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Defecation problems in children with Hirschsprung's disease: a prospective controlled study of a multidisciplinary
E M van Kuyk1, A T Brugman-Boezeman, M Wissink-Essink
1Department of Medical Psychology, University Medical Centre Nijmegen, The Netherlands.
Insights
Multidisciplinary behavioral treatment significantly improved chronic defecation issues in children post-Hirschsprung
Area of Science:
- Pediatric surgery
- Gastroenterology
- Behavioral therapy
Background:
- Hirschsprung's disease surgery often leaves children with chronic defecation problems.
- These issues include constipation, fecal incontinence, and difficult toilet training, impacting quality of life.
Purpose of the Study:
- To evaluate the effectiveness of a multidisciplinary behavioral treatment for chronic defecation problems in children after Hirschsprung's disease surgery.
Main Methods:
- A prospective controlled study compared a behavioral treatment group (14 children) with a waiting-list control group (13 children).
- Outcomes were assessed on multiple variables, with follow-up at 7 months post-treatment.
Main Results:
- The treatment group showed significantly better outcomes across all variables compared to the control group.
- No age-related differences in treatment efficacy were observed.
Conclusions:
- Multidisciplinary behavioral treatment is a successful approach for managing chronic defecation problems in children with Hirschsprung's disease.
- The positive effects of the treatment were sustained at follow-up.
Unlabelled:
Constipation, faecal incontinence, soiling and difficult toilet training remain significant problems in children with Hirschsprung's disease after corrective surgery. Chronic defecation problems can have various negative implications. At the University Medical Centre Nijmegen, a multidisciplinary behavioural treatment was developed to treat defecation problems. In this paper, a prospective controlled study is presented concerning the effect of this treatment upon children suffering from chronic defecation problems following corrective surgery for Hirschsprung's disease. The effect of treatment was studied in 27 children (21M, 6F, mean age 5.2y, range 2-11 y). Fourteen children were allocated to the experimental treatment group. The 13 children allocated to the waiting-list control group were also treated following a waiting period of 6 mo. On all outcome variables, children in the experimental treatment group had significantly better results after treatment than children in the waiting-list control group after the waiting period. No effect of age upon treatment was found. The effect of treatment remained significant on all outcome variables at a mean follow-up of 7 mo after the end of treatment.
Conclusion:
Multidisciplinary behavioural treatment is successful in decreasing chronic defecation problems in children with Hirschsprung's disease.
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