Abstract

Simple, incentive based behaviour modification, with or without a modest programme of psychotherapy involving outpatient visits every four to six weeks, seems to be associated with a useful cure rate in children with lower bowel function disorders. Appreciable social disadvantage seems to be the most important factor mitigating against a successful outcome, associated with non-compliance with treatment. Failure to respond to treatment was associated with important psychological problems. These were more common in the socially disadvantaged groups. Children from satisfactory social backgrounds who have lower bowl disturbances can be effectively treated by fairly simple programmes. More elaborate and expensive strategies should be reserved for those whose psychosocial circumstances make it possible to predict a less satisfactory outcome.