Bowel Management Program for Children with True Fecal Incontinence and Its Efficacy on Their Quality of Life
Main Article Content
Keywords
Bowel Management Program, True Fecal Incontinence & Quality of Life.
Abstract
Fecal incontinence (FI) resembles a disastrous challenge for those who suffer from it. It frequently makes it more difficult for children to fit in with society, resulting in serious psychological consequences. This study aimed to evaluate the effectiveness of bowel management program (BMP) for patients that have true FI. Subject & Methods: This prospective case series was conducted in the paediatric surgery department in Zagazig University hospitals, included 26 children with faecal incontinence after anorectal surgery who divided equally according to type of colon by contrast enema into: Group (A)patients with dilated colon “hypomotile colon” which need large volume and concentrated enema; and Group (B) patients with non-dilated colon “hyper motile colon” which need small volume enema, constipating diet and may need loperamide. Results: The average ages of the studied groups were (8.1±1.5) and (7.9±1.1). Regarding sex, male to female ratio was 4:1. Majority of parents were poorly educated in both groups. There was a highly statistically significant association between the parent education and the easy follow-up visits. There was a statistically significant positive correlation (increase aged was accompanied by increased the amount of saline and glycerin) between the children age and the amount of saline and glycerin. There was a highly statistically significant improvement in all quality-of-life score items as provided by children and parents before and after 3 months of BMP among the hypo and hyper motile colon groups (p-value<0.001). Conclusion: The implementation of BMP after 3 months improves the quality of life of children and their parents in both hyper and hypomotile colon groups.
References
2- Bischoff, A., & Tovilla, M. (2010). A practical approach to the management of pediatric fecal incontinence. In Seminars in pediatric surgery (Vol. 19, No. 2, pp. 154-159). WB Saunders.
3- Whoqol Group. (1995). The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Social science & medicine, 41(10), 1403-1409.
4- Peña, A., Guardino, K., Tovilla, J. M., Levitt, M. A., Rodriguez, G., & Torres, R. (1998). Bowel management for fecal incontinence in patients with anorectal malformations. Journal of pediatric surgery, 33(1), 133-137.
5- Vriesman, M. H., Rajindrajith, S., Koppen, I. J. N., van Etten-Jamaludin, F. S., van Dijk, M., Devanarayana, N. M., Tabbers, M. M., & Benninga, M. A. (2019). Quality of Life in Children with Functional Constipation: A Systematic Review and Meta-Analysis. The Journal of pediatrics, 214, 141–150. https://doi.org/10.1016/j.jpeds.2019.06.059.
6- Levitt, M.A., Falcone, R.A., Peña, A. (2007). Pediatric Fecal Incontinence. In: Ratto, C., Doglietto, G.B., Lowry, A.C., Påhlman, L., Romano, G. (eds) Fecal Incontinence. Springer, Milano.
7- Timmerman, M. E. W., Trzpis, M., & Broens, P. M. A. (2019). The problem of defecation disorders in children is underestimated and easily goes unrecognized: a cross-sectional study. European journal of pediatrics, 178(1), 33–39.
8- Peña, A., & Levitt, M. A. (2002). Colonic inertia disorders in pediatrics. Current problems in surgery, 39(7), 666–730.
9- Norton C, Chelvanayagam S, Wilson-Barnett J, Redfern S, Kamm MA. Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology. 2003 Nov 1;125(5):1320-9.
10- Dobben AC, Terra MP, Berghmans B, Deutekom M, Boeckxstaens GE, Janssen LW, Bossuyt PM, Stoker J. Functional changes after physiotherapy in fecal incontinence. International journal of colorectal disease. 2006;21:515-21.
11- Bray, L., & Sanders, C. (2013). An evidence-based review of the use of transanal irrigation in children and young people with neurogenic bowel. Spinal Cord, 51(2), 88-93.
12- Rajindrajith, S., Devanarayana, N. M., & Benninga, M. A. (2013). Review article: fecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management. Alimentary pharmacology & therapeutics, 37(1), 37–48.
13- Shen, Z. Y., Zhang, J., Bai, Y. Z., & Zhang, S. C. (2022). Diagnosis and management of fecal incontinence in children and adolescents. Frontiers in pediatrics, 10, 1034240.
14- Bischoff A, Levitt MA, Pena A (2009). Bowel management for the treatment of pediatric fecal incontinence. Pediatric surgery international. 2009 Dec; 25:1027-42.
15- Halleran, D. R., Lane, V. A., Leonhart, K. L., Fischer, B., Sebastião, Y. V., Chisolm, D. J., Deans, K. J. (2019). Development of a patient-reported experience and outcome measures in pediatric patients undergoing bowel management for constipation and fecal incontinence. Journal of pediatric gastroenterology and nutrition, 69(2), e34-e38.
16- Dingemans, A. J., Krois, W., Rios, J. C., Wood, R. J., Levitt, M. A., & Reck-Burneo, C. A. (2018). Health literacy and health-related quality of life in patients with anorectal malformations: A comparison between a charity hospital in Honduras and a tertiary care center in the United States. Journal of Pediatric Surgery, 53(10), 1951-1954.
17- Cushing, C. C., Martinez-Leo, B., Bischoff, A., Hall, J., Helmrath, M., Dickie, B. H., Levitt, M. A., Peña, A., Zeller, M. H., & Frischer, J. S. (2016). Health-Related Quality of Life and Parental Stress in Children With Fecal Incontinence: A Normative Comparison. Journal of pediatric gastroenterology and nutrition, 63(6), 633–636.
18- John, V., Chacko, J., Mathai, J., Karl, S., & Sen, S. (2010). Psychosocial aspects of follow-up of children operated for intermediate anorectal malformations. Pediatric surgery international, 26, 989-994.
19- Bai, Y., Yuan, Z., Wang, W., Zhao, Y., Wang, H., & Wang, W. (2000). Quality of life for children with fecal incontinence after surgically corrected anorectal malformation. Journal of pediatric surgery, 35(3), 462-464.
20- Bongers ME, van Dijk M, Benninga MA, Grootenhuis MA. Health related quality of life in children with constipation-associated fecal incontinence. The Journal of pediatrics. 2009 May 1;154(5):749-53.
21- Miner Jr PB (2004). Economic and personal impact of fecal and urinary incontinence. Gastroenterology. 2004 Jan 1;126:S8-13.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.