<<Disclaimer: Verify this information before applying it to your situation.>>

I was referred to a website by one of the nice Listserv readers about
encopresis, the medical term.  See
http://hsc.virginia.edu/cmc/tutorials/constipation/encopre.htm



I sent the Dr. Brazelton article to gastroenterologist Sheila E. Crowe,
M.D., now at the University of Virginia (former medical advisor for the
Houston chapter).   She quickly sent this response.



"Celiac disease is still a very rare cause of encopresis just as it is a
very rare cause of constipation in adults. The antibodies are not 100%
sensitive or specific so in cases of low likelihood of celiac disease
the false positive rate is an issue. In medicine the usual approach is
to deal with common causes of a condition first and in both encopresis
and adult constipation, management with fiber supplements, osmotic
laxatives, etc, and pyschologic issues in kids in particular is
recommended. Insurance companies will not cover the costs of serologic
investigations in all instances and in someone who gets better with
straight forward approaches tests wouldn't be indicated to look for
diseases including celiac disease. If the child is having true diarrhea
then it is very appropriate to look for CD but as in adults with
overflow incontinence, looking for the causes of the constipation
leading secondarily to loose stools is what needs to be done first. I
don't take exception to what was written in this article below. The
pyschologic and developmental issues in encopresis, a condition that is
mainly in boys, are substantial and the article hints at this major
factor. Stressing celiac disease in this setting is not appropriate in
my opinion.

 I hope this helps. Sheila "



Janet in Houston

Houston Celiac Support Group

www.houstonceliacs.org <http://www.houstonceliacs.org/>

* Visit the Celiac Web Page at www.enabling.org/ia/celiac/index.html *