Systematic review and meta-analysis of behavioral interventions for fecal incontinence with constipation

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34 Scopus citations


Background: Multiple treatments exist for fecal incontinence. However, the relative and additive influence of commonly used behavioral approaches remains unclear. Objective: We conducted a systematic review of randomized controlled trials to synthesize the effects of behavioral treatment of fecal incontinence with constipation in children aged 4-18 years. Mixed treatment comparisons (MTCs) and random effects models were used to analyze outcomes. Risk of bias and quality of evidence were rated. Results: Although 10 studies were identified for MTCs, results did not yield reliable or valid estimates. Four studies were retained for random effects pooled outcome analysis. Results indicated that behavioral intervention was more effective than control conditions for author-defined success and soiling frequency. Conclusion: Although evidence supports behavioral treatments for fecal incontinence with constipation in children, available evidence is limited. More and higher-quality trials are needed to better understand the relative effects of different treatments, including behavioral strategies.

Original languageEnglish (US)
Pages (from-to)887-902
Number of pages16
JournalJournal of pediatric psychology
Issue number8
StatePublished - Sep 2014


  • Encopresis
  • Evidence-based practice
  • Fecal incontinence
  • Meta-analysis
  • Systematic review

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology


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