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Outcome of the antegrade colonic enema procedure in children with chronic constipation

E R Kokoska1, M S Keller, T R Weber

  • 1Department of Surgery, Division of Pediatric Surgery, Saint Louis University Health Sciences Center and Cardinal Glennon Children's Hospital, 1465 S. Grand Blvd., St. Louis, MO 63104, USA.

American Journal of Surgery
|February 13, 2002
PubMed

Insights

The antegrade colonic enema (ACE) procedure significantly improved bowel control in children with chronic constipation and fecal incontinence. This surgical option offers a better quality of life, avoiding more invasive treatments.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Chronic constipation and fecal incontinence cause significant psychosocial distress in children.
  • Maximal medical management (daily enemas, laxatives) is often challenging for pediatric patients.

Purpose of the Study:

  • To evaluate the efficacy of the antegrade colonic enema (ACE) procedure in managing chronic constipation and fecal incontinence in children.

Main Methods:

  • The antegrade colonic enema (ACE) procedure was performed on 11 children.
  • A conduit to the cecum was created using the appendix (n=8) or a cecal flap (n=3).

Main Results:

  • 91% of children (10/11) showed significant improvement after a mean follow-up of 14 months.
  • 64% of children (7/11) achieved complete bowel control with no soiling post-irrigation.

Conclusions:

  • The ACE procedure enables children to achieve normal bowel habits and improved lifestyles.
  • This surgical approach is a viable alternative to colostomy for fecal incontinence in children and adults.
Abstract

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