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Fecal Incontinence in Children

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Pediatric Neurogastroenterology

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Abstract

Fecal incontinence (FI) is a common problem in the pediatric age. FI has a large physical, emotional, social, and economic impact on patients and their families. In about 95% of cases, incontinence is functional and can be divided into two discrete entities: (1) non-retentive fecal incontinence or (2) retentive fecal incontinence (constipation-associated). Tests are not routinely indicated as a good history and physical exam are all that are needed for diagnosis. Treatment should be aimed at improving bowel frequency and eliminating incontinence episodes. All treatments should include education, demystification, and a toilet regimen in conjunction with pharmacological interventions. Relieving impaction is the first goal for the treatment of retentive FI, followed by maintenance therapy. Most patients will respond to laxatives; if there is no success with adequate daily doses of osmotic laxatives, therapy should escalate to stimulant laxatives in sufficient quantity to produce regular bowel movements. Treatment for non-retentive FI focuses primarily on sitting regimen and behavioral modification. More complicated patients can respond to other therapies including transanal irrigation. Multidisciplinary teams for fecal incontinence are becoming more widely available to help evaluate and treat these refractory patients and improve outcomes.

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Authors and Affiliations

  1. Gi Care for Kids, Atlanta, GA, USA

    Jose M. Garza

  2. Neurogastroenterology and Motility Program, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Jose M. Garza

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  1. Jose M. Garza
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Editors and Affiliations

  1. Division of Gastroenterology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Christophe Faure

  2. Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children’s Hospital School of Medicine University of Queensland, Brisbane, QLD, Australia

    Nikhil Thapar

  3. Division of Pediatric Gastroenterology, Nationwide Children’s Hospital, Columbus, OH, USA

    Carlo Di Lorenzo

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Garza, J.M. (2022). Fecal Incontinence in Children. In: Faure, C., Thapar, N., Di Lorenzo, C. (eds) Pediatric Neurogastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-031-15229-0_42

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