Jamshed Akhtar, Ali Raza Brohi, Abdul Aziz.
Pattern and development of bowel control in children.
J Coll Physicians Surg Pak Jan ;9(5):209-10.

The objective of the present study was to determine as to when children develop self control of daefecation so that management of paediatric patients with bowel disorders could be standardized. Three hundred subjects without any congenital or acquired bowel disorders attending paediatric clinic for other ailments were randomly selected to find out frequency and regularity of daefecation and the time at which they develop call for daefecation and self control. The subjects were divided according to age into three groups. At one year of age bowel training was already started in all subjects. Discomfort/abnormal posture/gesture suggestive of call for daefecation were noticed in 80% children. Frequency was on average 3 times per day. At two years of age self control was found in 68 % and at 3 year all subjects were continent. This study showed that most of our children develop control of daefecation earlier. This probably is due to religious and cultural habits of cleanliness and earlier toilet training. Better functional results can be expected if surgery for anorectal disorders is performed in early infancy as passage of stool can help in development of neural connections and ample time would be available for rehabilitation in those where bowel control is inadequate .

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