The child who soils

Abstract 

Soiling can best be understood in childhood with reference to normal anorectal function, and the development of the awareness of the social value of continence. The pathophysiology as well as the disturbed behaviour associated with faecal incontinence is described. An illustrative case history is given to emphasize the evolution of the problems with age. The range of associated problems from neuropathic rectum, megarectum with overflow soiling, and through to the more psychological encopresis is described with some suggested treatments. Although there is little hard evidence about effectiveness of different treatment regimes, there is a strong consensus that early multidisciplinary help for these common problems is likely to prevent major social and psychological consequences of coping with faecal incontinence in late childhood and adolescence.

Keywords: soiling, faecal incontinence, encopresis, constipation, laxatives, biofeedback

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• f1 E-mail: clayden@which.net