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Elimination disorders in children and adolescents

Elimination disorders (EDs) encompass faecal incontinence or encopresis, daytime urinary incontinence, and nocturnal enuresis. Many different subtypes can be identified. EDs are common disorders in childhood, associated with emotional distress and a higher rate of comorbid psychiatric disorders such as attention-deficit/hyperactivity disorder. These have to be addressed separately. Genetic and environmental factors play a role in the aetiologies of EDs. Medical causes have to be ruled out, but most EDs are functional, that is, non-organic. Assessment is non-invasive and clinically based in most cases. Treatment is symptom-oriented, with the goal of complete continence. The most effective treatment is primarily by urotherapy, cognitive behavioural therapy, and medication. As each subtype of ED requires a specific treatment approach, an exact diagnosis is essential. International guidelines are available to ensure optimal care for children and adolescents with EDs.