FECAL INCONTINENCE in a child over 3 years of age becomes a matter of most serious psychological and social importance, increasing with age. We have developed a program for controlling this condition, which, with modification, has been successful in children whose difficulty results from various causes ranging from gross anatomical abnormalities and faulty innervation to "overtraining" and overt psychiatric disease.
Emotional problems are commonly associated with fecal incontinence, sometimes as a causative factor, or inevitably as a direct result of the social disgrace of fecal soiling. Although these emotional problems are important, we will confine our discussion to the nonpsychiatric, medical management.
Anatomic Causes
Included in the group of patients we have had the opportunity to treat, are children with myelodysplasia; children with paraplegia secondary to infectious transverse myelitis or vascular accidents of spinal arteries; children with traumatic transection of the spinal cord; and children who have no anal sphincters,