American Medical Association Family Medical Guide - American Medical Association [185]
Diagnosis and Treatment
A diagnosis of encopresis is based on the child’s symptoms and a physical examination. The doctor will feel the child’s abdomen to check for the presence of hardened stools in the intestines. He or she may also examine the child’s rectum for hardened stools. The doctor may order laboratory tests to rule out an underlying disorder that may be causing the problem.
To treat encopresis, the doctor may prescribe enemas or suppositories to clear the rectum and the lower part of the large intestine and eliminate the blockage. He or she will ask you to encourage your child to sit on the toilet at least once a day, at a specific time. In some cases, a doctor may prescribe enemas, glycerin suppositories, stool softeners, or laxatives for a few days or longer. He or she will recommend dietary changes to prevent constipation, such as drinking eight glasses of water every day and eating a high-fiber diet. If the problem persists, the doctor may recommend that your child see a psychiatrist or other specialist for further evaluation and treatment.
Neurological Disorders
The nervous system consists of the brain, the spine, and nerves throughout the body. Neurological disorders may be congenital (present from birth) or can result from damage to or dysfunction of part of the nervous system caused by injury or disease.
Fetal Alcohol Syndrome
Fetal alcohol syndrome is a group of preventable physical and mental birth defects, which can range from mild to severe, that occur in the children of women who drink alcohol during pregnancy. The syndrome is the leading cause of preventable mental retardation in the United States. When a woman drinks during pregnancy, the alcohol crosses the placenta and enters the fetus’s bloodstream. The more alcohol a woman drinks, the greater the potential damage to the fetus. There is no safe amount of alcohol a pregnant woman can drink; any time a woman drinks alcohol during pregnancy, she puts her developing fetus at risk. In some cases, prenatal exposure to alcohol may result in death of the fetus.
Symptoms
Symptoms of fetal alcohol syndrome in a newborn include feeding and sleep difficulties, irritability, and unusual sensitivity to sound. Physical symptoms include facial abnormalities such as narrow, wide-set eyes; protruding, low-set ears; a wider than normal space between the nose and mouth; a thin upper lip; and small teeth. Toddlers with fetal alcohol syndrome may be smaller than other children their age, may have poor coordination, and may be hyperactive. Most children with fetal alcohol syndrome have some degree of mental retardation, delayed development, and learning disabilities. They may also have a small brain, heart defects (see page 389), a cleft palate (see page 403), or dislocation of the hip (see page 401). Adolescents with fetal alcohol syndrome often exhibit inappropriate behavior and emotional responses.
Diagnosis and Treatment
A diagnosis of fetal alcohol syndrome is based on the child’s symptoms, a physical examination, and information about the mother’s use of alcohol during pregnancy. The effects of fetal alcohol syndrome are not reversible. Treatment focuses on correcting specific physical defects such as a cleft palate, a dislocated hip, or a heart defect. Some children may also need physical therapy, speech therapy, occupational therapy, and special education to help them reach their full potential.
Cerebral Palsy
Cerebral palsy is a disorder of the nerves and muscles caused by faulty development of or damage to the areas of the brain that control muscle movement, resulting in weakness of the arms and legs accompanied by stiffness (called spasticity) or floppiness and, sometimes, unusual body postures. Cerebral palsy may be congenital (present from birth), or it may develop after birth. The disorder cannot be cured, but it does not worsen as the child gets older.
For most children who have cerebral palsy, the exact cause is unknown. The majority