Management of functional nonretentive fecal incontinence in children: Recommendations from the International Children's Continence Society. Issue 1 (February 2016)

• Record Type: Journal Article
• Authors: Koppen, I.J.N.; von Gontard, A.; Chase, J.; Cooper, C.S.; Rittig, C.S.; Bauer, S.B.; Homsy, Y.; Yang, S.S.; Benninga, M.A.
• Is Part Of: Journal of pediatric urology. Volume 12:Issue 1(2016)
• Page Start: 56
• Page End: 64
• Publication Date: 2016-02
• Subjects: Fecal incontinence -- Nonretentive -- Soiling -- Encopresis; Pediatric urology -- Periodicals; Urologic Diseases -- Periodicals; Urogenital Diseases -- Periodicals; Urologic Surgical Procedures -- Periodicals; Child; Infant; Urologie pédiatrique -- Périodiques; Appareil urinaire -- Maladies -- Périodiques; Pédiatrie; Urologie; Pediatric urology; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); Electronic journals; Periodicals; Electronic journals; 618.926
• DOI: 10.1016/j.jpurol.2015.09.008
• Languages: English
• ISSNs: 1477-5131

Abstract

Summary: Background: Fecal incontinence (FI) in children is frequently encountered in pediatric practice, and often occurs in combination with urinary incontinence. In most cases, FI is constipation-associated, but in 20% of children presenting with FI, no constipation or other underlying cause can be found – these children suffer from functional nonretentive fecal incontinence (FNRFI). Objective: To summarize the evidence-based recommendations of the International Children's Continence Society for the evaluation and management of children with FNRFI. Recommendations: Functional nonretentive fecal incontinence is a clinical diagnosis based on medical history and physical examination. Except for determining colonic transit time, additional investigations are seldom indicated in the workup of FNRFI. Treatment should consist of education, a nonaccusatory approach, and a toileting program encompassing a daily bowel diary and a reward system. Special attention should be paid to psychosocial or behavioral problems, since these frequently occur in affected children. Functional nonretentive fecal incontinence is often difficult to treat, requiring prolonged therapies with incremental improvement on treatment and frequent relapses.