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Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management

S Rajindrajith1, N M Devanarayana, M A Benninga

  • 1Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. shamanr0@lycos.com

Alimentary Pharmacology & Therapeutics
|October 31, 2012
PubMed

Insights

Functional faecal incontinence (FI) in children is common, often linked to constipation. While retentive FI has advances, nonretentive FI options are limited, though most children improve over time.

Area of Science:

  • Pediatric Gastroenterology
  • Child Health
  • Bowel Dysfunction

Background:

  • Functional faecal incontinence (FI) significantly impacts children's lives, characterized by recurrent involuntary defecation.
  • While both functional and organic causes exist, functional etiologies are more prevalent.

Purpose of the Study:

  • To comprehensively review the epidemiology, pathophysiology, clinical evaluation, and management strategies for functional faecal incontinence in pediatric populations.
  • To synthesize current knowledge on the diagnosis and treatment of childhood FI.

Main Methods:

  • A systematic literature search was performed using PubMed with keywords 'faecal incontinence' and 'encopresis'.
  • Relevant articles focusing on epidemiology, pathophysiology, clinical evaluation, investigation, and management of functional FI in children were retrieved and analyzed.

Main Results:

  • Community prevalence of FI in children ranges from 0.8% to 7.8% globally, with a male predominance (3:1 to 6:1).
  • Constipation is associated with the majority (82%) of functional FI cases; biopsychosocial factors are key to pathogenesis.
  • Management requires a multidisciplinary approach, including pharmacotherapy and behavioral treatments, with limited physiological testing recommended for atypical cases.

Conclusions:

  • Therapeutic advances are notable for retentive faecal incontinence, yet options for functional nonretentive faecal incontinence remain limited.
  • Long-term data suggest most children eventually outgrow faecal incontinence, but a significant portion may experience persistent symptoms into adulthood.
Abstract

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