Enuresis and encopresis are technical terms referring to functional difficulties in bladder and bowel control, respectively. Eliminative control ordinarily is accomplished in the sequence bowel-asleep, bowel-awake, bladder-awake, bladder asleep (Stein and Susser, 1967). Encopresis and diurnal (daytime) enuresis can be recognized when a child is between 2 and 3 years of age. The last stage of bladder control in sleep appears to be particularly difficult to achieve for a significant minority of children from 4 to 5 years of age and beyond. In fact, bedwetting (nocturnal enuresis) may be regarded as the most chronic and prevalent of all childhood disorders.
Organic causes and complications of bladder and bowel incontinence are almost always sought but rarely found. While maturational and hereditary mechanisms are undoubtedly implicated, they clearly interact with personal-societal concerns and toilet training procedures. The effectiveness of the various surgical, biochemical, and behavioral conditioning interventions attests to the highly interactive nature of enuresis or encopresis. The visibility of enuretic and encopretic symptoms lends an objectivity to clinical assessment procedures which are not generally found for other functional disorders. This realization, the robustness of modern medical and behavioral sciences, and the centuries-old concerns surrounding soiling promise increased freedom from the problem of urinary and fecal incontinence.
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