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Painful defecation and fecal soiling in children

J C Partin1, S K Hamill, J E Fischel

  • 1Department of Pediatrics, School of Medicine, State University of New York, Stony Brook 11794-8111.

Pediatrics
|June 1, 1992
PubMed

Insights

Painful defecation in infants often leads to chronic constipation and fecal soiling in older children. Early treatment of painful bowel movements in babies may prevent these issues later in childhood.

Area of Science:

  • Pediatric Gastroenterology
  • Childhood Colorectal Disorders

Background:

  • Fecal soiling is a common pediatric complaint, often linked to chronic constipation and megacolon of unknown origin.
  • The relationship between painful defecation, chronic impaction, and fecal soiling in children requires further investigation.

Purpose of the Study:

  • To determine the incidence of painful defecation in children with difficult defecation.
  • To examine the relationship between painful defecation, chronic impaction, and fecal soiling.

Main Methods:

  • Retrospective review of 227 children presenting to a pediatric gastroenterology clinic (1981-1990) with difficult defecation.
  • Categorization of children into two age groups: younger than 36 months and older than 36 months.
  • Analysis of presenting symptoms including pain, impaction, withholding, and fecal soiling.

Main Results:

  • 86% of younger children and 57% of older children presented with painful defecation.
  • 63% of children with fecal soiling had a history of painful defecation before 36 months of age.
  • Painful defecation preceded chronic fecal impaction and soiling in a significant majority of cases.

Conclusions:

  • Painful defecation is a common precursor to chronic fecal impaction and fecal soiling in American children.
  • Early intervention for painful defecation in infancy may decrease the incidence of these conditions in school-aged children.

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