a child is experiencing anxiety or stress related to bowel movements or toilet training.
- Neurodevelopmental disorders (e.g., autism spectrum disorder): Children with neurodevelopmental disorders may have difficulty with toilet training or experience constipation due to sensory or motor issues.
- Do Not Miss Diagnoses
- Hirschsprung's disease: A congenital condition characterized by the absence of ganglion cells in the distal bowel, leading to severe constipation and potential for intestinal obstruction.
- Spinal cord abnormalities (e.g., spina bifida): Neurological defects can affect bowel function and lead to encopresis.
- Thyroid disorders (e.g., hypothyroidism): Certain thyroid conditions can cause constipation and contribute to encopresis.
- Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): Chronic inflammation and bowel dysfunction can lead to encopresis.
- Rare Diagnoses
- Celiac disease: An autoimmune disorder that can cause malabsorption and gastrointestinal symptoms, including constipation and encopresis.
- Cow's milk protein allergy: A rare condition that can cause gastrointestinal symptoms, including constipation and encopresis.
- Neurological disorders (e.g., cerebral palsy, muscular dystrophy): Certain neurological conditions can affect bowel function and lead to encopresis.