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The bowel management tube: an effective means for controlling fecal incontinence
G K Blair1, K Djonlic, G C Fraser
1Department of Surgery, British Columbia Children's Hospital, Vancouver, Canada.
Insights
A new bowel management tube (BMT) effectively manages fecal incontinence in children. This enema system significantly improved symptoms and satisfaction for most pediatric patients studied.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Medical Device Innovation
Background:
- Fecal incontinence in children poses management challenges, particularly with weak anal sphincters.
- Traditional bowel washout enemas can be difficult to administer effectively in pediatric patients.
- A novel silastic balloon-tipped enema catheter, the bowel management tube (BMT), was developed to address these issues.
Purpose of the Study:
- To prospectively evaluate the effectiveness of the new bowel management tube (BMT) system for managing fecal incontinence in children.
- To assess clinical improvement and patient satisfaction with the BMT enema system.
- To identify factors influencing the success or failure of the BMT system.
Main Methods:
- A prospective study involving 31 children with fecal incontinence over one year.
- Participants included children with diagnoses such as meningomyelocele and postoperative Hirschsprung's disease.
- Effectiveness was assessed using clinical evaluation and a patient diary grading incontinence and satisfaction before and after BMT use.
Main Results:
- The BMT system was successful in 23 out of 31 pediatric patients (74%).
- Successful outcomes were characterized by significant amelioration of fecal incontinence and high patient satisfaction.
- Reasons for failure included noncompliance (3 patients) and balloon extrusion (2 patients).
Conclusions:
- The bowel management tube (BMT) system offers an effective method for controlling fecal incontinence in children.
- The BMT facilitates regular washout enemas, improving management for pediatric patients with weak anal sphincters.
- The high success rate and patient acceptance suggest the BMT is a valuable tool in pediatric bowel management.
Abstract:
Regular bowel washout enemas have been used as a method of management of fecal incontinence. The effective administration of a washout enema to a child with weak anal sphincters is often a problem. Using a new silastic balloon-tipped enema catheter (bowel management tube [BMT]) of our design, we prospectively studied its effectiveness in a group of children who suffered fecal incontinence. Thirty-one children were studied over a 1-year period. Their diagnoses included meningomyelocele (19), postoperative Hirschsprung's disease or imperforate anus (10), and other (2). Before and after starting the BMT enema system, clinical assessment and a diary, which graded the degree of fecal incontinence and satisfaction with the system, were completed. Five patients failed to benefit because of noncompliance (3) or balloon extrusion (2). Three more patients discontinued the use of the tube system. Twenty-three patients achieved successful results with this system as evidenced by a significant amelioration in their fecal incontinence and their unwillingness to give up the use of the BMT. We conclude that the use of a regular washout enemas with BMT can be an effective method for control of fecal incontinence in children.