Bowel management for fecal incontinence in patients with anorectal malformations

Peña, Alberto; Guardino, K; Tovilla, J.M; Levitt, Marc A.; Rodriguez, George; Torres, Ricardo

doi:10.1016/s0022-3468(98)90380-3

Cited by 158 publications

(121 citation statements)

References 9 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…Definitions and criteria to judge incontinence varied from any episodes or incidences of staining, soiling or faecal incontinence, 4,6,9,11,12,19 soiling once a month, 10 soiling three times a month, 16 not needing to wear pads for stool incontinence 13 to no information being supplied on how the studies had characterised continence or incontinence. 5,14,15,17,18 This review has correlated with the studies, whose report rates of continence were achieved. In order to combine the findings, a successful outcome of transanal irrigation is defined in this narrative review as an increased level of continence in those children still using transanal irrigation at the point of follow-up.…”

Section: Effectiveness Of Transanal Irrigation In Childrenmentioning

confidence: 85%

“…4,5,12,13 Several of the studies reported data collected retrospectively from medical case notes 6,13,14 or reported findings based on data without it being stated how data had been obtained. 6,[15][16][17][18] The follow-up of children after initiation of transanal irrigation varied widely both within and across the studies. Where detailed, follow-up and data collection occurred from 3 months, 10 4 months, 8,17 12 months, 4 33 months, 14 64 months 6 to 96 months.…”

Section: Details Of the Included And Excluded Studiesmentioning

confidence: 99%

“…Two studies describe the outcomes of children with constipation and faecal incontinence separately, Pena et al 12,15 reports that 41 out of 45 children with constipation (91%) and 112 out of 128 (88%) children with faecal incontinence demonstrated improvements to their continence using transanal irrigation. The study by Liptak and Revell 12 at 18-month follow-up indicates that 5 out of 25 (20%) children reported difficulties with constipation, this decreased further at the 30-month follow-up with 2 out of 16 children reporting the passage of hard stool as problematic.…”

Section: Effectiveness Of Transanal Irrigation In Childrenmentioning

confidence: 99%

“…Some studies do not report rates of faecal continence achieved 7 and report outcomes as those satisfied with the regime, 5 those still using the procedure at the point of follow-up 18 or improved bladder function. 13 Saline (either isotonic or made by families within the home) was used to irrigate the bowel in 8 of the 17 studies, 4,7,12,[15][16][17][18][19] which included 495 children. Tap water was used in 7 of the studies, 5,6,8,[9][10][11]14 which in total included 270 children.…”

Section: Effectiveness Of Transanal Irrigation In Childrenmentioning

confidence: 99%

See 3 more Smart Citations

An evidence-based review of the use of transanal irrigation in children and young people with neurogenic bowel

Bray

Sanders

2012

Spinal Cord

View full text Add to dashboard Cite

Study design: Evidence-based review. Objective: To determine the effectiveness and acceptability of transanal irrigation in children and young people with neurogenic bowel. Setting: International literature. Methods: Electronic databases were searched supported by hand-searching strategies to conduct a comprehensive literature review in accordance with Centre for Reviews and Dissemination procedures guidelines. Sixteen studies were selected for inclusion. Results: The studies indicate that transanal irrigation can be an effective treatment for children and young people with constipation or faecal incontinence as a result of neurogenic bowel (90%, n ¼ 346 children). Transanal irrigation is reported as improving quality of life and family's satisfaction with their bowel management, although the procedure is invasive, time consuming and can impact negatively on child, parent and family life. Conclusion: Transanal irrigation may be considered as a first line treatment option for children and young people with neurogenic bowel but further research is required to prove the efficacy and acceptability of this procedure. Spinal Cord (2013) 51, 88-93; doi:10.1038/sc.2012.146; published online 11 December 2012Keywords: transanal irrigation; rectal irrigation; children; neurogenic bowel INTRODUCTION Transanal irrigation involves the physical placement of an irrigation catheter or cone device safely into the rectum to allow the administration of irrigation fluid. The aim of irrigation is to washout stool from the rectum and lower end of the descending colon in order to facilitate a period of faecal continence and/or alleviate constipation. Transanal irrigation is not a new technique but is regaining popularity as a treatment option in the management of neurogenic bowel following the advent of new and improved irrigation systems. Transanal irrigation is a prescribed regime, which should only be started or considered as a treatment after assessment by suitably qualified or experienced health professional. Neurogenic bowel often occurs in children or young people as a result of neurological antenatal development, such as spina bifida, childhood spinal cord injury or acute viral illness such as transverse myellitus. Although there is an evidence that transanal irrigation is a useful management approach in adult patients with neurogenic bowel, 1,2 there is less published research on the use of this approach with children and young people. This review aimed to systematically examine the current literature relating to the use of transanal irrigation in children and young people with neurogenic bowel.

show abstract

Section: Effectiveness Of Transanal Irrigation In Childrenmentioning

confidence: 85%

Section: Details Of the Included And Excluded Studiesmentioning

confidence: 99%

Section: Effectiveness Of Transanal Irrigation In Childrenmentioning

confidence: 99%

Section: Effectiveness Of Transanal Irrigation In Childrenmentioning

confidence: 99%

See 2 more Smart Citations

An evidence-based review of the use of transanal irrigation in children and young people with neurogenic bowel

Bray

Sanders

2012

Spinal Cord

View full text Add to dashboard Cite

show abstract

“…The indicators of good prognosis of bowel control are normal sacrum, prominent midline groove (good muscles), rectal atresia, vestibular fistula and low defects. The indicators of poor prognosis of bowel control are abnormal sacrum (more than 2 vertebrae missing), flat perineum (poor muscles) and high defects [1].…”

Section: Methodsmentioning

confidence: 99%

Fecal Incontinence after Posterior Sagittal Anorectoplasty – Follow up of 2 years

Harjai

Puri

Vincent

et al. 2003

Medical Journal Armed Forces India

View full text Add to dashboard Cite

After an anorectal malformation (ARM) is repaired, the goal is fecal continence of the patient. Toilet training is not complete in children below 4 years of age. Manometric and radiological studies need cooperation of the child, and are therefore of little value during the critical preschool years. In this present study, we used only clinical criteria to assess the child for constipation and incontinence after definitive operation. We included all patients of ARM wef 01 April 1998 to 31 March 2000. Only 2 children had crossed 4 years of age at the time of this assessment and therefore it was not possible to assess total continence postoperatively. We found that the incidence of incontinence was less in low anomalies and more in high or intermediate anomalies, while the incidence of constipation was higher in low anomalies and less in high and intermediate anomalies. 31% of all patients born with anorectal malformations and subjected to posterior sagittal anorectoplasty (PSARP) approach were totally continent, 38% suffered with soiling of faeces while 31% had problems of constipation. The higher incidence of constipation as well as incontinence in our study is because of a short follow-up and secondly, these problems are known to improve with passage of time. The purpose of this article is to highlight the problems of bowel control even after the definitive operation and still much more is required to improve the quality of life of these unfortunate children. MJAFI 2003; 59 : 194-196

show abstract

Defecation disorders in Spina Bifida: Realistic goals and best therapeutic approaches

Brochard

Peyronnet

Hascoët

et al. 2018

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aims Spina Bifida (SB) is a rare congenital condition that frequently impairs the neurological control of both fecal continence and defecation. Several therapeutic strategies have been proposed but impact assessment is lacking. Our objectives were to quantify the symptomatic improvement and to determine the optimal strategy in this rare condition where randomized controlled trials are difficult to conduct. Methods Data were extracted from a prospective database. The present analysis focused on patients having undergone at least two gastroenterological assessments. A standardized therapeutic approach was used from the first visit. Improvement was quantified by the variation of quantified symptomatic scores. Results The data of of 57 adults with SB (gender F/M: 30/27 [52.6/47.4%]; mean age: 33.8 [18.5] years) were extracted. After a mean follow‐up of 46 months, 23/57 patients (40.4%) had at least improvement of one point of the Cleveland Clinic Incontinence score (CCIS); 13/57 (22.8%) reported a significant improvement of continence (delta score >50%). Five of the twelve patients (41.6%) with CCIS < 5 at baseline became incontinent over time. The neurological level was not associated with a worse continence outcome. Work on stool consistency and transanal irrigation were the most useful strategies in those with significant improvement of continence. Conclusions Using conventional strategies, a benefit on fecal continence occurs in only one out of five patients suffering from Spina Bifida and continent patients at baseline can develop fecal incontinence over time. A strategy targeting improved control of defecation (transanal irrigation) and a standardization of follow‐up protocol might be beneficial.

show abstract

Bowel management for fecal incontinence in patients with anorectal malformations

Cited by 158 publications

References 9 publications

An evidence-based review of the use of transanal irrigation in children and young people with neurogenic bowel

An evidence-based review of the use of transanal irrigation in children and young people with neurogenic bowel

Fecal Incontinence after Posterior Sagittal Anorectoplasty – Follow up of 2 years

Defecation disorders in Spina Bifida: Realistic goals and best therapeutic approaches

Contact Info

Product

Resources

About