Summary

• Involuntary defecation at inappropriate times, occurring after the typical age of completed toilet training (generally 4 years).
• In most cases, caused by overflow soiling associated with chronic constipation and severe faecal impaction in an otherwise healthy child without underlying anatomical abnormalities.
• May have a significant negative impact on the quality of life for the child and the family.
• A thorough history and physical examination are the crux of diagnosis. Laboratory and radiological studies may be used on a case-by-case basis to determine the underlying aetiology.
• The goal of therapy is for patient to stool 1 to 3 times per day in the toilet with no episodes of soiling.
• Treatment involves complete colon disimpaction, long-term treatment with laxatives and stool softeners, and bowel re-education. Any underlying causes should also be addressed.