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My son keeps having accidents in his underwear. He's 6 years old. Shouldn't he be old enough to know better by now?

Often, parents bring in a child with statements of this sort, accompanied by frustration and misunderstanding. Children who have encopresis commonly are embarrassed and ostracized because of their symptoms. Most families are surprised to hear that they are not the only ones dealing with encopresis; the nature of the symptom complex does not lend itself to casual conversation. Some parents think their child is just difficult or lazy; others are concerned that there is something seriously wrong. Is the child experiencing functional encopresis or is there something physically or neurologically pathologic that needs to be addressed? Most importantly, how does the clinician differentiate between functional and organic encopresis, and how can encopresis be treated?

Functional encopresis is defined as...

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