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Fecal Soiling Due to Paradoxic Obstipation

WALTER PICK, M.D.
Am J Dis Child. 1963;105(3):229-233. doi:10.1001/archpedi.1963.02080040231001.
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Fecal soiling is considered to be an abnormal condition after the second year of life; yet it is not an infrequent finding in older children. The paucity of reports in the medical journals and the dearth of discussion in the standard pediatric texts on this subject are striking.

Recently, 2 children with fecal soiling of long duration were observed. One of these had been treated for several months by a child psychiatrist, and the other had been diagnosed as having ulcerative colitis. Both children were cured of the soiling when it was recognized that it was caused by obstipation—a clinical picture which was first described by Priesel and Siegl1 in 1936 and later designated by Jekelius2 as "paradoxic obstipation." This term describes graphically the continuous oozing of soft, mushy fecal material in the presence of severe obstipation.

The following case studies summarize the pertinent clinical features of

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