Functional fecal incontinence in infants and children: Definition, clinical manifestations and evaluation
- Manu R Sood, FRCPCH, MD
Manu R Sood, FRCPCH, MD
- Professor and Chief
- Division of Pediatric Gastroenterology, Hepatology and Nutrition Medical College of Wisconsin
Fecal incontinence, also known as encopresis or soiling, refers to the repetitive, voluntary or involuntary, passage of stool in inappropriate places by children four years of age and older, at which time a child may be reasonably expected to have completed toilet training and to exercise bowel control.
In most children with fecal incontinence, the problem is associated with and probably caused by underlying constipation . Determining whether there is underlying constipation is an important step in the evaluation of a child with fecal incontinence because it directly affects treatment approaches. In many cases, the constipation is well recognized before the child presents with fecal incontinence. In other children presenting with fecal incontinence, the underlying constipation is not recognized by the family and is only identified after a focused history and physical examination is performed.
The definition, clinical manifestations, and evaluation of fecal incontinence will be discussed here. Related material is presented in the following topic reviews:
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- DEFINITIONS AND DIAGNOSTIC CRITERIA
- Functional constipation
- Functional fecal incontinence
- - Retentive
- - Nonretentive
- CLINICAL MANIFESTATIONS
- HISTORY AND PHYSICAL EXAMINATION
- - Exclude organic causes
- - Evidence of constipation
- - Psychosocial precipitants
- Physical examination
- Imaging and laboratory testing
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS