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Faecal incontinence: Retentive, non-retentive and when to suspect organic pathology

Carlo Di Lorenzo1

  • 1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.

Alimentary Pharmacology & Therapeutics
|June 26, 2024
PubMed

Insights

Pediatric faecal incontinence, often caused by functional constipation, requires understanding of gut-brain disorders and organic conditions. Advances in diagnosis and treatment offer hope for improved quality of life in affected children.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Surgery
  • Pediatric Urology

Background:

  • Faecal incontinence is a common and distressing condition in children.
  • It affects children of all ages, impacting their quality of life.

Purpose of the Study:

  • To review current knowledge on the epidemiology, pathophysiology, evaluation, and treatment of pediatric faecal incontinence.
  • To cover conditions related to disorders of gut-brain interaction and organic diseases.

Main Methods:

  • A literature review was conducted on the prevalence, impact, diagnosis, and treatment of pediatric faecal incontinence.
  • The review incorporated expert observations on motility disorders in children.

Main Results:

  • Functional constipation with overflow incontinence is the most common cause of pediatric faecal incontinence.
  • Non-retentive faecal incontinence (NRFI) may be more prevalent than previously recognized and is challenging to treat.
  • Organic conditions like anorectal malformations (ARMs), Hirschsprung disease, and spinal defects significantly impact quality of life.

Conclusions:

  • Recognizing distinct pathophysiologic mechanisms is crucial for effective treatment.
  • Diagnosis often relies on thorough history and physical examination, with imaging and manometry aiding specific cases.
  • A range of interventions, including behavioral, medical, and surgical options, can alleviate symptoms and improve daily life for affected children.
Abstract

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