Table 2

 Differential diagnosis

Newborn (1st month)Infant (1–12 months)Toddler (1–2.5 years)Pre-school (2.5–4 years)1st school (5–7 years)Junior school (8–12 years)Teenager (13–18 years)
Anorectal anomalyDietary fluid balanceDiet and perianal discomfortLearned avoidanceIntermittent full megarectumPermanently full megarectum
Denial?? Acceptance of responsibility
Anterior ectopic anusInadequate intakeFood fadsFaecal retentionFaecal retentionFaecal retentionFaecal retention
Anal stenosisPoor feedingPoor feedingPoor compliancePoor compliancePoor compliancePoor compliance
HirschsprungFood intoleranceFood intoleranceBehaviour problemsBehaviour problemsBehaviour problemsBehaviour problems
Anal fissureAnal fissureNeuropathic if urinary incontinenceSchool problemSchool problemSchool problem
Perianal streptococcus infectionBullyingBullying
Rectal prolapse