Kids Pee Poo Physio


  • Home
  • About
  • Consultation & Treatment
  • Pelvic Floor
  • Urinary
  • Digestive
  • Your Friend - The Potty
  • M.O.P.
  • Articles
  • Physiotherapist
  • Terms & Conditions
  • Visit Us

Faecal Incontinence / Encopresis


Read More

FAECAL INCONTINENCE / ENCOPRESIS



• Characterised by recurrent loss of faecal matter into the underwear

• Male to female ratio 3:1 to 6:1

• In 82 % of children with faecal incontinence, the cause is functional constipation

• The child can develop behavioural, emotional and upbringing problems, learning difficulties, depression and frequently subjected to maltreatment



2 Types of Faecal Incontinence



1. Organic causes of faecal incontinence in children


• Repaired anorectal malformations

• Post-surgical Hirschsprung disease

• Spinal cord trauma

• Spinal cord tumours

• Cerebral palsy

• Myopathies affecting the pelvic floor muscle and external anal sphincter


2. Functional cause of faecal incontinence


Functional constipation associated with faecal incontinence- (Retentive FI)

• Rectum loaded with faeces leading to overflow incontinence due to witholding.

• Withholding leads to megarectum and mega colon and decreased propulsive contractile forces of the rectal musculature

• Rectal sensitivity is blunted due to rectal hyposensitivity or constant accumulation of faeces

• Semi liquid faeces seeps between the faecal mass and rectal wall and escape through the anal canal when sphincter muscle is relaxed

- Leaked stools are generally small

- Incontinence of faeces can occur in day or at night

• 29-34% of children with FI have daytime wetting


Functional non-retentive FI-massive poos in pants but not constipated

• Large amounts of poo without knowing it happens e.g. 1x week or 1x month- complete evacuation of the bowels, not just staining the underwear

• Regularly pass stools on toilet with no pain or difficulty

• Usually have leaks in the afternoon due to fatigue of the pelvic floor muscle.

• On anorectal manometry the inability to relax the external anal sphincter is seen- likely to be an acquired control mechanism after first involuntary passage of stool

• Child is older than 4 years

- Now evidence of faecal retention

• Defecation into place inappropriate to the social context at least once a month

• No evidence of inflammatory, metabolic, or neoplastic process to explain the symptoms

• Colonic transit time, rectal compliance and sensory thresholds are normal



Antoinette Jansen van Vuuren



Suite 13, Netcare Pretoria East Hospital, Cnr Garsfontein Road & Netcare Ave, Pretoria East