Bowel management program for pediatric postoperative fecal incontinence in China

Abstract

The purpose of this article is to report the status of the efficacy of and long-term adherence to the Bowel Management Program (BMP) for fecal incontinence (FI) postoperation in China.Children over 3 years of age with FI postoperation referred to our medical center were included in the study. Evaluations were performed before and 2 years after their clinic visit. The cost of bowel care, improvement in incontinence, health-related quality of life, and family functioning with the BMP were analyzed.A total of 48 children with FI were included in our study, of whom 38 were boys. The median treatment fee was 660.1 dollars. The complications included abdominal pain (4 patients, 8%), occasional vomiting (2 patients, 4%), and hypoglycemia (1 patient, 2%). The incontinence status and health-related quality of life improved significantly after the BMP. Despite the good outcome of the BMP, half of the patients discontinued the program.The BMP is an effective approach to manage FI and improve the patients’ quality of life. Poor long-term adherence is currently the main challenge affecting the BMP application in China.

Evaluating the Effect of Bowel Management Training Program on Quality of Life in Children with Fecal Incontinence

“…Wang et al illustrated that the implementation of this training program improved the QOL in all aspects. The mean score of QOL in this study rose from 59.14 to 73.09, indicating the effectiveness of the BMP based on its unique bowel management plan (18). Peña BMP, by examining the intestinal function of each individual child, can improve intestinal function (14,16).…”

“…Regarding the physical aspect, after practicing the BMP, the subjects performed better in walkingrelated activities, running, exercising, lifting equipment, bathing, and they had more energy to do the things. In this regard, Wang et al (18) demonstrated that the implementation of a BMP on 48 children with fecal incontinence reduced the score of the Cleveland index, meaning that they had a greater control over defecation. The Cleveland Index…”

“…Similarly, Wang et al showed that children with fecal incontinence were more sensitive and shyer, and they had more difficulty in concentrating compared to normal children. After several months, a significant improvement in QOL was observed in children attending a BMP, leaning particularly more towards the emotional aspect of life (18). Based on the evidence, children's presence in the community and playing with their peers were linked with heightened self-esteem, as well as with diminished negative thoughts and feelings (6).…”

“…The procedure of sampling lasted from February 2019 to July 2019. Using the study by Wang et al (18) and considering 5% error, 80% study power, and 10% loss n ≥ 2…”

Diagnosis and treatment of fecal incontinence after surgical correction of congenital anocolorectal pathology in children

“…Виділяли три ступені тяжкості АІ: I ступінь -нетримання газів, II ступінь -нетримання неоформлених калових мас, III ступінь -нетримання щільних калових мас. Більш детально тяжкість АІ в оперованих дітей оцінювали за шкалою S. D. Wexner (1993) [30].…”