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Abstract
Fecal soiling is a common problem that pediatricians are frequently asked to evaluate. Fecal incontinence represents a devastating problem that may prevent a child from becoming socially accepted. More children are affected than previously believed, including those born with surgical conditions such as anorectal malformations (ARMs) and Hirsch sprung disease (HD), as well as those who have spinal cord problems or injuries. Patients can have true fecal incontinence or can suffer from overflow pseudo incontinence. These two conditions have completely different treatments. Those who experience true incontinence include a percentage of surgical patients (who have ARMs and HD) as well as those who have congenital or acquired spinal problems. Pseudo incontinence (encopresis) occurs in patients who have the potential for bowel control but whose constipation leads to overflow and soiling