ABSTRACT
A 10-year-old male with a history of functional constipation and fecal soiling since birth comes to your clinic. He soils daily. His past medical history is significant for attention deficit hyperactivity disorder, oppositional defiant disorder, and sexual molestation with resultant anal defensiveness. He has had chronic constipation since the age of 1. At age 9, he had anal dilation and anal botulinum toxin at another institution for withholding behavior with no improvement in his symptoms. He has tried polyethylene glycol 3350 and senna, but this resulted in significant cramping, decreased appetite, and multiple daily accidents. He has been hospitalized twice in the last 3 months for impactions requiring a GoLYTELY cleanout.
