A child may develop functional non-retentive soiling. This can be diagnosed using criteria from the Rome II conference.
(1) school-aged child > 4 years of age
(2) >= 1 time per week for >= 12 weeks
(3) defecation occurs at times and places inappropriate to the social context
The presence of an emotional disturbance (anger, impulsivity, etc.) is supportive for the diagnosis, especially if a correlation between the soiling episodes and a triggering event can be demonstrated.
(1) structural anorectal disease
(2) inflammatory disease
(3) fecal retention with fecal mass (presence suggests functional fecal retention)
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