Children with certain types of neurological abnormalities may have difficulty with neuromuscular control of their rectum, resulting in accidents. In particular, patients with various types of spina bifida (myelomeningocele) commonly have problems with stool control or elimination. These patients as well as others will often have severe constipation. Poorly controlled constipation is often associated with impaction of stool in the rectum and results in uncontrolled passage of stool around the fecal impaction. This is referred to as overflow pseudo-incontinence.

The doctor will want to take a detailed medical history, and a detailed account your child's bowel movement patterns. The doctor will perform a physical examination of the anus and surrounding areas to look for the presence of any scars, defects, or abnormalities. If your child's doctor suspects a neurological problem, your child may undergo certain neurological evaluations. Any of the following diagnostic procedures may also be performed depending on what is believed to be causing the problem:

Treatments for more mild cases can include dietary alteration or treatment with medications to slow transit or increase stool consistency, or sphincter exercises. An enema may be prescribed by your child's physician to help remove impacted stool. An enema is a liquid that is placed in your child's rectum and helps loosen the hard, dry stool. (DO NOT give your child an enema without the approval of a physician or healthcare provider.)

Some children will require surgery. Surgery can include surgical correction of an anatomical problem or, the creation of a small opening in the abdominal wall, through which a small tube is passed into the colon to irrigate it on a daily basis, the so-called ACE procedure. This may allow restoration of control and prevention of stool impaction.