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Journal of Pediatric Psychology 21(5) pp. 659-670, 1996
© 1996 Society of Pediatric Psychology

other

Additive Benefits of Laxative, Toilet Training, and Biofeedback Therapies in the Treatment of Pediatric Encopresis1

Daniel J. Cox2, James Sutphen, William Ling, Warren Quillian and Steve Borowitz

University of Virginia Health Sciences Center

2All correspondence should be addressed to Daniel J. Cox, Behavioral Medicine Center, Box 223, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908

Compared the additive benefits of laxative, behavior, and biofeedback treatments for encopresis, while attempting to identify treatment mechanisms and predictors of treatment outcome. 44 encopretic children, ages 6–15 years, were randomly assigned to either laxative therapy (LAX), LAX plus enhanced toilet training (ETT), or LAX + ETT + anal sphincter biofeedback (BF). Daily symptom diaries were completed 14 days before, upon initiation of, and 3 months following treatment initiation. ETT and BF were superior to LAX in reducing encopresis. Outcome was significantly predicted by improvement during the initial 14 days of treatment. Reduction of soiling was associated with an increase in bowel movement frequency, and reductions in defecation pain and parental prompting to use the toilet. Because of its efficacy and minimal reliance on technology, ETT should be the initial treatment of choice.

Key words: encopresis; laxatives; behavior therapy; biofeedback; prediction.


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