Clinical guidelines for the diagnosis and management of pediatric fecal incontinence: A comprehensive review and treatment algorithm
Abstract
Pediatric fecal incontinence (FI) is a multifactorial condition with functional, neurodevelopmental, and organic etiologies. Despite its prevalence, FI remains underdiagnosed, stigmatized, and associated with significant psychosocial and family burden. This review synthesizes current evidence on the diagnosis, pathophysiology, and management of pediatric FI and proposes practical, algorithm-based guidance for frontline clinicians and subspecialists. A structured literature search of PubMed, Scopus, and Cochrane databases was conducted, focusing on pediatric FI, functional and organic subtypes, neurodevelopmental comorbidities, and multidisciplinary interventions. Emphasis was placed on evidence-based management strategies, emerging therapeutic innovations, and psychosocial considerations. Functional retentive FI often responds to structured disimpaction, maintenance laxatives, and behavioral interventions, whereas non-retentive forms require tailored psychological and behavioral therapies. Organic etiologies often require long-term, multidisciplinary care, surgical intervention, or neuromodulation. Special populations—including children with autism spectrum disorder, attention-deficit/hyperactivity disorder, developmental delay, and postoperative anorectal conditions—require individualized, developmentally adapted programs. Psychosocial impacts on children and families are significant and require coordinated counseling. Emerging research highlights the gut-brain axis, microbiome modulation, digital behavioral applications, and precision bowel management as future directions. Limitations include heterogeneous study designs, lack of long-term pediatric randomized controlled trials, and variable outcome measures. Pediatric FI is a complex condition requiring early recognition, subtype-specific management, and multidisciplinary care. Algorithm-based, individualized strategies that integrate physiological, behavioral, and psychosocial components optimize long-term continence, psychosocial well-being, and quality of life. Future research should focus on standardized outcomes, neuromodulatory interventions, and precision, technology-enhanced therapies.
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BibTeX
@article{albeltagi2026clinical,
title = {{Clinical guidelines for the diagnosis and management of pediatric fecal incontinence: A comprehensive review and treatment algorithm}},
author = {Mohammed Al-Beltagi},
journal = {World Journal of Clinical Pediatrics},
year = {2026},
month = nov,
doi = {10.5409/wjcp.120203},
url = {https://doi.org/10.5409/wjcp.120203},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Clinical guidelines for the diagnosis and management of pediatric fecal incontinence: A comprehensive review and treatment algorithm
AU - Mohammed Al-Beltagi
PY - 2026
DA - 2026/11/03
JO - World Journal of Clinical Pediatrics
DO - 10.5409/wjcp.120203
UR - https://doi.org/10.5409/wjcp.120203
AB - Pediatric fecal incontinence (FI) is a multifactorial condition with functional, neurodevelopmental, and organic etiologies. Despite its prevalence, FI remains underdiagnosed, stigmatized, and associated with significant psychosocial and family burden. This review synthesizes current evidence on the diagnosis, pathophysiology, and management of pediatric FI and proposes practical, algorithm-based guidance for frontline clinicians and subspecialists. A structured literature search of PubMed, Scopus, and Cochrane databases was conducted, focusing on pediatric FI, functional and organic subtypes, neurodevelopmental comorbidities, and multidisciplinary interventions. Emphasis was placed on evidence-based management strategies, emerging therapeutic innovations, and psychosocial considerations. Functional retentive FI often responds to structured disimpaction, maintenance laxatives, and behavioral interventions, whereas non-retentive forms require tailored psychological and behavioral therapies. Organic etiologies often require long-term, multidisciplinary care, surgical intervention, or neuromodulation. Special populations—including children with autism spectrum disorder, attention-deficit/hyperactivity disorder, developmental delay, and postoperative anorectal conditions—require individualized, developmentally adapted programs. Psychosocial impacts on children and families are significant and require coordinated counseling. Emerging research highlights the gut-brain axis, microbiome modulation, digital behavioral applications, and precision bowel management as future directions. Limitations include heterogeneous study designs, lack of long-term pediatric randomized controlled trials, and variable outcome measures. Pediatric FI is a complex condition requiring early recognition, subtype-specific management, and multidisciplinary care. Algorithm-based, individualized strategies that integrate physiological, behavioral, and psychosocial components optimize long-term continence, psychosocial well-being, and quality of life. Future research should focus on standardized outcomes, neuromodulatory interventions, and precision, technology-enhanced therapies.
SN - 2219-2808
ER -