Evaluation of bowel management program on quality of life in children with fecal incontinence

Shahba, Zohreh; Ahmadi, Bahareh; Haji Bandeh, Saeedg; Hosseinpour, Mehrdad

Evaluation of bowel management program on quality of life in children with fecal incontinence

Document Type : Original Article

Authors

Departement of Pediatric Surgery, Imam Hossein Children Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Fecal incontinence (FI) is a common disorder that affects the psychological, social, and mental aspects in children. It was showed that the quality of life (QoL) in children with FI was in low level. Bowel management program (BMP) is one of the most effective and low-cost therapies in selected children with FI, but it has also significant effects on mental functions. This study was conducted to evaluate the impact of BMP on the QoL of children with FI. Materials and Methods: In a case series study, we prospectively included all school-age children suffering from FI who had visited in colorectal follow-up center of Isfahan University of Medical Sciences. Patient eligibility included children with FI between 8 and 12 years who were candidate of BMP. The QoL was assessed by Persian version of pediatric QoL (PedsQL) 4.0. Results: In this study, 24 children with FI were studied. Our results showed that total QoL score is significantly different after BMP. The mean score of physical performance before and after BMP was significantly different (P = 0.02). In terms of emotional performance, the mean score of this dimension before and after starting of BMP was significantly different (P = 0.06). In terms of social performance, the mean score of this dimension before and after starting of BMP was significantly different (P = 0.008). Conclusion: BMP is a low-cost and affordable treatment that can have a significant impact on improving the QoL of the child by improving intestinal function.

Keywords

References

1.	Rajindrajith S, Devanarayana NM, Benninga MA. Review article: Faecal incontinence in children: Epidemiology, pathophysiology, clinical evaluation and management. Aliment Pharmacol Ther 2013;37:37-48.
2.	Wang Y, Liang H, Wu Q, Zheng H, Liu G, Wen Z, et al. Bowel management program for pediatric postoperative fecal incontinence in China: A surgeon's experience. Medicine (Baltimore) 2017;96:22.
3.	Bischoff A, Levitt MA, Bauer C, Jackson L, Holder M, Peña A. Treatment of fecal incontinence with a comprehensive bowel management program. J Pediatr Surg 2009;44:1278-83.
4.	Rodriguesa BD, Reisc IG, Coelhoc FM, Buzattib KC. Fecal incontinence and quality of life assessment through questionnaires. J Coloproctol 2017;37:341-8.
5.	Bai Y, Yuan Z, Wang W, Zhao Y, Wang H, Wang W. Quality of life for children with fecal incontinence after surgically corrected anorectal malformation. J Pediatr Surg 2000;35:462-4.
6.	Bongers ME, van Dijk M, Benninga MA, Grootenhuis MA. Health related quality of life in children with constipation-associated fecal incontinence. J Pediatr 2009;154:749-53.
7.	Bischoff A, Tovilla M. A practical approach to the management of pediatric fecal incontinence. Semin Pediatr Surg 2010;19:154-9.
8.	Lombardi L, Garrisi E, Ricco' M, Marchesi F, Casolari E, Gatti C, et al. Study of intestinal function in anorectal malformations: The role of Bowel management in quality of life. Acta Biomed 2016;87:197-204.
9.	Kovacic K, Sood MR, Mugie S, Di Lorenzo C, Nurko S, Heinz N, et al. A multicenter study on childhood constipation and fecal incontinence: Effects on quality of life. J Pediatr 2015;166:1482-7.e1.
10.	Mohamadian H, Akbari H, Gilasi H, Gharlipour Z, Moazami A, Aghajani M, Monsef M, Tahvilian H, Azar Abdad A.Validation of Pediatric Quality of Life Questionnaire (PedsQL) in Kashan city. SJIMU 2014;22:10-8.
11.	Hunt RH, Dhaliwal S, Tougas G, Pedro C, Labbé JF, Paul H, et al. Prevalence, impact and attitudes toward lower gastrointestinal dysmotility and sensory symptoms, and their treatment in Canada: A descriptive study. Can J Gastroenterol 2007;21:31-7.
12.	Olaru C, Diaconescu S, Trandafir L, Gimiga N, Olaru RA, Stefanescu G, et al. Chronic functional constipation and encopresis in children in relationship with the psychosocial environment. Gastroenterol Res Pract 2016;2016:7828576.
13.	Smith CA, Avansino JR. Commentary on “One-year impact of a bowel management program in treating fecal incontinence in patients with Anorectal malformations”. J Pediatr Surg 2021;56:1694-5.
14.	Grano C, Aminoff D, Lucidi F, Violani C. Long-term disease-specific quality of life in children and adolescent patients with ARM. J Pediatr Surg 2012;47:1317-22.
15.	Muddasani S, Moe A, Semmelrock C, Gilbert CL, Enemuo V, Chiou EH, et al. Physical therapy for fecal incontinence in children with pelvic floor dyssynergia. J Pediatr 2017;190:74-8.

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