Dr j. GolmirzaeiChild & adolescent psychiatrist

EnuresisDefinitionEtiologyEpidemiologyDifferential Diagnosis

TreatmentRate of spontaneous remission 15% per yearBehavioral conditioning with bell and pad DDAVPImipramineAnticholinergicCombination

Outcome & follow-up6 months treatment6 months later treatment Observation 16%Imipramine 16%DDAVP 10%Behavioral 56% First line

EncopresisDefinationEpidemiologyEtiologyDifferential Diagnosis

SubtypesRetentive (most frequent)Non-retentiveVolitional(least frequent)

First line of treatment for retentive subtype is Education about bowel functioning

Physiological treatment (laxative or mineral oil)

BehavioralBiofeedback

Case report : Imipramine for non-retentive encopresis

Psychodynamic assessment for volitional encopresis