Diagnosis and Management of Idiopathic Constipation with Overflow Incontinence

Definition and Diagnosis

• The Rome criteria for Irritable Bowel Syndrome (IBS) require abdominal pain associated with changes in stool frequency or form, and specifically presume the absence of structural or biochemical explanations for symptoms, which distinguishes it from idiopathic constipation with overflow incontinence 1

Treatment Approach

• Education is paramount, explaining to the family that soiling is involuntary overflow, not behavioral defiance, and initial disimpaction can be achieved with polyethylene glycol (PEG) for children over 6 months, while lactulose is preferred for infants under 6 months 2