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Elimination Disorders

Elimination disorders in children are a failure to eliminate excrement in a regular, healthy fashion. They can be subdivided into encopresis, the improper expulsion of fecal matter, or enuresis, inappropriate urination. This blurb will address the disorders under the assumption that the possibility of medical causes, which is often the case, has been eliminated. However, it should be noted that even a medically-caused occurrence of an elimination disorder can have psychological aspects or, if not treated properly, be detrimental to psychological health - causing low self-esteem, for example.


When unintentional, this disorder can something be a result of failed toilet training. If the child becomes afraid of the toilet due to pressure to learn quickly (or disproportionate punishments for misuse), or confused due to inconsistent training behaviour, it may lead the child to empty their bowels outside of the bathroom due to fear or lack of understanding. If intentional, this could simply be a symptom for a larger behavioural disorder such as Conduct Disorder or Oppositional Defiant Disorder.

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Enuresis is the more common of the two, and also the one more likely to reappear after successful treatment. Like encopresis, involuntary urination may be a sign of irregular or ineffective toilet training in young children but it is far from unheard of for older children to have this disorder as well. The most common psychiatric cause for enuresis is stress - shifts in family make-ups, new schools or houses or even exams are enough to revive old symptoms or turn healthy children into bed-wetters, often to the detriment of their self-esteem. Again, voluntary inappropriate urination in children older than 3 is uncommon and tends to point to underlying behavioural problems.

Either branch of the disorder can occur at day or night; the activity is not bound to being nocturnal as one might expect.




Encyclopedia of Mental Disorders (). Elimination Disorders. [ONLINE] Available at: [Last Accessed 13.12.13].

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