Fecal Incontinence
Fecal continence is one of the most important achievements
in a child’s development. Ability to control passage of stool is one of the
first manifestations of independence by which interaction with parents and
environment is exerted by the child.
Fecal continence, which is usually reached by the age of 2 or
3, may be partially or entirely compromised in children born with some
anomalies of the large bowel (anorectal anomalies and Hirschsprung’s disease)
or anomalies of the pelvic organs such as spina bifida.
Fecal incontinence has a significant social impact
regardless of the age it arises. Moral conditioning, which is usually
associated with toilet training, leads to a close association between stool and
something “dirty” and negative. It is not difficult to imagine the kinds of
difficulties a child can go through when he or she is unable to have bowel
control. Fecal incontinence represents a devastating problem; it is often a
barrier to social acceptance. It can affect many children including those with
prior surgery (for anorectal malformations and Hirschsprung’ s disease) as well
as those with spinal problems or injuries.
Nowadays, much can be done for children with fecal
incontinence. An accurate evaluation, along with an appropriate follow-up
program, can have an enormous impact on psychological and social consequences
of being incontinent.
