ABSTRACT
Fecal incontinence and constipation are major causes of morbidity in children with underlying colorectal problems including Hirschsprung disease and anorectal malformations. Bowel management is a term that is used to describe methods in which the bowel can be controlled in order to keep the patient clean or, expressed another way, socially continent. Chronic diarrhea may be caused by excess bile acids entering the colon, rather than being absorbed in the ileum. This can be a primary idiopathic condition or secondary to surgical resection or inflammatory bowel disease. Children with developmental delay from a variety of conditions such as Down's syndrome may not potty train on time, or ever, but they can still be socially clean with the appropriate bowel management regimen. Children may require psychological support to deal with the negative effects that persistent soiling has had on their ability to form friendships and to cope with bullying.
