Nonretentive Encopresis And Toilet Training Process Refusal

January 11, 2018 0

in Home Improvement @ 2:54 am

Nonretentive Encopresis and Toilet Training Process Refusal


Connie Limon

An inappropriate soiling without evidence of fecal constipation and retention is referred to as ‘nonretentive encopresis. Signs and symptoms of nonretentive encopresis include:

— Soiling accompanied by daily bowel movements that are normal in size and consistency

There is rarely an identifiable organic cause for nonretentive encopresis. A medical assessment is usually normal. A full developmental and behavioral assessment is necessary to determine if the child is ready for intervention to correct encopresis. The assessment is also necessary to identify any barriers to success of correcting encopresis, particularly disruptive behavior problems.

Successful therapy depends upon:

— The presence of soft, comfortable bowel movements

— Addressing toilet refusal behavior

Before therapy:

— Daily scheduled positive toilet sits are recommended

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— Incentives to reinforce successful defecation during these sits

— A plan for management of stool withholding agreed on by parents/caretakers and the family physician

Encopresis affects boys more than girls and may go undetected unless health professionals directly inquire about toileting habits.

About 80 to 95 percent of encopresis cases involve fecal constipation and retention. It is estimated that encopresis in which fecal retention is not a primary etiologic component is under-represented in the literature. Most of the time, children with the latter condition have daily, normal size and consistency bowel movements. Terms used to describe this problem include:

— Functional encopresis

— Primary nonretentive encopresis

— Stool toileting refusal

There are four subgroups these children may be further divided into:

— Those who fail to obtain initial bowel training

— Those who exhibit toilet ‘phobia’

— Those who use soiling to ‘manipulate’ their environment

— Those who have irritable bowel syndrome

Behavioral characteristics and toileting dynamics of children with nonrententive encopresis are well described; however, few specific treatment guidelines are available for family physicians.

Research of retentive encopresis

Over the past 20 years the treatment of retentive encopresis has progressed impressively, however, less attention has been paid to the 5 to 20 percent of cases in which constipation is not contributory, or where a child refuses the toilet-training process.

Evaluation for retentive encorpresis

In most cases, the family physician is who first identifies the problem of retentive encopresis and provides an intervention. If the problem is due to the child not being mature enough for toilet training, waiting until the child matures is the sensible answer. Many times, a lack of maturity is not the cause, but it is a child who is behaviorally resistant or parents who need information on effective behavior management or toilet-training techniques.

Possible causes for retentive encorpresis

The cause for a child’s resistance must be identified first. When the cause is determined, specific therapy can be started.

1. If the problem is related to a skill deficit such as opening the bathroom door, seating self on toilet or wiping then teaching and reinforcement of those skills the child lacks is preferred to passive waiting.

2. If the child is noncompliant with adult instructions, the physician may refer the family to a pediatric psychologist familiar with compliance training techniques.

In either of the two above cases, without active intervention, a strong-willed child may refuse toilet training and create unnecessary stress on the parent-child relationship, which may in turn increase the risk of abuse.

If you have a toddler who exhibits any of the characteristics of retentive encorpresis consult with your toddler’s pediatrician for an appropriate evaluation and treatment plan.

Source: American Academy of Family Physicians

Disclaimer: *This article is not meant to diagnose, treat or cure any kind of a health problem. These statements have not been evaluated by the Food and Drug Administration. Always consult with your health care provider about any kind of a health problem and especially before beginning any kind of an exercise routine.

This article is FREE to publish with the resource box.

Written by: Connie Limon. Visit us at for more information about toilet training toddlers and for articles available as FREE reprints to your newsletters, website or blog.

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Healthy Penis In Public Covering Up Accidental Slips}

October 30, 2017 0

in Home Improvement @ 3:00 am

Healthy Penis in Public – Covering Up Accidental Slips


John Dugan

When a man has a healthy penis, he likes for others to admire it in the proper setting, such as a bedroom. Sometimes, however, penis slips occur while in public, putting a man in a situation where his manhood is suddenly on display for all to see. Exhibitionists may relish this situation, but for many men this can be a case for extreme embarrassment. Even those who have been practicing superb penis care don’t necessarily want that fact broadcast in public.

Below are several examples of penis slips and actions that a man can take to cover up and/or prevent the exposure. It always pays to be prepared.

The open fly.

This is probably the situation which affords the most unintentional public penis showings. A man is at a gathering and goes to the bathroom to relieve himself and forgets to zip back up when he is finished. He wanders back into a room full of people with his fly open. At first, things may be fine; no one notices the little faux pas, least of all the man himself. Unfortunately, he becomes engaged in a conversation with an especially attractive woman and after a minute realizes his healthy penis is poking out, firm and proud, from his pants.

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An evasive maneuver is most definitely called for. Crossing his hands in front of his crotch will do for a start, but if he has a full erection, this may not provide sufficient coverage. If an object, such as a book, is nearby, it can help to grab the object and hold it over the crotch. In a best case scenario, a man may be holding a jacket or sweater and can nonchalantly use this for a cover up. As soon as possible, he needs to excuse himself and retire to the bathroom or another private area to fix the situation.

Clearly, wearing underwear is one way to lessen the chance that the open fly issue will lead to a penis slip. It also helps to make sure that the fly on the underwear closes and covers properly.

Gym shorts.

Working out at the gym requires taking some wide open stances. In many cases, especially when on a bench press type of machine, this can result in the penis and testicles falling into view through the leg opening of the shorts.

Fortunately, most people carry a towel while doing a workout, so simply spreading the towel across the lap may be enough to hide penis slips of this sort. Also, wearing an athletic supporter rather than loose underwear can be a big help.

Rough waves.

Spending a summer day at the ocean can be great, especially when the surf is roaring and creating big waves. Unfortunately, sometimes those waves can pull down a guy’s swimsuit. In these cases, a man needs to keep the waist below water as he rights the situation.

But what if the wave is so rough it pulls the suit all the way off and a guy can’t find it? In this situation, he needs to remain waist-deep in water and get the attention of another male swimmer. Explain the situation and ask if he can please go ashore and return with a towel big enough to wrap around the midsection. He may get some ribbing from the guy, but it’s better than walking ashore and getting a public indecency citation.

Embarrassing as penis slips are, exposing a healthy penis is preferable to one with dry, flaky skin or other issues. Regularly using a quality penis health crme (health professionals recommend Man1 Man Oil) helps in this area. Natural hydrators like Shea butter and vitamin E should be included in the crme, to make sure the organ is well moisturized and the skin is at its best. In addition, a potent antioxidant like alpha lipoic acid helps prevents an unsightly “wrinkled” penis look. And a crme with L-arginine can prevent a display of broken capillaries in the member. If it is going to be shown, show it at its best!


for more information about treating common penis health problems, including soreness, redness and loss of penis sensation. John Dugan is a professional writer who specializes in men’s health issues and is an ongoing contributing writer to numerous online web sites.

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Healthy Penis in Public – Covering Up Accidental Slips }