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Review: behavioural interventions plus laxatives are effective for defaecation disorders, but biofeedback does not add benefit

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 QUESTION: In children with defaecation disorders, are behavioural modification (B-mod) techniques and cognitive therapies more effective than conventional treatments?

Data sources

Studies were identified by searching 12 databases (including the Cochrane Incontinence Group Trials Register and the Enuresis Resource and Information Centre Register) in March 2001, scanning reference lists, and contacting experts.

Study selection

Studies were selected if they were randomised or quasi-randomised controlled trials of cognitive, behavioural, or cognitive and behavioural interventions in children with a history of faecal soiling with or without constipation.

Data extraction

The quality of studies was assessed. Data were extracted on participant characteristics, interventions, and outcomes.

Main results

14 studies (12 randomised controlled trials, 843 children) met the selection criteria. Children had encopresis (ie, inappropriate passage of stool in children > 4 y of age) in 12 studies and faecal incontinence resulting from congenital abnormalities in 2 studies. Study duration ranged …

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  • Source of funding: National Health Service.

  • For correspondence: Ms M Brazzelli, University of Aberdeen, Aberdeen, Scotland, UK. mgb{at}

  • A modified version of this abstract also appears in Evidence-Based Nursing.