Repeated involuntary or intentional passage of feces by a child in inappropriate places, after the age when bowel control is normally expected, is called:

Appeared in: ESIC Nursing Officer -2019 (Shift -1)

Explanation

Encopresis is the medical term for the repeated passage of feces into inappropriate places, such as clothing or the floor.
This behavior can be either involuntary (due to constipation and overflow) or intentional.
The diagnosis is typically made in a child who is at least 4 years old, the age by which most children have achieved bowel control.

Option A: Nightmares are distressing dreams that cause fear or anxiety upon waking. They are a sleep-related phenomenon (parasomnia) and have no connection to bowel control.
Option B: Night sweats refer to episodes of excessive sweating during sleep. They are a symptom of various underlying conditions, such as infections or hormonal changes, not an elimination disorder.
Option C: Enuresis refers to the repeated, involuntary or intentional, voiding of urine in inappropriate places (e.g., bedwetting). The key difference is that enuresis involves urine, while encopresis involves feces.

Visual 1: Flowchart: Differentiating between Retentive and Non-retentive Encopresis. This visual would help learners understand the two main pathways leading to encopresis, guiding assessment and intervention strategies.
Visual 2: Infographic: Key Differences between Encopresis and Enuresis. A simple side-by-side comparison of the two conditions, highlighting age of diagnosis, type of waste, and common causes.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Childhood Elimination Disorders as background academic context rather than a clinical decision trigger.
A key nursing role is to educate parents that encopresis, especially the retentive type, is not a willful act of misbehavior but a medical issue stemming from chronic constipation. This reduces blame and encourages adherence to treatment.
Nurses must perform a thorough assessment, including diet history, toilet training history, and psychosocial stressors, to help determine the underlying cause of encopresis.
What if the child also experiences recurrent urinary tract infections (UTIs)? This finding would strongly suggest retentive encopresis. A large mass of retained stool in the rectum can press on the bladder, preventing it from emptying completely and leading to urinary stasis and infection.

How to Approach the Question

First, identify the core concept in the question stem: 'repeated...passage of feces...in inappropriate places' in a child past the age of bowel control.
Scan the options to see if they relate to this concept. Notice that two options (Nightmares, Night sweats) are unrelated to elimination.
Focus on the remaining two options, Enuresis and Encopresis. These are the most likely candidates as both are elimination disorders.
Recall the specific definitions: 'Enur-' relates to urine, while 'Copr-' relates to feces (from the Greek 'kopros').
Based on this distinction, select Encopresis as the correct term for the passage of feces.

Concept Tested & Keywords

Concept Tested: Childhood Elimination Disorders
Stem keywords: involuntary passage of feces, intentional passage of feces, child, inappropriate places, bowel control
Lead-in keywords: is called
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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Practise the full ESIC Nursing Officer -2019 (Shift -1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.