Rome IV Diagnostic Criteria for Child Non-retentive Fecal Incontinence
Official Rome IV criteria for the diagnosis of child nonretentive fecal incontinence.
Use in a child or adolescent with fecal incontinence for at least 1 month.
Patients with any of the following alarm features must be evaluated clinically for other diagnoses even though nonretentive fecal incontinence may be present:
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Physical exam findings suggesting structural disease, such as:
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Fistulous opening.
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Abnormalities of the back (Hair tuft, gluteal cleft deviation, sacral dimple).
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Anal tenderness or tags.
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Absent anal or cremasteric reflex.
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Decreased lower extremity strength/tone/reflexes.
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Anal scars.
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Hematochezia or melena.
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Abdominal distension.
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Vomiting.
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Urinary retention or incontinence.
If diagnosis not met (negative):
Current symptoms are unlikely to be related to nonretentive fecal incontinence. Consider further assessment as clinically indicated. Also, see pearls and pitfalls above.
If meets diagnosis (positive):
Likely diagnosis of nonretentive fecal incontinence. Consider initiating treatment.
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Treatment includes education, behavioral and medical treatment.
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Rectal interventions are sometimes necessary to empty the rectosigmoid in a more predictable manner.
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Loperamide combined with behavioral interventions can be helpful.
The choice of therapy is outside the scope of this calculator and will depend on clinical context.
This calculator should only be used in patients who do not have signs or symptoms suggestive of a structural, metabolic, neurologic or other systemic cause of their symptoms based on clinical history, physical exam, and initial work-up.