Constipation and fecal incontinence

Abstract

Severe chronic refractory constipation is a substantial health and emotional burden to affected children and their families. Chronic constipation with or without fecal incontinence may be secondary to a variety of conditions treated by pediatric surgeons, including anorectal malformations, Hirschsprung disease, and spinal cord problems. True fecal incontinence must be distinguished from overflow pseudoincontinence or encopresis. Understanding this major differentiation is key to determining the correct bowel management program. Manometric evaluation, both colonic and anorectal, can be helpful in the workup of children with constipation and guide therapy.