{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:00:31Z","timestamp":1791489631766,"version":"4.3.4"},"reference-count":99,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,10,28]],"date-time":"2012-10-28T00:00:00Z","timestamp":1351382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Faecal incontinence (<jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content>) in children is a significant gastrointestinal problem, with great personal and social impacts. It is characterised by recurrent loss of faecal matter into the underwear. Both functional and organic causes contribute to its aetiology with the former predominating.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To review the epidemiology, pathophysiology, clinical evaluation and management of functional faecal incontinence in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A PubMed search was conducted using search terms f(a)ecal incontinence, and encopresis. Articles on epidemiology, pathophysiology, clinical evaluation, investigation and management of functional <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> in children were retrieved and assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Community prevalence of this distressing problem ranges from 0.8% to 7.8% globally. Male: female ratio varies from 3:1 to 6:1. The diagnosis of <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> is often based on established clinical criteria. The majority (82%) have constipation associated functional <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content>. Biopsychosocial factors play a crucial role in the pathogenesis. Limited physiological testing of anorectal function is recommended in the diagnostic procedures, particularly in children with atypical symptoms and possible organic disorders. Management of <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> needs a multidisciplinary approach which includes establishment of an effective doctor\u2010patient partnership, understanding the underlying mechanisms, pharmacotherapy and behavioural treatment. Approximately 15% of children with functional nonretentive faecal incontinence (<jats:styled-content style=\"fixed-case\">FNRFI<\/jats:styled-content>) had the same symptoms at the age of 18\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Significant therapeutic advances have been made for retentive faecal incontinence, but treatment options for functional nonretentive faecal incontinence are limited. Limited long\u2010term outcome data show that the majority outgrow faecal incontinence. A substantial proportion of children progress to adulthood with faecal incontinence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.12103","type":"journal-article","created":{"date-parts":[[2012,10,29]],"date-time":"2012-10-29T19:01:25Z","timestamp":1351537285000},"page":"37-48","source":"Crossref","is-referenced-by-count":88,"title":["Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management"],"prefix":"10.1111","volume":"37","author":[{"given":"S.","family":"Rajindrajith","sequence":"first","affiliation":[{"name":"Department of Paediatrics Faculty of Medicine University of Kelaniya Ragama Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. M.","family":"Devanarayana","sequence":"additional","affiliation":[{"name":"Department of Physiology Faculty of Medicine University of Kelaniya Ragama Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Benninga","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology and Nutrition Emma Children's Hospital Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004703-199312010-00008"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02225088"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1773"},{"key":"e_1_2_11_5_1","first-page":"1","article-title":"Studies on encopresis","volume":"170","author":"Bellman M","year":"1966","journal-title":"Acta Paediatr Scand"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.11.029"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2010.12.004"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MPG.0000149964.77418.27"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.08.063"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181d1b23e"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2009.12.022"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181d33b7d"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2006.098335"},{"key":"e_1_2_11_14_1","first-page":"412","article-title":"Children with encopresis: a descriptive analysis","volume":"56","author":"Levine MD","year":"1975","journal-title":"Pediatrics"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.04.050"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1973.tb08120.x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(05)70406-5"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.39.207.465"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2005.10.001"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.173716"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmr013"},{"key":"e_1_2_11_22_1","first-page":"663","article-title":"Behavioural symptom substitution in children cured of encopresis","volume":"134","author":"Levine MD","year":"1980","journal-title":"Am J Dis Child"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/27.7.585"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.75.5.367"},{"key":"e_1_2_11_25_1","first-page":"13","article-title":"Colonic transit times and behavioural profiles in children with defecation disorders","volume":"89","author":"Benninga MA","year":"2004","journal-title":"Arch Dis Child"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2009.07.004"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2010.12.003"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-200411000-00002"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01536418"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00194.2001"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.00947.x"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1998.00293.x"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01751.x"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.03.066"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-005-0087-8"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00604.x"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000233159.97667.c3"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.71.3.186"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2003.040220"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.08.061"},{"key":"e_1_2_11_41_1","first-page":"2171","article-title":"Treatment guidelines for primary nonretentive encopresis and stool toileting refusal","volume":"59","author":"Kuhn BR","year":"1999","journal-title":"Am Fam Physician"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2011.17.1.35"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000252187.12793.0a"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.100.2.228"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2010.12.005"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2011.130"},{"key":"e_1_2_11_47_1","unstructured":"NICE Guidelines 2010"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.40105.x"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-200210000-00002"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-200104001-00019"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.06.004"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992287901801103"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.73.6.534"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050583"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181cb4309"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.159.7.671"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.12.045"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.07.009"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02605761"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(87)90837-7"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199610000-00007"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199808000-00002"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.11.029"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.07.063"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.68.1.126"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.58.4.257"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199401000-00012"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-003-0988-3"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-004-1233-4"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.09.048"},{"key":"e_1_2_11_71_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-2-33"},{"issue":"2","key":"e_1_2_11_72_1","first-page":"S49","article-title":"Diagnostic testing in constipation: is it necessary?","volume":"53","author":"Burgers R","year":"2011","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2005.12.018"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)36077-1"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)34143-8"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004310050691"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1097\/00152192-200401001-00002"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2009.06.007"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.3.e259"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2011.01.012"},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0090"},{"key":"e_1_2_11_82_1","first-page":"145","article-title":"Mechanisms of action of loperamide","volume":"96","author":"Ooms LA","year":"1984","journal-title":"Scand J Gastroenterol"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.22.8.658"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01391374"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-200308000-00022"},{"key":"e_1_2_11_86_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.126603"},{"key":"e_1_2_11_87_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079907X210462"},{"key":"e_1_2_11_88_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.117002"},{"key":"e_1_2_11_89_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000228097.58960.e6"},{"key":"e_1_2_11_90_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.127233"},{"key":"e_1_2_11_91_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007997709115268"},{"key":"e_1_2_11_92_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.109153"},{"key":"e_1_2_11_93_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.10.012"},{"key":"e_1_2_11_94_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)82877-X"},{"key":"e_1_2_11_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)03206-0"},{"key":"e_1_2_11_96_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-200204000-00012"},{"key":"e_1_2_11_97_1","first-page":"CD002240","article-title":"Behavioural and cognitive interventions with or without other treatments for the management of fecal incontinence in children","volume":"19","author":"Brazzelli M","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_98_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2001.25768"},{"key":"e_1_2_11_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(03)00888-6"},{"key":"e_1_2_11_100_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181afcdc3"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.12103","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.12103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T13:14:18Z","timestamp":1697634858000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.12103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,28]]},"references-count":99,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1111\/apt.12103"],"URL":"https:\/\/doi.org\/10.1111\/apt.12103","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,10,28]]}}}