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Decision-making for a successful bowel continence program.

S Leibold1, E Ekmark, R C Adams

  • 1Texas Scottish Rite Hospital for Children, Dallas 75219, USA.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|February 24, 2001
PubMed
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This study introduces a decision-making algorithm to create personalized bowel continence programs for individuals with spina bifida. The algorithm improves success rates by tailoring interventions to individual patient needs.

Area of Science:

  • Urology
  • Pediatric Surgery
  • Rehabilitation Medicine

Background:

  • Bowel incontinence presents significant challenges for spina bifida patients, impacting social integration and employment opportunities.
  • Effective management of bowel continence is crucial for improving the quality of life for individuals with spina bifida.

Purpose of the Study:

  • To present a novel algorithm for stepwise decision-making in developing personalized bowel continence programs for spina bifida patients.
  • To enhance the likelihood of success in achieving bowel continence through a structured, individualized approach.

Main Methods:

  • The algorithm incorporates 13 key assessment points, including stool characteristics, mobility, neurological level, diet, and family routines.
  • Individualized bowel programs are constructed based on the outcomes of these comprehensive assessments.

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  • Components may include timed toileting, suppositories, enemas, or the ACE procedure, guided by the algorithm.

    • Main Results:

    • The algorithm facilitates informed decisions regarding program components and success indicators for practitioners and patients.
    • Patient education and evaluation focus on fluid/fiber intake, toileting equipment, and appropriate use of stool modifiers.
    • Monitoring considers factors like constipation, age, family support, and physical accessibility.

    Conclusions:

    • The developed algorithm enables careful, information-driven decision-making, leading to improved bowel continence outcomes in children with spina bifida.
    • Personalized continence programs are essential for addressing the complex needs of individuals with spina bifida.