Tap-water enema for children with myelomeningocele and neurogenic bowel dysfunction

Mattsson, Sven; Gladh, Gunilla

doi:10.1080/08035250500437507

Cited by 40 publications

(66 citation statements)

References 19 publications

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“…Relief of constipation was successfully achieved in all 40 children and faecal continence was achieved in 35; the other 5 children had faecal soiling less than once per month. 30 Overall, 90% of parents spontaneously reported general improvements in the well-being of the child, including improved appetite, increased alertness and fewer complaints of stomach pain and headache. 30 There are few data from clinical studies of TAI in adults with spina bifida.…”

Section: Efficacy Of Tai In Patients With Sci or Cauda Equinamentioning

confidence: 97%

“…30 Overall, 90% of parents spontaneously reported general improvements in the well-being of the child, including improved appetite, increased alertness and fewer complaints of stomach pain and headache. 30 There are few data from clinical studies of TAI in adults with spina bifida. Of the 15 adults with spina bifida included in one observational study, 6 were prescribed retrograde colonic washout (system type not reported) as all or part of their bowel management routine: 3 of 6 patients achieved continence.…”

Section: Efficacy Of Tai In Patients With Sci or Cauda Equinamentioning

confidence: 97%

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Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Emmanuel

2010

Spinal Cord

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Study design: Neurogenic bowel dysfunction (NBD) is a common occurrence after spinal cord injury (SCI) and in patients with spina bifida or multiple sclerosis. The impact of NBD on well-being is considerable, affecting both physical and psychological aspects of quality of life. Transanal irrigation (TAI) of the colon promotes the evacuation of faeces by introducing water into the colon and rectum through a catheter inserted into the anus. Regular and controlled evacuation in this manner aims at preventing both constipation and faecal soiling. Objectives: The aim of this study was to review current evidence for the efficacy and safety of TAI in patients with NBD. Materials and methods: A literature search was conducted in PubMed. All identified papers were assessed for relevance based on the title and abstract; this yielded 23 studies that were considered to be of direct relevance to the topic of the review. Results: A multicentre, randomized, controlled trial has supported observational reports in demonstrating that TAI offers significant benefits over conservative bowel management in patients with SCI, in terms of managing constipation and faecal incontinence, reducing NBD symptoms and improving quality of life. Among other populations with NBD, TAI shows the greatest promise in children with spina bifida; however, further investigation is required. The overall safety profile of TAI is good, with few, and rare, adverse effects. Conclusions: Building on the positive data reported for patients with SCI, continued evaluation in the clinical trial setting is required to further define the utility of TAI in other populations with NBD.

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Section: Efficacy Of Tai In Patients With Sci or Cauda Equinamentioning

confidence: 97%

Section: Efficacy Of Tai In Patients With Sci or Cauda Equinamentioning

confidence: 97%

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Emmanuel

2010

Spinal Cord

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“…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. 8 Findings of the review This evidence-based narrative review aimed to explore how effective and acceptable transanal irrigation is within this population and the findings are discussed within these two sections.…”

Section: Details Of the Included And Excluded Studiesmentioning

confidence: 99%

“…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. One paper did not report the type of solution used to irrigate the bowel.…”

Section: Effectiveness Of Transanal Irrigation In Childrenmentioning

confidence: 99%

“…11 Another questionnaire study reported that 35 out of 40 parents found transanal irrigation satisfactory (although no information is provided on the scale used) and reported positive improvements in their child's wellbeing (open comments at the end of the questionnaire). 8 All of these 35 parents reported the regime as time consuming.…”

Section: Acceptability Of Transanal Irrigation To Children Parents Amentioning

confidence: 99%

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

Bray

Sanders

2012

Spinal Cord

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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.

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International children's continence society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children

Rawashdeh

Austin

Siggaard

et al. 2012

Neurourology and Urodynamics

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Guidelines on pharmalogical and surgical intervention are presented. First the multiple modalities for intervention that do not involve surgical reconstruction are summarized concerning pharmacological agents, medical devices, and neuromodulation. The non-surgical intervention is promoted before undertaking major surgery. Indicators for non-surgical treatments depend on issues related to intravesical pressure, upper urinary tract status, prevalence of urinary tract infections, and the degree of incontinence. The optimal age for treatment of incontinence is also addressed. This is followed by a survey of specific treatments such as anticholinergics, botulinum-A toxin, antibiotics, and catheters. Neuromodulation of the bladder via intravesical electrical stimulation, sacral nerve stimulation, transcutaneous stimulation, and biofeedback is scrutinized. Then follows surgical intervention, which should be tailored to each individual, based on careful consideration of urodynamic findings, medical history, age, and presence of other disability. Treatments mentioned are: urethral dilation, vesicostomy, bladder, augmentation, fascial sling, artificial urinary sphincters, and bladder neck reconstruction and are summarized with regards to success rates and complications. Finally, the treatment on neuropathic bowel dysfunction with rectal suppositories irrigation and transrectal stimulation are scrutinized.

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Tap-water enema for children with myelomeningocele and neurogenic bowel dysfunction

Abstract: Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction, but it does not help children to independence at the toilet.

Cited by 40 publications

References 19 publications

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

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

International children's continence society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children

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