Encopresis and soiling.

Constipation, encopresis, and fecal incontinence are common problems in children. Constipation can have a variety of causes, such as organic and anatomic causes or intake of medication. Encopresis is the involuntary loss of formed, semiformed, or liquid stool into the child's underwear in the presence of functional (idiopathic) constipation in a child 4 years of age or younger. Fecal incontinence is fecal soiling in the presence of an organic or anatomic lesion, such as Hirschsprung's disease, anal malformation, anal surgery or trauma, meningomyelocele, and some muscle disease. This article reviews the symptoms of functional constipation in young children and the symptoms of functional constipation and encopresis in older children, presents the differential diagnosis of constipation with or without fecal incontinence, describes the evaluation and treatment of these children, and reports on treatment outcome.