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Constipation and Encopresis Clinic

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Help for Kids with Constipation and Encopresis

The MultiCare Mary Bridge Pediatric Constipation & Encopresis Clinic offers a range of services to diagnose and treat infants, children and adolescents struggling with constipation and encopresis (leaky stool). We are one of two encopresis treatment centers in Washington State.

Our experienced team includes a certified pediatric nurse practitioner specializing in gastroenterology disorders, registered nurses, a psychologist, a social worker and other support staff. Our goal is to work hand-in-hand with you and your child’s primary care provider to ensure your child gets better. Mary Bridge pediatric gastroenterologists and other sub-specialists are also available for consultation, if necessary.

Overview of Constipation and Encopresis

Both constipation and encopresis are common in children.

Constipation is when infants or children have few bowel movements or bowel movements in which the stool is dry and hard to pass.

Encopresis is the uncontrolled leaking of stool into the underwear by a child older than 4 years of age developmentally. It is caused when a mass of stool develops in the rectum if it is not emptied. Stool from the colon leaks around this mass, resulting in stool accidents.

Who We Treat

The Mary Bridge Constipation and Encopresis Clinic treats infants, children and adolescents who are:

  • Having irregular or hard-to-pass stools
  • Toilet trained, but having stool incontinence (stool accidents)
  • Having painful bowel movements
  • Failing to respond to the constipation/encopresis treatment plan

Evaluation and Treatment

We'll complete a medical history and check-up during your child’s first visit and the nurse practitioner will determine if further testing is needed. Some children may require x-rays or other imaging tests and blood work. Others may need to see a pediatric gastroenterologist for other outpatient tests or procedures. To help facilitate these tests, we offer child-friendly sedation services provided by an expert physician, when that extra level of comfort is needed.

After a diagnosis is made, a plan for improving your child’s condition is developed and shared with your child’s pediatrician.

Treatment for constipation or encopresis may include:

  • Family education
  • Clean-out using enemas or oral laxatives
  • Outpatient clean-out
  • Maintenance medication
  • Behavioral strategies
  • Diet modifications
  • Psychology interventions
  • Biofeedback

Resolving defecation issues often takes time. The nurse practitioner and other experts will stay involved throughout this process and your family’s active participation is also necessary to help your child.

Appointments and Lab Test Information

Consider the following tips to help make the time with your child’s nurse practitioner as useful and beneficial as possible:

  • Schedule follow-up appointments as soon as you can to take advantage of optimum time slots and avoid lengthy delays.
  • Your nurse practitioner wants to spend as much time as possible with you and your child during the appointment to thoroughly address all concerns. To help with this, you and your child must arrive on time. If you are more than 15 minutes late the appointment will have to be rescheduled.
  • We request 24 to 48 hours notice if you must cancel an appointment.
  • Please turn off cell phones and pagers during your visit. If possible, arrange childcare or babysitting for siblings or other children.
  • Food and drinks are not permitted in the examination rooms.

Allow one to two weeks for lab results. If the results of any test given to your child come back abnormal, you will be contacted by your child’s nurse practitioner.

Between Appointments

For questions or concerns regarding your child’s condition or treatment that arise in between scheduled visits:

  • Call the clinic at 253-792-6630 from 8am to 4pm Monday through Friday to speak to a gastroenterology nurse, who will consult with your nurse practitioner as needed.
  • For after hours, weekends or holidays, please call the MultiCare Consulting Nurse Service at 253-792-6300.
  • Call 9-1-1 anytime your concern is a life-threatening emergency.
  • For medication refills, please call your pharmacy, or, if you need further assistance call the clinic. Medications are refilled up to your next clinic appointment. Keeping those appointments ensures that your child's refills can continue without interruption.