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Parental Knowledge of Fecal Incontinence in Children

van Tilburg, Miranda A.L.*; Squires, Megan*; Blois-Martin, Nanette*; Williams, Cathy; Benninga, Marc A.; Peeters, Babette; Ulshen, Martin

Journal of Pediatric Gastroenterology and Nutrition: September 2012 - Volume 55 - Issue 3 - p 283–287
doi: 10.1097/MPG.0b013e31824cf555

Objectives: Fecal incontinence (FI) is a common and stressful symptom of constipation in children. Recurrent FI causes psychological and physiological changes, complicating treatment as symptom duration progresses; however, parental misconceptions about the causes of FI may delay seeking medical care. The aim of the present study was to assess parental knowledge about FI and determine how this relates to the care and treatment of FI.

Methods: A questionnaire was developed from qualitative interviews and clinician input. The questionnaire was administered to 251 parents and tested for reliability and validity. Subscales were compared between parents who did and did not consult a clinician. In addition, 30 parents completed the questionnaire before and after consultation with a pediatric gastroenterologist and after 2 months of treatment.

Results: Two subscales were identified with good psychometric properties: “Blame and Punish” and “Worry and Help.” Families who consulted a physician for their child's FI acknowledged the role of constipation and scored higher on Worry and Help (mean 36.4 vs mean 46.9; P < 0.0001). Trends were found for Blame and Punish to decrease after consultation with a pediatric gastroenterologist (mean 1.7 vs 1.5; P = 0.08) and after 2 months of treatment (mean 1.5; P = 0.08).

Conclusions: Parental knowledge about FI changes with physician consultation. These findings can help in developing educational materials for parents to encourage early diagnosis and treatment and prevent chronic problems that are difficult to manage.

*University of North Carolina, Center for Functional GI and Motility Disorders, Chapel Hill, NC

Duke University Medical Center, Durham, NC

Department of Peadiatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam, The Netherlands.

Address correspondence and reprint requests to Miranda van Tilburg, PhD, University of North Carolina, Center for Functional Gastrointestinal and Motility Disorders, 130 Mason Farm Rd, CB 7080, Chapel Hill, NC 27599 (e-mail:

Received 7 September, 2011

Accepted 19 January, 2012

The present study was supported by Takeda Pharmaceuticals North America Inc.

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN