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

Compared the additive benefits of laxative, behavior, and biofeedbacktreatments for encopresis, while attempting to identify treatmentmechanisms and predictors of treatment outcome. 44 encopreticchildren, ages 6–15 years, were randomly assigned to eitherlaxative therapy (LAX), LAX plus enhanced toilet training (ETT),or LAX + ETT + anal sphincter biofeedback (BF). Daily symptomdiaries were completed 14 days before, upon initiation of, and3 months following treatment initiation. ETT and BF were superiorto LAX in reducing encopresis. Outcome was significantly predictedby improvement during the initial 14 days of treatment. Reductionof soiling was associated with an increase in bowel movementfrequency, and reductions in defecation pain and parental promptingto use the toilet. Because of its efficacy and minimal relianceon technology, ETT should be the initial treatment of choice.