Abstract
Fecal incontinence (FI) in children is frequently encountered in pediatric practice and represents a difficult and distressing problem. Usually, this is a functional defecation disorder. In approximately 80 % of cases FI is related to constipation, being the result of overflow incontinence, whereas in the remaining 20 % no constipation or other underlying cause can be found; these children suffer from functional nonretentive fecal incontinence (FNRFI). A thorough medical history and physical examination are typically sufficient for an adequate assessment of the underlying cause of functional FI. The non-pharmacological treatment of functional FI consists of education, demystification, a daily bowel diary, and a toilet program with a reward system. The pharmacological treatment of functional FI depends on the underlying cause. Treatment of constipation starts with oral laxatives, preferably polyethylene glycol. In addition, there is anecdotal evidence that loperamide or imipramine could be beneficial in children with FNRFI.
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