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Behavioural interventions for the treatment of faecal incontinence in children

Brazzelli M, Griffiths PV, Cody JD, Tappin D
Published Online: 
7 December 2011

Children with "faecal incontinence" cannot control their bowel movements and so they soil their underwear. Sometimes people use the word "soiling" or "encopresis" to mean the same thing. Faecal incontinence can be caused by either physical or psychological problems. The term "organic faecal incontinence" is used when faecal incontinence is due to a physical damage or abnormality whilst "functional faecal incontinence" is used when faecal incontinence is caused by non-organic/psychological factors. Behavioural interventions (toilet training, rewards) are used to reduce children's anxiety and to restore normal bowel habits. Biofeedback is a technique that can be used to teach children how to control the muscles around their back passage.

This review identified 21 studies with a total of 1371 children. Behavioural interventions when used together with laxative therapy may improve continence in children with non-organic faecal incontinence and constipation whilst biofeedback does not add any long-term benefit. Children who received biofeedback treatment had not always been evaluated beforehand for the suitability of the treatment.

There was not enough evidence to assess the effects of biofeedback in children with organic faecal incontinence.

This record should be cited as: 
Brazzelli M, Griffiths PV, Cody JD, Tappin D. Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children. Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD002240. DOI: 10.1002/14651858.CD002240.pub4
Assessed as up to date: 
28 October 2011