Elimination Disorders

What are Elimination Disorders? 

Elimination disorders are characterised by children who are old enough to eliminate bodily waste appropriately, yet repeatedly eliminate feces or urine in inappropriate places, or at inappropriate times. This can result from physical factors including diabetes, constipation, dehydration or irritable bowel syndrome, as well as from psychological factors, such as learning and association, stress or anxiety. The most common forms of elimination disorders are Eneuresis and Encopresis:

Eneuresis

  • Repeated voiding of urine into bed or clothes, whether involuntary or intentional
  • The behaviour is clinically significant as manifested by either a frequency of at least 3 consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning
  • Chronological age is at least 5 years (or equivalent development level)
  • The behaviour is not attributable to the physiological effects of a substance (e.g. a diuretic, an antipsychotic medication) or another medical condition (e.g. diabetes, spina bifida, a seizure disorder)
The subtypes of Eneuresis are:
  • Nocturnal only: Passage of urine only during night time sleep
  • Diurnal only: Passage of urine during waking hours
  • Nocturnal and Diurnal: A combination of the two subtypes above

Encopresis

  1. Repeated passage of feces into inappropriate places (e.g. clothing, floor),  whether involuntary or intentional
  2. At least one such event occurs each month for at least 3 months
  3. Chronological age is at least 4 years (or equivalent developmental level)
  4. The behaviour is not attributable to the psychological effects of a substance (e.g. laxatives) or another medical condition except through a mechanism involving constipation