Consequently, defecation is ineffective, and stool builds into a hard rectal mass. FFR may begin as early as the first year of life. A child's bowel movements are usually soft until he or she is weaned. In affected infants, the switch from breast milk to commercial formula is associated with a change in stool consistency from soft and seedy to hard little pellets. Children beginning kindergarten learn that they cannot get up from class whenever they have to go to the bathroom.
Encopresis occurs when loose stool leaks around the fecal mass and presents at the anoderm.
They may develop misconceptions that they are not like everyone else, and that they are stinky, bad or being punished. One key to treatment is education to dispel any myths and fears, and to create an expectation for getting well in both the child and the family. Explain that functional fecal retention is common and that we know exactly what it is and how to make it better. It is a good idea to state the child's fear before he or she asks, because it reinforces that you know what is affecting the patient. Let the child know that he or she does not have a disease at all, but simply needs to relearn to relax their bottom when feeling an urge to defecate.