The Experts below are selected from a list of 282 Experts worldwide ranked by ideXlab platform
Vera Loeningbaucke - One of the best experts on this subject based on the ideXlab platform.
-
functional fecal retention with Encopresis in childhood
Journal of Pediatric Gastroenterology and Nutrition, 2004Co-Authors: Vera LoeningbauckeAbstract:Objectives: The most common cause of Encopresis in children is functional fecal retention (FFR). An international working team suggested that FFR be defined by the following criteria: a history of >12 weeks of passage of <2 large-diameter bowel movements (BMs) per week, retentive posturing, and accompanying symptoms, such as fecal soiling. These criteria are usually referred to as the ROME II criteria. The aims of this study were to evaluate how well the ROME II criteria identify children with Encopresis; to compare these patients to those identified as having FFR by historical symptoms or physical examination; to determine whether 1-year treatment outcome varied depending on which definition for FFR was used; and to suggest improvements to the ROME II criteria, if necessary. Methods: Data were reviewed from the history and physical examination of 213 children with Encopresis. One-year outcomes identified were failure, successful treatment, or full recovery. Results: Only 88 (41%) of the patients with Encopresis fit the ROME II criteria for FFR, whereas 181 (85%) had symptoms of FFR by history or physical examination. Thirty-two (15%) patients did not fit criteria for FFR, but only 6 (3%) appeared to have nonretentive fecal soiling. Rates of successful treatment (50%) and recovery (39%) were not significantly different in the two groups. Conclusions: The ROME II criteria for FFR are too restrictive and do not identify many children with Encopresis who have symptoms of FFR. The author suggests that the ROME II criteria for FFR could be improved by including the following additional items: a history of BMs that obstruct the toilet, a history of chronic abdominal pain relieved by enemas or laxatives, and the presence of an abdominal fecal mass or rectal fecal mass.
-
long term efficacy of polyethylene glycol 3350 for the treatment of chroni constipation in children with and without Encopresis
Clinical Pediatrics, 2003Co-Authors: Dinesh S Pashankar, Warren P Bishop, Vera LoeningbauckeAbstract:Seventy-four children (43 with chronic constipation, 31 with constipation and Encopresis) treated with polyethylene glycol 3350 (PEG) for longer than 3 months were studied to assess long-term efficacy. The mean duration of PEG therapy was 8.4 months (range, 3-30). Weekly stool frequency, stool consistency, and symptoms associated with constipation improved significantly with PEG therapy in all 74 patients. In 31 children with Encopresis, soiling ceased completely in 16 patients and frequency of soiling decreased significantly in all others. The average effective long-term dose of PEG was 0.7 g/kg/day. Long-term PEG therapy is effective for the treatment of chronic constipation with and without Encopresis in children.
-
polyethylene glycol without electrolytes for children with constipation and Encopresis
Journal of Pediatric Gastroenterology and Nutrition, 2002Co-Authors: Vera LoeningbauckeAbstract:ABSTRACTBackgroundChildren with functional constipation and Encopresis benefit from behavior modification and from long-term laxative medication. Polyethylene glycol without electrolytes has become the first option for many pediatric gastroenterologists.MethodsTwenty-eight children treated with poly
-
balloon defecation as a predictor of outcome in children with functional constipation and Encopresis
The Journal of Pediatrics, 1996Co-Authors: Vera LoeningbauckeAbstract:Abstract OBJECTIVE: To evaluate whether the ability to defecate a rectal balloon might predict 12-month recovery in children with functional constipation and Encopresis. METHODS: We evaluated the ability to defecate within 5 minutes a 100 ml water-filled rectal balloon by 20 healthy children and 139 children with functional constipation and Encopresis. RESULTS: All healthy children and only 47% of the patients were able to defecate the balloon. Twelve months after the start of treatment, 51% of patients able to and 34% of patients unable to defecate the balloon had recovered ( p p CONCLUSION: Children with functional constipation and Encopresis who were able to defecate the rectal balloon were twice as likely to recover. Even though there was a clinically significant difference in the recovery rates between patients who could and those who could not defecate the balloon, calculation of predictive values showed that the balloon defecation test could not reliably predict recovery. (J P EDIATR 1996;128:336-40)
-
is the afferent pathway from the rectum impaired in children with chronic constipation and Encopresis
Gastroenterology, 1995Co-Authors: Vera Loeningbaucke, Thoru YamadaAbstract:Abstract Background & Aims: Rectal sensations to balloon distention are impaired in children with chronic constipation and Encopresis. The impairment of rectal sensation, which is often persistent and is related to nonrecovery, could be caused by a defect in the visceral afferent pathways. The aim of this study was to test whether the afferent pathway from the rectum is impaired in children with constipation and Encopresis. Methods: Fifteen healthy children and 15 children with constipation and Encopresis were studied. Cerebral evoked potentials (EPs) were studied by averaging results of 100 rectal distentions, which used 10, 20, and 30 mL air. EPs were recorded from Cz′ to Fz. Results: Two different types of EPs were recorded in each control subject and each child with constipation and Encopresis. One EP had an early onset and showed multiple positive and negative peaks. The other EP had a much later onset and was triphasic. Early-onset EPs were recorded with significantly smaller distention volumes than the late-onset EPs. N1 and P2 latencies of the early-onset EPs and NI, PI, and NII latencies of the late-onset EPs were significantly prolonged in children with constipation and Encopresis compared with controls. Conclusions: The prolonged latencies suggest a defect in the afferent pathway from the rectum in children with chronic constipation and Encopresis.
James L Sutphen - One of the best experts on this subject based on the ideXlab platform.
-
An Internet Intervention as Adjunctive Therapy for Pediatric Encopresis
Journal of Consulting and Clinical Psychology, 2003Co-Authors: Lee M Ritterband, Stephen M Borowitz, Lynn S. Walker, Boris P. Kovatchev, Lela Mcknight, Kushal Patel, James L SutphenAbstract:This study evaluated the benefits of enhanced toilet training delivered through the Internet for children with Encopresis. Twenty-four children with Encopresis were randomly assigned to the Internet intervention group (Web) or no Internet intervention group (No-Web). All participants continued to receive routine care from their primary care physician. The Web participants demonstrated greater improvements in terms of reduced fecal soiling, increased defecation in the toilet, and increased unprompted trips to the toilet (ps
-
an internet intervention as adjunctive therapy for pediatric Encopresis
Journal of Consulting and Clinical Psychology, 2003Co-Authors: Lee M Ritterband, Stephen M Borowitz, Lynn S. Walker, Boris P. Kovatchev, Lela Mcknight, Kushal Patel, James L SutphenAbstract:This study evaluated the benefits of enhanced toilet training delivered through the Internet for children with Encopresis. Twenty-four children with Encopresis were randomly assigned to the Internet intervention group (Web) or no Internet intervention group (No-Web). All participants continued to receive routine care from their primary care physician. The Web participants demonstrated greater improvements in terms of reduced fecal soiling, increased defecation in the toilet, and increased unprompted trips to the toilet (ps <.02). Both groups demonstrated similar improvements in knowledge and toileting behaviors. Internet interventions may be an effective way of delivering sophisticated behavioral interventions to a large and dispersed population in a convenient format.
-
assessment of behavioral mechanisms maintaining Encopresis virginia Encopresis constipation apperception test
Journal of Pediatric Psychology, 2003Co-Authors: Lee M Ritterband, James L Sutphen, Boris P. Kovatchev, Warren Quillian, James Morris, Stephen M BorowitzAbstract:OBJECTIVE: To develop and test a scale for parent and child, evaluating theoretical and clinical parameters relevant to children with Encopresis. Encopretic children were hypothesized to have more bowel-specific, but not more generic, psychological problems, as compared with nonsymptomatic control children. In addition, mothers were also believed to be more discerning than children. METHODS: The Virginia Encopresis-Constipation Apperception Test (VECAT) consists of 9 pairs of bowel-specific and 9 parallel generic drawings. Respondents selected the picture in each pair that best described them/their child. It was administered to encopretic children (N = 87), nonsymptomatic siblings (N = 27), and nonsymptomatic nonsiblings (N = 35). The mothers of all the participants also completed the VECAT. Encopretic children were retested 6 and 12 months posttreatment with Enhanced Toilet Training. RESULTS: The VECAT demonstrated good test-retest reliability and internal consistency. Encopretic children and their mothers reported more bowel-specific, but not more generic, problems. Bowel-specific scores improved significantly posttreatment only for those patients who demonstrated significant symptom improvement. Mothers were significantly more discerning than children. CONCLUSION: The VECAT is a reliable, valid, discriminating, and sensitive test. Bowel-specific problems appear to best differentiate children with and without Encopresis.
-
psychological differences between children with and without chronic Encopresis
Journal of Pediatric Psychology, 2002Co-Authors: James B Morris, Stephen M Borowitz, James L SutphenAbstract:Objective: To validate a theoretical model of Encopresis in terms of psychological factors that differentiates children with and without chronic Encopresis and to identify scales that demonstrate these differences. Methods: Eighty-six children with Encopresis were compared to 62 nonsymptomatic children on five psychometric instruments. Differences in the mean scores and the percentages of children falling beyond preselected clinical thresholds were compared across the patient-control groups. Results: Children with Encopresis were found to have more anxiety/depression symptoms, family environments with less expressiveness and poorer organization, more attention difficulties, greater social problems, more disruptive behavior, and poorer school performance ( ps = .01 ≤ .001 on 15/20 subscales). There were no differences in self-esteem. On those subscales where proportionately more encopretic children exceeded clinical thresholds, approximately 20% more of the encopretic children exceeded thresholds than control children. Conclusions: As a group, children with Encopresis differ from children without Encopresis on a variety of psychological parameters. However, only a minority of children with Encopresis demonstrated clinically significant elevations in these parameters. Identification and treatment of such clinical issues may enhance treatment efficacy.
-
contribution of behavior therapy and biofeedback to laxative therapy in the treatment of pediatric Encopresis
Annals of Behavioral Medicine, 1998Co-Authors: James L Sutphen, Boris P. Kovatchev, Steve Borowitz, William LingAbstract:A model incorporating physiological, behavioral, and psychological parameters are presented to explain the maintenance and consequences of pediatric Encopresis. It was hypothesized that the more comprehensive a treatment in addressing these parameters, the more efficacious it would be and the more children it would benefit. Eighty-seven children between the ages of 6 and 15 with the primary complaint of Encopresis were randomly assigned to one of three treatments: (a) Intensive Medical Care (IMC), receiving enemas for disimpaction and laxatives to promote frequent bowel movements; (b) Enhanced Toilet Training (ETT), using reinforcement and scheduling to promote response to defecation urges and instruction and modeling to promote appropriate straining, along with laxatives and enemas; or (c) Biofeedback (BF), directed at relaxing the external anal sphincter during attempted defecation, along with toilet training, laxatives, and enemas. Three months following initiation of treatment, ETT and BF produced similar reductions in soiling/child (76% and 65%) that were superior (p's<.04) to IMC (21%). ETT significantly benefited more children than the other two treatments, employing fewer laxatives and fewer treatment sessions at a lower cost. Consistent with the presented model, reduction in soiling was associated with an increase in bowel movements in the toilet, reduction in parental prompting to use the toilet, and defecation pain. These results demonstrate that ETT should be used routinely with laxative therapy in the treatment of chronic Encopresis.
Stephen M Borowitz - One of the best experts on this subject based on the ideXlab platform.
-
An Internet Intervention as Adjunctive Therapy for Pediatric Encopresis
Journal of Consulting and Clinical Psychology, 2003Co-Authors: Lee M Ritterband, Stephen M Borowitz, Lynn S. Walker, Boris P. Kovatchev, Lela Mcknight, Kushal Patel, James L SutphenAbstract:This study evaluated the benefits of enhanced toilet training delivered through the Internet for children with Encopresis. Twenty-four children with Encopresis were randomly assigned to the Internet intervention group (Web) or no Internet intervention group (No-Web). All participants continued to receive routine care from their primary care physician. The Web participants demonstrated greater improvements in terms of reduced fecal soiling, increased defecation in the toilet, and increased unprompted trips to the toilet (ps
-
an internet intervention as adjunctive therapy for pediatric Encopresis
Journal of Consulting and Clinical Psychology, 2003Co-Authors: Lee M Ritterband, Stephen M Borowitz, Lynn S. Walker, Boris P. Kovatchev, Lela Mcknight, Kushal Patel, James L SutphenAbstract:This study evaluated the benefits of enhanced toilet training delivered through the Internet for children with Encopresis. Twenty-four children with Encopresis were randomly assigned to the Internet intervention group (Web) or no Internet intervention group (No-Web). All participants continued to receive routine care from their primary care physician. The Web participants demonstrated greater improvements in terms of reduced fecal soiling, increased defecation in the toilet, and increased unprompted trips to the toilet (ps <.02). Both groups demonstrated similar improvements in knowledge and toileting behaviors. Internet interventions may be an effective way of delivering sophisticated behavioral interventions to a large and dispersed population in a convenient format.
-
assessment of behavioral mechanisms maintaining Encopresis virginia Encopresis constipation apperception test
Journal of Pediatric Psychology, 2003Co-Authors: Lee M Ritterband, James L Sutphen, Boris P. Kovatchev, Warren Quillian, James Morris, Stephen M BorowitzAbstract:OBJECTIVE: To develop and test a scale for parent and child, evaluating theoretical and clinical parameters relevant to children with Encopresis. Encopretic children were hypothesized to have more bowel-specific, but not more generic, psychological problems, as compared with nonsymptomatic control children. In addition, mothers were also believed to be more discerning than children. METHODS: The Virginia Encopresis-Constipation Apperception Test (VECAT) consists of 9 pairs of bowel-specific and 9 parallel generic drawings. Respondents selected the picture in each pair that best described them/their child. It was administered to encopretic children (N = 87), nonsymptomatic siblings (N = 27), and nonsymptomatic nonsiblings (N = 35). The mothers of all the participants also completed the VECAT. Encopretic children were retested 6 and 12 months posttreatment with Enhanced Toilet Training. RESULTS: The VECAT demonstrated good test-retest reliability and internal consistency. Encopretic children and their mothers reported more bowel-specific, but not more generic, problems. Bowel-specific scores improved significantly posttreatment only for those patients who demonstrated significant symptom improvement. Mothers were significantly more discerning than children. CONCLUSION: The VECAT is a reliable, valid, discriminating, and sensitive test. Bowel-specific problems appear to best differentiate children with and without Encopresis.
-
psychological differences between children with and without chronic Encopresis
Journal of Pediatric Psychology, 2002Co-Authors: James B Morris, Stephen M Borowitz, James L SutphenAbstract:Objective: To validate a theoretical model of Encopresis in terms of psychological factors that differentiates children with and without chronic Encopresis and to identify scales that demonstrate these differences. Methods: Eighty-six children with Encopresis were compared to 62 nonsymptomatic children on five psychometric instruments. Differences in the mean scores and the percentages of children falling beyond preselected clinical thresholds were compared across the patient-control groups. Results: Children with Encopresis were found to have more anxiety/depression symptoms, family environments with less expressiveness and poorer organization, more attention difficulties, greater social problems, more disruptive behavior, and poorer school performance ( ps = .01 ≤ .001 on 15/20 subscales). There were no differences in self-esteem. On those subscales where proportionately more encopretic children exceeded clinical thresholds, approximately 20% more of the encopretic children exceeded thresholds than control children. Conclusions: As a group, children with Encopresis differ from children without Encopresis on a variety of psychological parameters. However, only a minority of children with Encopresis demonstrated clinically significant elevations in these parameters. Identification and treatment of such clinical issues may enhance treatment efficacy.
-
using the internet to teach parents and children about constipation and Encopresis
Medical Informatics and The Internet in Medicine, 2001Co-Authors: Stephen M Borowitz, Lee M RitterbandAbstract:Since 1995, we have maintained a tutorial about chronic childhood constipation and Encopresis on our web site. The tutorial is directed at parents and older children and includes a feedback form comprised of six multiple-choice questions and a free-text comment field. Between 1 January 1998 and 30 April 2000, we received 1 142 completed feedback forms. The vast majority of respondents identified themselves as parents or guardians of a child with constipation or Encopresis. All respondents felt the tutorial was clear and easy to understand. 98% of respondents felt the tutorial helped them understand why children develop constipation and/or Encopresis and 91% of respondents felt the tutorial made them better able to take care of a child suffering from constipation and/or Encopresis. More than 99% of respondents felt this type of tutorial was a good way to teach people about health problems. 74% of respondents sent us comments about the tutorial. Most often, the comments expressed thanks for having this info...
William Ling - One of the best experts on this subject based on the ideXlab platform.
-
contribution of behavior therapy and biofeedback to laxative therapy in the treatment of pediatric Encopresis
Annals of Behavioral Medicine, 1998Co-Authors: James L Sutphen, Boris P. Kovatchev, Steve Borowitz, William LingAbstract:A model incorporating physiological, behavioral, and psychological parameters are presented to explain the maintenance and consequences of pediatric Encopresis. It was hypothesized that the more comprehensive a treatment in addressing these parameters, the more efficacious it would be and the more children it would benefit. Eighty-seven children between the ages of 6 and 15 with the primary complaint of Encopresis were randomly assigned to one of three treatments: (a) Intensive Medical Care (IMC), receiving enemas for disimpaction and laxatives to promote frequent bowel movements; (b) Enhanced Toilet Training (ETT), using reinforcement and scheduling to promote response to defecation urges and instruction and modeling to promote appropriate straining, along with laxatives and enemas; or (c) Biofeedback (BF), directed at relaxing the external anal sphincter during attempted defecation, along with toilet training, laxatives, and enemas. Three months following initiation of treatment, ETT and BF produced similar reductions in soiling/child (76% and 65%) that were superior (p's<.04) to IMC (21%). ETT significantly benefited more children than the other two treatments, employing fewer laxatives and fewer treatment sessions at a lower cost. Consistent with the presented model, reduction in soiling was associated with an increase in bowel movements in the toilet, reduction in parental prompting to use the toilet, and defecation pain. These results demonstrate that ETT should be used routinely with laxative therapy in the treatment of chronic Encopresis.
-
lack of correlation of anorectal manometry with symptoms of chronic childhood constipation and Encopresis
Diseases of The Colon & Rectum, 1996Co-Authors: Stephen M Borowitz, James L Sutphen, William LingAbstract:Chronic constipation is an extremely common problem in children. Many authors have advocated using anorectal manometric examination during evaluation of chronic childhood constipation and Encopresis as a means of developing individualized modes of treatment. PURPOSE: This study was designed to prospectively examine frequency and severity of symptoms of childhood constipation and Encopresis and associate these symptoms with anorectal manometric findings. METHODS: Forty-four children with chronic constipation participated in the study. Before performing anorectal manometry, bowel-related symptoms were collected for two consecutive weeks with a computerized voice mail system. Anorectal manometry was performed using a triple lumen catheter attached to a hydraulic manometry infusion system. RESULTS: Frequency of voluntary bowel movements did not correlate with any manometric parameters. Frequency of fecal soiling, age at onset of symptoms, and duration of symptoms were all highly correlated with degree of sphincter spasm during attempted defecation; however, none of these variables correlated with any other manometric parameter. Amount of pain associated with bowel movements correlated with frequency of soiling and was inversely correlated with maximum squeeze pressure but was not correlated with any other manometric parameter. CONCLUSIONS: In children with chronic constipation and Encopresis, sphincter spasm demonstrated with anorectal manometry is highly correlated with frequency of fecal soiling, age at onset, and duration of symptoms; however, none of the other commonly measured manometric parameters appear to correlate with symptoms of chronic childhood constipation and Encopresis.
Sabri Herguner - One of the best experts on this subject based on the ideXlab platform.
-
effect of oros methylphenidate on Encopresis in children with attention deficit hyperactivity disorder
Journal of Child and Adolescent Psychopharmacology, 2014Co-Authors: Savas Yilmaz, Ayhan Bilgic, Sabri HergunerAbstract:Abstract Objectives: Although Encopresis shows a high rate of comorbidity in patients with attention-deficit/hyperactivity disorder (ADHD), the etiologic origin of this relationship and the effect of ADHD drugs on Encopresis are unclear. In this chart review, we explored the effect of OROS long-acting methylphenidate (MPH) treatment on Encopresis in children with ADHD. We also evaluated the relationship between the clinical variables of ADHD and Encopresis. Methods: The sample consisted of 21 children and adolescents (20 boys and 1 girl) with Encopresis and coexisting ADHD 7–15 years of age. Their clinical characteristics and baseline (visit 1) and end of the second months' (visit 2) Conners' Parent Rating Scale (CPRS) subscores were recorded. Retrospective clinician determinations were made using the Clinical Global Impressions-Severity subscale (CGI-S) for Encopresis severity and the Clinical Global Impressions-Improvement subscale (CGI-I) for Encopresis response. Results: According to the CGI-I, 14 sub...
-
Effect of OROS Methylphenidate on Encopresis in Children with Attention-Deficit/Hyperactivity Disorder
Journal of Child and Adolescent Psychopharmacology, 2013Co-Authors: Savas Yilmaz, Ayhan Bilgic, Sabri HergunerAbstract:Abstract Objectives: Although Encopresis shows a high rate of comorbidity in patients with attention-deficit/hyperactivity disorder (ADHD), the etiologic origin of this relationship and the effect of ADHD drugs on Encopresis are unclear. In this chart review, we explored the effect of OROS long-acting methylphenidate (MPH) treatment on Encopresis in children with ADHD. We also evaluated the relationship between the clinical variables of ADHD and Encopresis. Methods: The sample consisted of 21 children and adolescents (20 boys and 1 girl) with Encopresis and coexisting ADHD 7–15 years of age. Their clinical characteristics and baseline (visit 1) and end of the second months' (visit 2) Conners' Parent Rating Scale (CPRS) subscores were recorded. Retrospective clinician determinations were made using the Clinical Global Impressions-Severity subscale (CGI-S) for Encopresis severity and the Clinical Global Impressions-Improvement subscale (CGI-I) for Encopresis response. Results: According to the CGI-I, 14 sub...