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

Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Benninga, Marc A.

doi:10.1111/apt.12103

Cited by 90 publications

(80 citation statements)

References 95 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, this agrees with prior findings that the rate of pediatric IBS is highest in the 13–17 age group . The prevalence of FGIDs in these age groups is consistent with the findings of several studies done in the past . In this study, abdominal pain and IBS are more prevalent in girls and constipation and fecal incontinence are more prevalent in boys, which is consistent with prior studies.…”

Section: Discussionsupporting

confidence: 93%

Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009

Park

Mikami

LeClair

et al. 2015

Neurogastroenterology Motil

View full text Add to dashboard Cite

BACKGROUND Functional Gastrointestinal Disorders (FGIDs) are among the most common outpatient diagnoses in pediatric primary care and gastroenterology. There is limited data on the inpatient burden of childhood FGIDs in the U.S. The aim of this study was to evaluate the inpatient admission rate, length of stay, and associated costs related to FGIDs from 1997–2009. METHODS We analyzed the Kids’ Inpatient Sample Database (KID) for all subjects in which constipation (ICD-9 codes: 564.0–564.09), abdominal pain (ICD-9 codes: 789.0–789.09), irritable bowel syndrome (IBS) (ICD-9 code: 564.1), abdominal migraine (ICD-9 code:346.80 and 346.81)dyspepsia (ICD-9 code: 536.8) or fecal incontinence (ICD-codes: 787.6–787.63) was the primary discharge diagnosis from 1997–2009. The KID is the largest publicly available all-payer inpatient database in the U.S., containing data from 2–3 million pediatric hospital stays yearly. KEY RESULTS From 1997–2009, the number of discharges with a FGID primary diagnosis increased slightly from 6,348,537 to 6,393,803. The total mean cost per discharge increased significantly from $6115 to $18,058 despite the length of stay remaining relatively stable. Constipation and abdominal pain were the most common FGID discharge diagnoses. Abdominal pain and abdominal migraine discharges were most frequent in the 10–14 year age group. Constipation and fecal incontinence discharges were most frequent in the 5–9 year age group. IBS discharge was most common for the 15–17 year age group. CONCLUSIONS AND INFERENCES Hospitalizations and associated costs in childhood FGIDs have increased in number and cost in the U.S. from 1997–2009. Further studies to determine optimal methods to avoid unnecessary hospitalizations and potentially harmful diagnostic testing are indicated.

show abstract

Section: Discussionsupporting

confidence: 93%

Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009

Park

Mikami

LeClair

et al. 2015

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“…Fecal incontinence has an estimated worldwide prevalence of up to 8% . and in most children is secondary to constipation, but in approximately 20% it is associated with conditions such as non‐retentive fecal incontinence (NFI) . Pelvic floor dyssynergia, which describes poor coordination between pelvic floor muscles and abdominal wall muscles during defecation, can also lead to FI and will require different management strategies …”

Section: Introductionmentioning

confidence: 99%

Anorectal manometry in children with defecation disorders BSPGHAN Motility Working Group consensus statement

Athanasakos

Cleeve

Thapar

et al. 2020

Neurogastroenterology Motil

View full text Add to dashboard Cite

Defecatory disorders in children, including chronic constipation (CC) and fecal incontinence (FI), are common conditions worldwide and have a significant impact on children, their families, and the healthcare system. Anorectal manometry (ARM) and high‐resolution anorectal manometry (HRAM) are relatively novel tools for the assessment of anal sphincter function and rectal sensation and have contributed significantly to improving the understanding of the anorectum as a functional unit. ARM has been recognized as the investigation of choice for adults with symptoms of defecation disorders, including fecal incontinence (FI), evacuation difficulties, and constipation. Although it is the gold standard tool in adults, it has yet to be formally accepted as a standardized diagnostic tool in the pediatric age, with limited knowledge regarding indications, protocol, and normal values. ARM/HRAM is slowly becoming recognized among pediatricians, but given that there are currently no agreed guidelines there is a risk that will lead to diversity in practice. The British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN)—Motility Working Group (MWG) therefore has taken the opportunity to provide guidance on the use of ARM/HRAM in children with CC and/or FI.

show abstract

“…Retentive fecal incontinence (associated with constipation) has been reported in up to 85% of constipated children in previous studies 9 . The urinary system in human is adjacent to the gut and it is also under same neurological control.…”

Section: Discussionmentioning

confidence: 87%

Pattern of Constipation and Response to Polyethylene Glycol in Children

Saha

Bose

Das

et al. 2017

J. Nepal Paedtr. Soc.

View full text Add to dashboard Cite

Introduction: Constipation is a common problem in children with worldwide prevalence between 0.7% and 29.6%.Materials and Methods: Total number of children was 232 out of which 16 were discarded due to loss in follow up. Inclusion criteria: Any child aged one month to ten years presenting with constipation. We used NASPGHAN definition of constipation. Exclusion criteria: Critically sick and hemodynamically unstable patients were excluded from the study. Data were collected for age, sex, duration of constipation, symptoms and signs such as stool frequency, stool consistency, pain during defecation, presence of blood in stool, fecal and urinary incontinence, and presence of fecal impaction or an abdominal mass. Clinical evaluation (history and physical examination) of all patients was done by the same physician to avoid bias in clinical finding. Polyethylene glycol (PEG) was tried in all patients in a dose of 0.3 to 2.1g/kg. Response was defined as passage of at least one semisolid stool without discomfort with use of PEG for at least 4 weeks.Results: In our prospective study done on 232 patients with constipation over three year period (dividing patient’s into1month to 5months, 6months to 5year and 6 years to 10 years) revealed that constipation is mostly prevalent in 6 months to 5 year age group with slight male preponderance. Most of them had symptom onset after six months of age. Commonest symptom was hard stool in general (79.6%) but prevalence of pain abdomen increases with age and peaks in above five year group. Commonest sign is palpable fecal mass. Complications-urinary dysfunction, fecal incontinence, fissure are common in older age group. Functional constipation was the commonest cause (96.2%). Hirschprung disease was diagnosed in 1.4%. Polyethylene glycol shows good response in above 6 months of age groups.Conclusion: Functional constipationis the commonest cause of constipation. Mostly affected group is six months to five years. Polyethelene Glycol is an effective treatment especially after six months. J Nepal Paediatr Soc 2016;36(3):263-267.

show abstract

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

Cited by 90 publications

References 95 publications

Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009

Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009

Anorectal manometry in children with defecation disorders BSPGHAN Motility Working Group consensus statement

Pattern of Constipation and Response to Polyethylene Glycol in Children

Contact Info

Product

Resources

About