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Feature Article

Management of childhood faecal incontinence

Theresa Ho, Patrina Caldwell

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Abstract

Effective management of children with faecal incontinence may require a multidisciplinary approach, including education, a toileting program, laxatives, dietary modification and psychological therapy.

Key Points

  • Faecal incontinence refers to the passage of stools in an inappropriate place. It is a common childhood condition that occurs in 1.5 to 3% of children, affecting boys more often than girls.
  • Risk factors for faecal incontinence include chronic constipation, dietary factors, cow’s milk protein intolerance, poor toilet posture, medical conditions (e.g. hypothyroidism, hypercalcaemia, hypokalaemia and porphyria) and some medications.
  • Faecal incontinence has an enormous impact on the self-esteem and social interactions of affected children leading to social isolation.
  • An accurate history should be taken from the child and his or her parents and a thorough physical examination is important to rule out organic causes of faecal incontinence.
  • A multidisciplinary approach may be required to treat children with faecal incontinence, including education, a toileting program, laxatives, dietary modification and psychological therapy.

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