Magnetic Resonance Imaging of the Lumbosacral Spine in Children with Chronic Constipation or Non-Retentive Fecal Incontinence: A Prospective Study

Bekkali, N; Hagebeuk, Eveline; Bongers, Marloes E.J.; Rijn, Rick R. van; Wijk, Michiel P. van; Liem, Olivia; Benninga, Marc A.

doi:10.1016/j.jpeds.2009.09.048

Cited by 30 publications

(13 citation statements)

References 22 publications

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“…MRI of the spinal cord is only indicated in children with suspected organic diseases of the spinal cord on clinical history and physical examination . Bekkali and co‐workers noted that almost all patients with defecation disorders, who have had spinal abnormalities upon MRI, had abnormalities such as deviation of the gluteal cleft detectable on physical examination …”

Section: Evaluation Of a Child With Fimentioning

confidence: 99%

Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management

Rajindrajith

Devanarayana

Benninga

2012

Aliment Pharmacol Ther

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Summary Background Faecal incontinence (FI) in children is a significant gastrointestinal problem, with great personal and social impacts. It is characterised by recurrent loss of faecal matter into the underwear. Both functional and organic causes contribute to its aetiology with the former predominating. Aim To review the epidemiology, pathophysiology, clinical evaluation and management of functional faecal incontinence in children. Methods A PubMed search was conducted using search terms f(a)ecal incontinence, and encopresis. Articles on epidemiology, pathophysiology, clinical evaluation, investigation and management of functional FI in children were retrieved and assessed. Results Community prevalence of this distressing problem ranges from 0.8% to 7.8% globally. Male: female ratio varies from 3:1 to 6:1. The diagnosis of FI is often based on established clinical criteria. The majority (82%) have constipation associated functional FI. Biopsychosocial factors play a crucial role in the pathogenesis. Limited physiological testing of anorectal function is recommended in the diagnostic procedures, particularly in children with atypical symptoms and possible organic disorders. Management of FI needs a multidisciplinary approach which includes establishment of an effective doctor‐patient partnership, understanding the underlying mechanisms, pharmacotherapy and behavioural treatment. Approximately 15% of children with functional nonretentive faecal incontinence (FNRFI) had the same symptoms at the age of 18 years. Conclusion Significant therapeutic advances have been made for retentive faecal incontinence, but treatment options for functional nonretentive faecal incontinence are limited. Limited long‐term outcome data show that the majority outgrow faecal incontinence. A substantial proportion of children progress to adulthood with faecal incontinence.

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Section: Evaluation Of a Child With Fimentioning

confidence: 99%

Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management

Rajindrajith

Devanarayana

Benninga

2012

Aliment Pharmacol Ther

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“…Disturbing neurological signs include motor and sensory dysfunction in the lower extremities, abnormal reflex activity and anorectal sensation. An MRI of the spinal cord is justified in these cases (31).…”

Section: Discussionmentioning

confidence: 99%

Encopresis in Children: An Overview of Recent Findings

Vuletic

2017

Serbian Journal of Experimental and Clinical Research

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“…MRI scan of the lower spine is useful to rule out lesions of the spinal cord that could lead to FI; however, most of the time, these lesions are associated with clinically detectable abnormalities (tuft of hair, hemangioma, asymmetry of the gluteal cleft, a scar of a repaired myelomeningocele) of the lower back (21).…”

Section: Other Investigationsmentioning

confidence: 99%

Functional Fecal Incontinence in Children

Rajindrajith

Devanarayana

Thapar

et al. 2021

J. pediatr. gastroenterol. nutr.

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Functional fecal incontinence (FI) is a worldwide problem in children and comprises constipation-associated FI and nonretentive FI. Irrespective of pathophysiology, both disorders impact negatively on the psychological well-being and quality of life of affected children. A thorough clinical history and physical examination using the Rome IV criteria are usually sufficient to diagnose these conditions in most children. Evolving investigations such as high-resolution anorectal and colonic manometry have shed new light on the pathophysiology of functional FI. Although conventional interventions such as toilet training and laxatives successfully treat most children with constipationassociated FI, children with nonretentive FI need more psychologically based therapeutic options. Intrasphincteric injection of botulinum toxin, transanal irrigation and, in select cases, surgical interventions have been used in more resistant children with constipation-associated FI.

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Magnetic Resonance Imaging of the Lumbosacral Spine in Children with Chronic Constipation or Non-Retentive Fecal Incontinence: A Prospective Study

Cited by 30 publications

References 22 publications

Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management

Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management

Encopresis in Children: An Overview of Recent Findings

Functional Fecal Incontinence in Children

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