Constipation & Encopresis Clinic
Constipation — having few bowel movements or bowel movements where the stool is dry or hard and hard to pass — can begin at any age. Things that can start constipation include:
- Beginning solid foods
- Illness
- Stress
- Toilet training
- Child not stopping playing to go to the bathroom
Although unusual, constipation can also be caused by hypothyroidism, Hirschsprung’s disease, celiac disease, spinal cord injury or as a side effect of some medications. Even children with normal bowel movement every day can still be constipated.
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.
Children can have a bowel movement every day and still have stool accidents if they do not totally empty when defecating.
These two conditions are quite common in children. Fortunately, expert help is close by. At the Mary Bridge Pediatric Constipation & Encopresis Clinic, highly trained professionals work with the latest technology to help treat children with defecation issues, and offer the care children and families need.
COMPREHENSIVE SERVICES – EVALUATION AND TREATMENT PROCESS
The Mary Bridge Pediatric Constipation & Encopresis Clinic — one of only two encopresis treatment centers in
A detailed medical history and check-up is completed 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. Some children 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. This plan may include medication, behavior change recommendations, and so on, depending on what would work best for your child’s condition.
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.
WHO SHOULD BE SEEN AT THE MARY BRIDGE
Infants, children and adolescents who are:
ü Having irregular or hard to pass stools
ü Toilet trained but having stool incontinence (stool accidents)
ü Having painful bowel movements
ü Failing to respond to the constipation/encopresis treatment plan
ü Exhibiting withholding behavior
Symptoms calling for immediate concern:
ü Vomiting bile
ü Rectal bleeding
ü Abdominal tenderness, bloating, and firmness
ü Severe abdominal pain
ü Rectal prolapse
ü Poor weight gain
ü Delayed passage of meconium (first infant stool)
Management for constipation and encopresis may include:
- Family education
- Clean-out using enemas or oral laxatives
- Inpatient or outpatient clean-out
- Maintenance medication
- Behavioral strategies
- Diet modifications
- Psychology interventions
- Biofeedback
WHAT FAMILIES CAN EXPECT
The Mary Bridge Constipation & Encopresis Clinic’s 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.
We hope this brochure answers many of the questions you may have regarding your child’s care and treatment at
Appointments
The following will help make the time with your child’s nurse practitioner as useful and beneficial as possible.
- Please 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.
Phone Calls
Questions or concerns regarding your child’s condition or treatment may arise in between scheduled visits.
- Call 253-403-3131, 8am to 4pm, Monday through Friday, to speak to a gastroenterology nurse, who will consult with your nurse practitioner as needed.
- After hours, weekends or holidays, calls will be answered by the MultiCare Consulting Nurse Service at 253-403-3131.
- Call 9-1-1 anytime your concern is a life-threatening EMERGENCY.
Labs and Test Results
If the results of any test given to your child come back abnormal, you will be contacted by your child’s nurse practitioner. Please allow one to two weeks for these results to become available.
Prescription Refills
Medications are refilled up to your next clinic appointment. It is very important to make and keep follow-up appointments so that your child’s refills can continue without interruption.
To request the medication refill you need, please call your pharmacy. If you need further assistance with your refill, call our clinic at 253-403-3131.