Question
My son’s fecal incontinence doesn’t seem to have any known cause. He had an episode in the summer of 9 years ago that lasted for about a week, almost once a day. After that, he recovered to normal, but now he’s having another episode, almost daily with fecal incontinence, which has been going on for more than a dozen days and hasn’t improved. I don’t know what the cause is and how to treat it?
Answer
Functional fecal incontinence refers to an inability to suppress bowel movements that is not caused by obvious organic defects or diseases, with an incidence rate of 17% in children at the age of 3 and 1% at the age of 4. Common causes include children refusing to undergo bowel training, but sometimes it is also due to chronic constipation, which causes feces to be expelled involuntarily. Constipation is characterized by difficulty in defecation or infrequent bowel movements, hard stools, or a feeling that not all waste has been evacuated. Possible reasons for recurrence include being too embarrassed to use the toilet and not finishing defecation; refusing to use the toilet; anal fissures; congenital malformations such as inflammation of the spinal cord, anal agenesis (following repair surgery), and other related abnormalities; Hirschsprung’s disease (a gastrointestinal defect at the 261st section); thyroid hormone dysfunction; malnutrition; cerebral palsy; or mental illness in children or family members. Treatment should first inform parents and children about the causes of fecal incontinence or chronic constipation, thoroughly eliminate any guilt children may feel due to their inability to suppress bowel movements, and alleviate any negative emotional responses that may arise from this. An abdominal X-ray can show a large amount of feces in the abdomen. If the initial medical history and physical examination can rule out specific causes…