Evaluation of a standard protocol for retentive encopresis: a replication.

Replicated the efficacy of a short-term, combined medical and behavioral intervention protocol for retentive encopresis. Fifty-nine children who had failed standard medical management for retentive encopresis and their parents participated in six 1-hour group treatment sessions. Treatment protocol combined the medical management strategies of enema clean out, increasing dietary fiber, and daily toilet sitting with the child behavior management strategies of differential attention, contingency management, and contracting. For the overall sample, the number of soiling incidents decreased 85%, the weekly frequency of independent bowel movements increased 15%, the weekly frequency of parent-prompted bowel movements increased 9%, and daily dietary fiber intake increased 121% pre- to posttreatment. The majority of the sample (86%) stopped soiling by the end of treatment and did not require further treatment. Results are discussed in terms of the comparability with previous findings and the utility of combined medical and psychological treatments for children with encopresis who have failed standard medical approaches.