involuntary passage of formed or semi0formed stools into underwear

occuring repeatedly for ≥ 1mo over 4yo

cause physiological (= poor diet)

features

• 1-2/100

• boys > girls 3:1

• inadequate toileting

• poor diet

• faecal retntion

• rectal dilatation and insensitive urge to stool

• unawareness of passage of stool

• enuresis common

Management

• structured toileting program

• initial task = empty bowel of faeces

• majority cured by:

  • ongoing interest and support

  • education

  • good noraml diet, adequate fluids, exercise

  • structured toileting program

    • reuglar sitting on toilet at least 10min 3times/day after each meal

  • laxative

  • senokot granules

  • if unsuccessful:

    • sodium phosphate enema if >2yo

  • starcheart with successful results

  • regular follow-up

  • consider encopresis clinic