Chronic constipation with encopresis persisting beyond 15 years of age

Childhood constipation with encopresis is a common malady. Previous reports suggest that essentially all patients either respond to standard treatments or have spontaneous recovery before 16 years of age. In this paper, we describe the results of anorectal function studies and treatment outcome in four patients in whom constipation and encopresis persisted beyond 15 years of age. Abnormalities in the ability to defecate water-filled balloons, in external sphincter relaxation with straining, in rectal sensation and development of the urge to defecate, and in maximum anal resting pressure were seen in some or all of these patients. In addition, two patients had impaired voluntary squeeze strength. Two patients responded to standard therapy; a colostomy was needed in one; and one failed therapy and has become a recluse.