It is involuntary defecation that occurs in children over 4 years of age.
It is more common in boys than in girls and in people of low socioeconomic level.
There is no organic cause that justifies it, the trigger is usually functional such as emotional problems.
It manifests with the leakage of feces in the clothes that can be confused with diarrhea. It can also present as constipation with dry and hard stools, elimination of large stools, avoidance of defecation, long periods between bowel movements, lack of appetite, abdominal pain, and problems with urinary continence during the day. In girls, it can also be associated with repeated urinary tract infections.
Diagnosis is made through clinical history and physical examination.
Treatment has two approaches: treatments aimed at curing and preventing constipation (diet, enemas, polyethylene glycol solutions) and psychotherapeutic treatments. In some instances, a combination of both may be necessary.
- Manu R Sood, FRCPCH, MD. Functional fecal incontinence in infants and children: Definition, clinical manifestations and evaluation. Uptodate. Dec 21, 2016.
- Manu R Sood, FRCPCH, MD. Chronic functional constipation and fecal incontinence in infants and children: Treatment. Uptodate. Feb 10, 2017.
- Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 2014; 58:258.
- Brazzelli M, Griffiths PV, Cody JD, Tappin D. Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children. Cochrane Database Syst Rev 2011; :CD002240.
- Peeters B, Noens I, Philips EM, et al. Autism spectrum disorders in children with functional defecation disorders. J Pediatr 2013; 163:873.
