ENCOPRESIS AND SOILING

Constipation, encopresis, and fecal incontinence are common problems i n children. Constipation can have a variety of causes, such as organic and anatomic causes or intake of medication. Encopresis is the involu ntary loss of formed, semiformed, or liquid stool into the child's und erwear in the presence of functional (idiopathic) constipation in a ch ild 4 years of age or younger. Fecal incontinence is fecal soiling in the presence of an organic or anatomic lesion, such as Hirschsprung's disease, anal malformation, anal surgery or trauma, meningomyelocele, and some muscle diseases. This article reviews the symptoms of functio nal constipation in young children and the symptoms of functional cons tipation and encopresis in older children, presents the differential d iagnosis of constipation with or without fecal incontinence, describes the evaluation and treatment of these children, and reports on treatm ent outcome.